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Insurance glossary: All the definitions you need to know to understand your insurance contract

23 May 2018

You are not used to some insurance vocabulary? Some words are unclear for you in your insurance contract or proposal? Do not panic! You’ll find here some definitions of the main insurance terms that you could need in Singapore.

Alternative medicine

Alternative medicine is a type of practices that can remplace “traditional” medicine. These treatments can be a complement of standard medicine. It can be Osteopath, Acupuncture, Homeopathy, etc.

Additional premium (AP)

AP stands for “additional premium”. A change to the insurance policy almost always causes a change in the premium. When it is an increase, we usually call it “AP” (for additional premium). When it decreases, it is often called “RP” (returned premium).

Adjuster

It is the person who settles insurance claims. More precisely, the adjuster investigates claims in order to be able to recommend settlement options. They are based on an estimation of damages and the active insurance policies. Adjusters are either:

Claim

It is a formal demand made to an insurance company for reimbursement, for a loss that comes within that policy. For example, for a hospitalisation stay, a GP visit, etc. A corporation or an individual makes the demand.

Co-pay

It is a common principle in insurance where the insured participates to all the health costs.  Most of the time it is a fixed percentage. Co-payment principle usually applies on small claims like General Practitioner (GP) consultations and rarely on inpatient.

How does it work? For example: if you have a 20% co-payement, you will have to pay from your own pocket 20% of the fees. We’ve wrote an article that details it.

Cover Note

It is a temporary document issued and provided by an insurance company. It is a proof of an insurance coverage before all the insurance paperwork has been processed and until a final insurance policy can be issued. A cover note must contain:

Usually, the cover note provides the same level of coverage as the insurance policy. However, insurers may put some restrictions. In that case, they need to make some assessments to the risks associated with the insurance contract.

Deductibles

It represents the amount the insured agrees to pay for health costs before the insurance plan starts the reimbursements. This allows the insured to reduce the premiums of an insurance. It also allows to control the financial risk per incident with a maximum ceiling.

How does it work? For example, you have an accident and you need to get a surgery that costs SGD 10,000. If you have a SGD 7,000 annual deductible, you have to pay the first SGD 7,000. Your insurance company pays the remaining SGD 3,000.

Let’s take another example: you fall in the street, break your arm and need a SGD 2,000 surgery. With a SGD 7,000 deductible, you will have to pay the full SGD 2,000. This is because the full cost is under the level of your deductible. The insurance will only reimburse once all the claims for one incident reach the amount of SGD 7,000. The plans with the highest premiums have lower deductibles or none at all. You can read about it in our article about it.

Dental

The dental option of an insurance policy allows you to receive routine dental treatments.  The contract mentions the limit of the reimbursement. Routine dental treatments could be:

Please note that the dental option usually does not include orthodontics.

Eligibility

You’ll find below the age rules to be able to subscribe to UEX covers:

You can cover your child with a UEX health insurance without taking any cover for yourself. However, you will be the policy holder. A newborn can be covered at birth (0 days). But only if one of his/her parents has been covered under Base Plan 3 or 4 for at least a year.

Endorsement

It is an amendment to an insurance policy adjusting the coverages of the general contract.

Exclusions

They are provisions of an insurance contract (perils, hazards, property or circumstances) that are not covered by the insurance policy. They can be excluded for the whole duration of the contract or limited by a waiting period. A common example would the scoliosis, very often tight to a waiting period.

General Practitioner (GP)

A General Practitioner or GP is a doctor who does not specialize in one particular area of medicine. You generally go see him in case of any common illness or for routine checks.

Health insurance

Of course no one plans to get sick or hurt, but almost everyone needs medical care at some point. Health insurance covers these costs and protects you from high medical costs.

Hospitals

The difference in terms of quality of healthcare between private and public hospitals in Singapore is quite similar. You can find here the list of the private and public hospitals in Singapore.

International plan

This mentioned in your insurance contract means that you are also covered outside of Singapore even for non-emergencies. You will also be fully reimbursed if you decide receive healthcare in your home country. For example: surgery, general practitioner and specialist consultations, etc. The annual limit for international plans is usually higher than for local plans. You can choose between 3 areas of coverage:

The area of coverage can make the premiums vary a lot. The coverage can be interesting for people living in a country where the quality of healthcare is quite low. In that case, they can choose to be treated abroad.

