We have gathered together the health insurance terms that you will encounter most often when reading a health insurance quote or policy. In this article, we will explain the most important insurance terms.
Health Insurance Terms You Should Know
What is Deductible Exemption?
Deductible exemption is a concept that refers to the insured’s responsibility for a certain percentage or amount of health expenses in order to reduce the premium to be paid when purchasing health insurance. For example, if you purchased a policy with a deductible of 1,000 TL and went to the hospital, you had a health expense of 1,500 TL. In this case, your health insurance pays the hospital 1,500-1,000=500 TL. If you have a health expense below 1,000 TL, your insurance company will not pay the hospital.
What is the Participation Share Rate?
In contracted and non-contracted healthcare institutions of the insurance company, the amount the insured will pay to the hospital for health expenses is determined by the co-payment rate. For example; if the insured has purchased a policy with a 20% co-payment for outpatient treatment expenses, he/she will pay 20% of the hospital expenses. The remaining 80% will be paid to the hospital by the insurance company.
Deductible exemption and co-payment rates do not exist in complementary health insurance ; they are applied in private health insurance .
What is the Waiting Period?
Insurance companies require a certain period of time to pass from the policy start date to cover the costs of certain surgeries and treatments. During this period, insurance companies will not cover your inpatient treatment expenses unless there is a life-threatening risk. You can find detailed information about the waiting period here .
What Does Cancellation from the Beginning Mean? (What is the Termination Period?)
Cancellation at its inception is the right of the insured to cancel the health insurance policy within 30 days from the policy start date. If the health insurance policy is canceled within 30 days from the policy start date, the paid premium is returned to the insured without any deductions.
You can find detailed information about the health insurance cancellation process in our article titled “ How to Cancel Supplementary Health Insurance? ”
What is a Broker and Agent?
An agent represents a specific insurance company and sells for them. However, a broker works with many insurance companies and represents you to insurance companies. Therefore, it is always more advantageous to get the policy through a broker.
What are Additional Guarantees?
The main coverages of health insurance are inpatient treatment and outpatient treatment coverage. In addition to these two coverages, coverages added to the policy scope are called additional coverage. Additional coverages are added to the policy scope by the insurance company free of charge; some additional coverages are paid. You can visit our “ Additional Benefits ” page to review paid and free additional coverages.
What is the Collection Period?
In order for an insurance policy to remain active, premiums must be paid on the specified maturity date. The insurance company has the right to cancel policies for which premium payments are not made within 45 days of the maturity date.
When purchasing health insurance, if you make your payment with a blocked withdrawal from your credit card, you reduce the risk of your policy being canceled due to non-collection to zero. However, if you purchase health insurance by making an unblocked withdrawal from your credit card when your credit card limit is not sufficient when the due date comes, there will be a risk that your policy will be canceled after a certain period of time.
Stay healthy.