HEALTH INSURANCE GLOSSARY OF TERMS

A disease, illness or injury which has one or more of these features:

• it needs to be checked regularly for a long time or for the rest of your life by a doctor, specialist, nurse or clinic
• it needs to be treated or controlled regularly for a long time
• it needs you to adapt to live with it or for you to be specially trained to cope with it
• it continues indefinitely
• it has no known cure
• it comes back or is likely to come back.

Someone who goes into hospital or a day-patient unit for treatment but doesn't need to stay in overnight.

The excess is the amount of money you pay towards the cost of a claim which applies to every person covered by the policy. You pay an excess only once each policy year, regardless of how many claims you make.

Your excess will renew at the beginning of each policy year, even if you’re midway through a claim. So, your excess could apply twice to a single claim if your treatment begins in one policy year and continues into the next.

It is likely that you’ll pay your excess to the hospital or specialist and we’ll then pay the remainder (if applicable) of the claim, once this has been deducted.

Someone who goes into hospital for treatment and needs to stay overnight or longer.

This is a discount you get on your premium when you renew if you have not made a claim in the previous year.

You can pay extra to keep your No Claim Discount after one claim. Find out more about No Claim Discount Protection.

To see a specialist or consultant, you need a referral letter from your GP. These letters often name the specialist the GP wants you to see. An open referral is when a GP says what type of specialist you need instead, such as skin or eye specialist.

Someone who goes to a hospital or outpatient clinic for an appointment with a doctor or specialist. Not a day or inpatient.

A practising member of certain professions allied to medicine who, in all cases, meets our recognition criteria for benefit purposes in their field of practice and who we have told in writing that we currently recognise as a practitioner for benefit purposes.

When such persons provide such services to you as part of your inpatient or day patient treatment those services will form part of the private hospital charges. The professions concerned are dietitians, nurses, orthoptists, speech therapists, audiologists, psychologists and psychotherapists.

A medical practitioner with particular training in an area of medicine (such as consultant surgeons, consultant anaesthetists and consultant physicians) with full registration under the Medical Acts, who meets our criteria for specialist recognition and benefit purposes, and who we have told in writing that we currently recognise as a specialist or benefit purposes in their field of practice.

Surgical or medical services (including diagnostic tests) that are needed to diagnose, relieve or cure a disease, illness or injury.

When you take out a Saga HealthPlan, you can choose from three different underwriting methods. Read more about underwriting methods.