Our advice: We usually advise to choose ASIA if you do not plan on going elsewhere to get treated. If you want to go to Europe or South-America to receive your treatment, we advise you the WORLDWIDE EXCLUDING USA coverage. WORLDWIDE coverage increases a lot the amount of your insurance premium. Choose it only if you need health care in the USA. For more advice, you can read our article about it. 

Letter of Guarantee (LOG)

A LOG is a guarantee of payment between a hospital and an insurance company. It is a pre-autorisation of the insurance company and allows you to benefit from “direct billing”. It allows you not having to advance the expenses in case of an admission at the hospital. In the event of a hospitalization, your insurance company issues a LOG. For you, it comes into action only when you are admitted into a hospital.

Local Plan

In this case, “local” means “in Singapore”. This means that you cannot decide to go abroad to be treated. At UEX, with a Base Plan 1 and 2, that are local plans, you will be covered for emergencies (repatriation/ evacuation) even outside of Singapore.

However, we advise you to contact your insurance company prior to your trip. Therefore, this will allow you to check if you are correctly covered abroad.

Optical

The optical option pays for the fees charged for corrective spectacle lenses, contact lenses and associated spectacle frames. At UEX, the ophthalmologist or optometrist need to prescribe them. The reimbursement will be up to SGD 380 per year. This benefit also pays for the eye examinations carried out by an ophthalmologist or optometrist. You can find more informations about ophthalmology in Singapore here.

Pre-existing conditions

A pre-existing condition is an illness or a health condition that existed and was know before signing a new health insurance contract. It can be related to a hospitalization that occurred in the past or an illness that is congenital (i.e. what you are born with). Furthermore, it can be linked to a major condition that you have suffered in the past or currently suffering. This means that you need to be medicated in order to live a normal life, including asthma, high blood pressure, heart diseases, or mental illness, etc. To read more about the declaration and coverage, you can read our article about it.

Premium

An insurance premium is the amount of money you pay for an insurance policy. It can be monthly, quarterly, yearly.The level of insurance premium depends on multiple factors. The type of coverage, the age of the insured, the geographical perimeter…

Room type

You can choose to be alone in your room or to share it with other patients. To have more information on this particular point, we’ve written an article about it.

Specialists

It is a doctor with a selected medical specialty to treat certain types of injury or illness. It often refers to cardiologist, allergist, dermatologist, endocrinologist, gastroenterologist, gynecologist, hepatologist, neurologist, psychiatrist, rheumatologist, surgeon… Here is a list of recognized specialists in Singapore.

Travel insurance

This insurance covers you while you travel and might provide reimbursement for any issues related to your travels. Trip cancellation or interruption, theft or loss to property during the trip (jewelry, cameras, baggage, passports…). Furthermore, it also covers you for emergency medical expenses during the trip. Travel insurance may be bought from travel agents like UEX or directly from certain insurers such as AXA.
However, a travel insurance can be worldwide or regional only. With UEX, the countries included in the  “ASIA” region are the following:

Waiting period

It is a period of time while you need to wait before being covered by your insurance company. It might be the case for example if you have a specific condition. It is very common for dental or maternity coverage.

On average, insurance companies have a 365-day waiting period for maternity coverages. This means you need to wait for 365 days before being covered for your costs related to your pregnancy. These costs include the delivery, the period before and following the delivery. These conditions depend on the terms of your contract. If you get pregnant during the waiting period, all your pregnancy related costs won’t be covered until the end of the waiting period.

For example: you sign a health insurance contract that includes a maternity cover. However, you get pregnant at the 10th month of the subscription. As the waiting period is one year long, there will not be any reimbursement for any costs related to the pregnancy for the first two months of your pregnancy. On the third month, the medical expenditures that follow will be covered. If you are pregnant and do not have a maternity coverage, please contact us.

You now know everything concerning insurance! If you need more information, here are a few articles that might be helpful:

To find out more about healthcare topics in Singapore you can check our articles. To understand, how your health insurance plans cover healthcare costs, you can approach UEX‘s happiness team by email or by phone for more information and guidance – and the good news is that they are super nice!

With UEX, you can obtain a quote for a health insurance contract customized to your needs and requirements – all in less than a minute!


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