The terms below are an explanation of key terms and are not necessarily the terms used in ISO plans. In case of any contradiction, the terms provided in the policies will prevail. If you are still not clear about a term, please do not hesitate to contact an ISO Customer Service and ask. We want you to be familiar with the key terms and understand them.
A sudden, unexpected and unintended event.
An additional cash benefit to be paid to the insured person or his beneficiaries (usually family members) if an accident causes either the death of the insured or to lose body parts.
Excessive and self-damaging use of drugs and alcohol, leading to addiction or dependence, including serious physical and mental damage, or death.
The maximum the insurance will provide for treatments or services per policy year.
The highest amount the insurance company will pay you for a claim that your plan covers. For example, if your limit is $1,500 and the cost of your claim is $1,700 - you will have to pay the remaining $200.
The items or services covered under an insurance plan.
The ratio (%) of splitting a bill between the insurance company and you. 80% for the first $5,000 means the insurance company will pay $4,000 and you are responsible for the remaining $1,000.
The day you got pregnant.
A method, devise or medication serving to prevent pregnancy.
This is the process of determining which of two or more insurance policies will have the primary responsibility of paying a claim and the extent to which the other policies will contribute.
The fee you pay for certain medical services. For example, you may pay $30 to fill a prescription and the health plan covers the balance of the charges.
The health insurance plan allows you to use any qualified medical service provider, but offers you to save money by using the PPO network the insurance plan is affiliated with. You will usually save money by getting higher benefits, or your Co-Insurance will be lower if you use PPO service providers.
The dollar amount of covered expenses you are responsible to pay the physician or hospital before the policy will pay any benefits. Deductible per event means you are responsible to pay the deductible once for each sickness or accident. If you return to the physician or hospital for the same sickness or accident, you do not have to pay the deductible again.
The person's immediate family members: spouse (wife or husband) and children.
The date specified on your certificate of insurance as the beginning of coverage.
A planned treatment/surgery that is subject to choice (election) and not involved in a medical emergency.
Most plans cover emergency care in a hospital emergency room if it is an extremely urgent medical emergency, even if the hospital you are taken to is not in the plan's network.
A method in which doctors and other health care providers are paid for each service performed.
A health plan offered by an employer or employee organization that provides health coverage to employees and their families.
Care in a hospital that requires admission as an inpatient and usually requires an overnight stay.
A policy that allows you to choose any doctor or hospital and is not limited to a specific PPO. The service you received, if eligible, will be covered by the terms of the policy.
Any harm to your body, usually as a result of an accident.
A medical service provider who participate in a PPO (see below) network to provide health care at a discounted or negotiated rate. When the doctor is not on the PPO list, he is considered as out-of-network.
The person who purchased the insurance, whose name appears on the certificate of insurance or medical insurance ID card. It might include his dependents, if added to the policy.
The total amount payable by the insurance company for covered medical expenses due to injury or sickness per policy lifetime.
The total amount the insurance company will pay for each injury or illness during the plan year.
Transferring the insured person to the nearest hospital or medical facility in case of an emergency injury or sickness or back to his home country.
A provider who does not have a contract with your insurer to provide services to you.
The most you pay during a policy period for covered treatments or services according to the benefit limits of your plan.
A medical treatment received without being admitted to a hospital.
A person who is legally qualified to practice medicine; doctor of medicine.
The person entitles for the insurance benefits, in most cases this is you, the insured person.
A network of doctors, clinics, hospitals and related medical service providers who are organized under the PPO to provide health care at a discounted or negotiated rate.
Any injury or illness which you suffered from or for which treatment was received prior to the date your insurance started.
A specified amount of money that the insurer receives in exchange for its promise to provide health insurance to an individual or a group.
A type of specified expense coverage that provides benefits for the purchase of drugs and medicines prescribed by a physician and not available over-the-counter.
A person or company legally qualified to provide medical services of a specif kind or practice medicine. Usually a physician, doctor of clinic.
The amount normally charged by medical service provider for similar services and supplies. It should not exceed the amount ordinarily charged by most providers of comparable services in the area where the services are rendered.
Transporting the remains of in insured person back to his home country.
The act of harming oneself on purpose in order to take advantage of being injured.
An illness, disease or condition of the insured for which he/she incurs medical expenses while covered under the Policy. All related conditions and recurrent symptoms of the same or similar condition will be considered one sickness.
A physician whose practice is limited to a particular branch of medicine or surgery. For example: Eye specialist.
Injury sustained while participating in any amateur, club, intramural, interscholastic, intercollegiate, professional or semi-professional sports.
A medical facility on campus (also known as "school clinic") that provides medical services for university's students. Some insurance plans offer lower deductible for treatments provided by the SHC.
The act of intentionally causing one's own death.
The date your insurance coverage ends or you are not eligible for benefits anymore.
Insurance that covers medical expenses, financial default of travel suppliers, and other losses incurred while traveling. Travel insurance coverage is usually provided for a limited time.
The insurance company, the Insurer. The party to an insurance arrangement who undertakes to indemnify for losses, provide financial benefits or render services.
A type of health benefit that at least partially covers vision care, like eye exams and glasses.
A form you have to submit to your university notifying them that you prefer an alternative insurance plan over the plan offered by the school.
Services aims at preventing people from getting sick and detecting diseases and conditions before they become serious and more expensive to treat. These include physical check-ups, vaccinations and immunizations.
An electromagnetic image often used to diagnose illnesses or injuries.