Glossary beginning with C

Glossary

Cashless

It is a health insurance plan for when you get hospitalized within a Cigna TTK Health Insurance network hospital and don’t have to pay for the hospital expenses.

Chronic Care

It is medical care for permanent or long term illnesses/ chronic diseases. These include a cover for all the related diagnostics, drug expenses and regular consultation expenses that a policy holder incurs.

Chronic Disease

A disease that is long lasting and needs to be managed over a long period of time.Examples of chronic diseases include cardiac diseases, diabetes, and arthritis amongst others.

Claim

It is a request by a policy holder to Cigna TTK Health Insurance to cover for medical services used.

Co-pay/Co-payment/Co-plan

Co-insurance simply means sharing the burden of paying for expenses along with an insurer such as Cigna TTK Health Insurance. Since the burden of payment is shared, the premium is correspondingly lower.Example: Raj has 20% co-insurance for his health insurance policy. He had to undergo a surgery recently. The total expense of the surgery came to Rs. 20,000. Raj while enrolling for his medical insurance policy opted for 20% co-insurance. This means that Raj would have to bear 20% of Rs. 20,000, i.e., Rs. 4,000 on his own, while Cigna TTK Health Insurance would bear the balance 80% of the expense or Rs. 16,000.Also, consider another situation. Raj has opted for a 20% co-insurance and a Rs. 2,000 deductible in order to reduce his premium amount. In this case, if the total medical expense amounts to Rs. 20,000, Raj would first pay Rs. 2,000 and then cover 20% of the balance Rs. 18,000. This implies he would incur, Rs. 2000 plus 20% of Rs. 18,000 or Rs. 5,600 in total. Cigna TTK Health Insurance would cover the balance Rs. 14,400.

Coverage

Coverage is the amount of money set for services and expenses in an insurance plan.Coverage summarizes the key features of the plan such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. Essentially, the details of what is covered and what isn’t.

Coverage Gap

It is a time period (gap) in your .Insurance policy cover during which the costs of your medicines/ drugs will have to be borne by you instead of the policy provider. This gap may occur if your yearly drug costs reach a certain amount (specified in the policy).

Covered Expenses

Those expenses which Cigna TTK Health Insurance will pay for if the need arises.As an example, imagine that Raj’s insurance plan covers medical expenses and surgeries however it does not cover emergency care visits to the hospital. Raj would have to pay for his visits to the emergency care section of the hospital while all other medical expenses would be borne by Cigna TTK Health Insurance.

Covered Person

A person who can avail the insurance cover. Someone who is a part of the health insurance plan.

Critical Illness

In simple words, critical illnesses are relatively serious forms of illnesses which are more difficult to treat and require more time to treat.The federation of Indian Chamber of Commerce and Industry (FICCI) lists the following illnesses as critical illnesses: cancer, heart attack, coronary bypass surgery, heart valve repair or replacement, coma, kidney failure requiring regular dialysis, stroke resulting in permanent symptoms, major organ or bone marrow transplants, permanent paralysis of limbs, motor neurone disease and multiple sclerosis with persisting symptoms.

Critical Illness Benefit

A benefit which helps cover for treatment of critical illnesses. Such situations entail relatively higher expenses and longer period of absence from work for the affected. Cigna TTK Health Insurance pays a lump sum cash payment to the policy holder if he/she has opted for a critical illness plan.Raj is diagnosed with the first stage of cancer. Raj's basic insurance doesn't cover critical illnesses. This means that Raj will not only be stressed about the disease he's contracted, but he'll have to pay for the treatments himself. He will also have to take long absences from work which translates to a loss of income. Had Raj opted for a critical illness 'add on' he could have focused on just getting treated rather than worrying about financing the treatment.