International Medical insurance Glossary

Benefits
The cover provided by your plan

Birth defect
Any deformity, abnormality or disability, arising during pregnancy, or caused during childbirth.

Bodily injury
Any physical harm or damage to you.

Cancer
A malignant tumour, tissues or cells, characterised by the uncontrolled growth and spread of malignant cells and invasion of tissue.

Cash benefit
A cash payment which is normally payable when a policyholder or member stays in a non-fee paying hospital.

Chronic
A medical condition which has one or more of the following characteristics:
• needs on-going or long-term monitoring through consultations, examinations, check-ups or tests
• needs on-going or long-term control or relief of symptoms
• requires your rehabilitation or for you to be specially trained to cope with it
• continues indefinitely
• has no known cure
• comes back or is likely to come back

Claim
An amount of benefit paid for providing treatment for a medical condition.

Co-insurance
The percentage of costs for a covered claim that you must pay.

Condition
Injury, illness and/or associated symptoms.

Congenital abnormality
A medical condition that is present at birth or is believed to have been present since birth, whether it is inherited or caused by an environmental factor.

Consultant
Please see specialist.

Continuation of Personal Medical Exclusions
If you transfer from another insurer they may offer to continue the same underwriting terms including any special exclusion which previously applied to you. Upon agreement, you will not be subject to any new personal underwriting terms.

CPME
See Continuation of Personal Medical Exclusions.

Critical
A medical condition which is unstable and serious, where the outcome cannot be medically predicted, prognosis is uncertain and the person may die.

Date of joining
When you first became a member on the plan.

Daycare treatment
Treatment at a hospital or a day-care unit when medical supervision is needed for recovery, but you do not stay overnight.

Dental
That which affects the teeth and gums.

Dependant
A plan holder’s
• husband, wife or partner
• unmarried child, stepchild or legally adopted child under a defined age
• unmarried child under a defined age who is in full-time education

Diagnostic tests and procedures
A medically necessary test or examination to investigate the cause of your symptoms.

Emergency
A sudden, unexpected acute medical condition or an unexpected acute episode of a chronic medical condition that, without treatment within 48 hours of onset, could result in death or serious damage to bodily functions.

Excess
The amount you must pay towards the cost of a covered claim

Exclusion
A medical condition which will not be covered by your policy

FMU
See full medical underwriting

Full medical underwriting
If you have fully underwritten cover, your policy will not cover medical conditions and any medical conditions that are directly linked to them which you have or had before the day that you take out a policy.

Hazardous pursuits
Any activity or sport that places you at an increased risk of suffering a medical condition or making an existing medical condition worse.

Hospice
An organisation providing services for patients with terminal illnesses. Hospice care may be received as an in-patient or out-patient, at home, or at a centre for controlling pain and other symptoms.

Hospital
An institution that provides medical, surgical or psychiatric care and treatment for the sick or the injured. Different insurers and their policies offer different hospital access.

In-patient treatment
Treatment at a hospital where you need to stay in a bed for one or more nights.

Insurance premium tax
A government tax

IPT
See Insurance premium tax.

Medical conditions
Signs or symptoms, injury, illness, sickness or disease.

Medical inflation
The average rate that medical insurance premiums increase annually

Moratorium
A waiting period of typically 5 years from your date of joining, or the date shown on the special terms section of your certificate of insurance, that must have passed before claims for pre-existing medical conditions may be eligible under the plan.

MRI scan
Full screening using a magnetic resonance imaging (MRI) scanner.

Nursing at home
Services of a registered nurse in your home when prescribed and supervised by a medical practitioner, consultant or specialist and related directly to a medical condition for which you are receiving treatment under the plan.

Orthodontic
That which affects the structure, function, or development of the teeth, upper or lower jaw or the oral cavity.

Oncology
A branch of medicine that deals with tumours (cancer).

Out-patient treatment
Treatment at a hospital, consulting room, or out-patient clinic where you do not need a bed.

Palliative
Treatment aimed to relieve the symptoms, rather than to stop, delay, or reverse progression of the medical condition causing them or provide a cure.

Physiotherapy
A practice to improve a broad range of physical problems associated with different parts of the body.

Plan start date
The date the plan begins and any future renewal date.

Plan year
A period of 12 months from the plan start date, as shown on a valid certificate of insurance.

Pre-authorised, pre-authorisation
The process you must follow to get approval from the insurer before receiving or incurring costs for treatment.

Pre-existing
Any medical condition or related medical condition which typically has one or more of the following characteristics:
• was foreseeable
• clearly showed itself
• you had signs or symptoms of
• you asked for advice about
• you received treatment for
• to the best of your knowledge, you were aware you had

Professional sports
Sports which you are being paid to take part in and where any payment is received.

Psychiatric
A medical condition which affects your mind, mental function or emotions whether the cause is organic, traumatic or reactive.

Rehabilitation
Treatment aimed to restore your health or mobility to help you live a more independent life.

Renewal date
The anniversary of the start date of the plan as shown on a valid certificate of insurance.

Routine health check
Diagnostic tests and procedures where no medical condition or symptoms are present.

Six week wait benefit
Where you will need to use NHS facilities or self-fund private treatment - unless the waiting list is 6 weeks or more, in which case private treatment can be typically received without delay.

Specialist
A medical practitioner who is practising and has a recognised certificate of higher specialist training or a consultant appointment (or equivalent), in the field of medicine for which the treatment is needed and in the country where treatment is provided.

Start date
The date you join the plan or any future renewal date as shown on a valid certificate of insurance.

Terminal
The end stages of a medical condition where life expectancy is considered to be weeks or months. Treatment is limited to relief of symptoms and no active treatment is being given.

Therapist
A physiotherapist, chiropractor, osteopath, homeopath or acupuncturist who is qualified.

Treatment
Any surgical or medical services, including diagnostic tests and procedures, which are needed to diagnose, relieve or cure a medical condition.

Underwriting
See Moratorium and Full Medical Underwriting