A helpful tool we’ve created to guide you through some of the insurance terms that are often used.
A handy jargon buster to help you understand some health insurance terminology.
Cancellation occurs when you stop your health insurance policy.
Most insurance plans come with a ‘cooling off period’ – usually 14 days – in which you can cancel and receive a full refund, provided you haven’t claimed. If you choose to cancel your health insurance outside of this period, you may lose some of the premiums you’ve paid so far.
Cancer occurs when cells in the body multiply and grow abnormally and attack body tissue and organs.
Case Management is where your insurance provider has medically qualified staff helping to manage your claim. This means that your insurance company know and have experience in the most appropriate support and treatments for your condition, so can help you get better whilst making sure your policy is cost effective.
Cash Plans, or HealthCare Cash Plans, cover the costs of everyday NHS and Private Dental, Optical and Medical treatments. They can either be taken out individually, or by a business to offer as an employee benefit, and can typically cover:
Health Cash Plans are separate to Private Medical Insurance, which is designed to protect against unexpected or emergency rather than everyday medical issues.
CAT Scans (also known as Computerised Tomography Scans) are a type of diagnostic test that helps your medical team see a two dimensional image of part of your body.
They are an outpatient procedure, which means you can have a CAT scan and go home the same day. CAT scans can help diagnose or monitor a number of health conditions.
Clinical Coding and Schedule Development Group. This industry body produces standard procedures for the private healthcare industry in the UK.
Health insurers usually state a list obstetric procedures they will cover, as a result of childbirth-related conditions. These could include post-partum haemorrhage and retained placental membrane.
It is important to check your policy documents fully or talk to your Towergate Health & Protection advisor to understand what is and isn’t covered.
A disease, illness or injury that has one or more of the following characteristics:
Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term for a range of lung diseases such as emphysema and chronic bronchitis.
A claim is when you call on your insurance policy, asking for the benefits. For example, under a health insurance policy, a claim could ask the insurers to pay for a treatment, or under a group income protection policy a claim could ask the insurers to start paying a supplementary income.
Also known as ‘loss adjustment expenses’, these are all of the costs incurred by your or your insurance provider whilst investigating and settling your claim, for example legal fees. Claim expenses are handled separately to the cost of the claim itself.
Complementary therapies, sometimes known as alternative therapies, holistic therapies or traditional medicines, are treatments that “exist outside of conventional Western medicine”. In general, they aim to treat a person as a whole, rather than focusing on symptoms or specific body areas. Therapies include:
Any instance of complementary therapy covered by your health insurance or cash plan must be carried out by an approved therapist.
CMO stands for Complex Major Operation. These are types of surgical operations that typically take more than 4 hours and require a highly skilled medical team – examples include Cardiac Surgery and Organ Transplants.
Large and complicated operations are graded by doctors on a scale of 1-5, with 1 being the least complex. The more complex the grading, the more likely it is to cost your insurance company, which is why the grading system is used.
Consultant’s fees are the amount private doctors charge you or your insurer for your care. This could include consultation fees, diagnostic test fees and surgical fees.
Every health insurance policy will differ on the level of consultant’s fees they will cover – for example if the policy is ‘in-patient only’ it would not cover the cost of diagnostic tests.
Coronary Heart Disease – CHD – is a medical condition where the arteries that deliver oxygenated blood to the heart become narrowed or blocked.
Corrective surgery is used to restore normal function and appearance in the body. This might be in response to disorders from birth, burns or diseases. Examples of corrective surgery could include:
Whether a health insurance policy would cover corrective surgery is often decided on a case-by-case basis, so if this is something you’re looking for we strongly recommend speaking to our insurance advisers about which policies might be suitable for you.
Corrective surgery is often mistaken for cosmetic surgery, which is more aesthetically focused on enhancing appearance, for example a breast enhancement or facelift. Cosmetic surgery is very rarely covered by health insurance policies.
In some instances an insurer may be prepared to offer a ‘switch’ whereby cover offered by one provider is switched to another. When this is agreed the insured person supplies the new insurer with a copy of their insurance documents so the new insurer can replicate and provide that cover.
Critical Illness. Insurers will specifically define in their policy wordings what they mean by a critical illness but typically these might include a cancer, heart or kidney failure, myocardial infarction (heart attack) and diseases like Parkinson’s and Motor Neurone Disease. Employers can introduce group critical illness cover.
A CT Scan is a diagnostic scan that uses computed X-rays to produce a 3D image of the inside of your body. As an outpatient procedure, you can have a CT scan and go home the same day.
CT scans can help diagnose or monitor a number of health conditions.