121 Healthcare Ltd

Private Medical Insurance

Glossary of terms

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Not sure what it means? Looking to make sense of the "fine print"?

Understanding insurance related terms could be puzzling to say the least. Use this guide as you would a dictionary, clicking on the appropriate letter to find English friendly explanations to the word or phrase's that you are looking for. Or you can browse the 121 Glossary starting here.

A B C D E F G H I J L M N O P Q R S T U V W

A

A & E

Accident and Emergency Department. The casualty department of the hospital.

Abdominal muscles

The large group of muscles that assist in the regular breathing movement and also supports the muscles of the spine while lifting. They also keep and protect other abdominal organs and intestines in place.

Access

The availability of medical care to a patient. This can be determined by location, transportation, type of medical services in the area etc.

Accident

An event that is unforeseen, unexpected, and unintended

Accidental bodily injury

Physical injury sustained as the result of an accident

Achilles tendon

One of the longest tendons in the body, it attaches the calf muscles to the heel bone.

Acupuncture

Treatment by the insertion of needles, performed by a member of the British Acupuncture Association Register or the British Medical Acupuncture Society.

Acute condition or episode

The period of time when an injury is at its worst, usually right after the injury or flare-up has occurred.

Aerobic exercise

Brisk exercise which helps to improve circulation of oxygen through the blood.

AIDS

Acquired Immune Deficiency Syndrome, which is caused by the human immune deficiency virus (HIV).

Allergic reaction

The body's response to an allergic stimulus. This can be localised to just one area of the body or may affect the entire body area. Examples of reactions to allergies include rash, itching, swelling, difficulty in breathing and/or low blood pressure.

Alopecia

Loss of hair, be it on the head or all over the body. Certain chemotherapy drugs can cause alopecia.

Alternative medicine

A catch-all phrase for a long list of treatments or medicinal systems including traditional systems such as Chinese or aromatherapy medicine, homeopathy, various herbal and other miscellaneous treatments that have not been accepted by the mainstream Western Medical Profession. Alternative medicine is also referred to as complementary medicine.

Amputate

To remove parts (cut off) of the living body by surgical means.

Anaesthetic

Chemical substance given to a patient to produce loss of sensation, with or without unconsciousness.

Anaesthetist

Medically approved person who administers anaesthetics to patients prior to any form of surgery.

Anaemic (Anaemia)

A condition involving the deficiency of the oxygen-carrying red blood cells.

Anti-coagulants

Drugs used to treat and prevent abnormal blood clotting.

Antibiotics

Drugs such as penicillin, tetracycline or cephalosporin that is able to kill or inhibit the growth of certain micro-organisms (bacteria). Primarily used to combat disease and infection. Some of the most common antibiotics are ampicillin, amoxicilin and penicillin.

Antibodies

Protein produced by white blood cells which neutralise or destroy foreign proteins in the body (antigens). When infected with virus or bacteria, the body produces antibodies, which destroy the invading micro-organisms.

Antibiotic allergy

An antibiotic may cause an allergic reaction, as is often the case with penicillin.

Anti-histamine

Drug used to offset the effects of histamine, more commonly know as hay fever.

Application

A signed statement of facts requested by the company on the basis of which the company decides whether or not to issue a policy. This becomes part of the health insurance contract when the policy is issued.

Asthma

A condition where the airways of the throat are inflamed and obstructed causing a person to have difficulty breathing.

Atopic dermatitis

The medical term for eczema. It is a skin disorder sometimes found in people with allergies. It is a very itchy, red, scaly rash that may ooze a clear fluid.

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B

Bacterial infection

An infection caused by bacteria (micro-organisms which attack the immune system). Bacterial infections can be treated with antibiotics.

Benefit

A benefit which will be provided or paid for under a policy for treatment.

Benign tumour

A non-cancerous growth that does not spread to other parts of the body.

Beta-blockers

Prescribed to treat heart disorders and high blood pressure, this group of drugs is also known as beta-adrenergic blocking agents.

Biopsy

The removal of a sample of tissue followed by microscopic examination by a pathologist to see whether cancer cells are present.

Blanket insurance

See group insurance.

Bleomycin

A chemotherapy drug commonly used to treat Hodgkin's disease.

Blood cell

A general term describing the three cellular components of blood (white blood cells, red blood cells, and platelets), all which are made in the bone marrow.

Blood count

A routine test to determine the amount of white blood cells, red blood cells, and platelets in a sample of blood. This test can and is often used to determine if the body can withstand another round of chemotherapy. Also known as the complete blood count (CBC).

Blood pressure

The pressure of the blood in the main arteries which rises and falls as the muscles of the body cope with varying demands e.g. exercise, stress, sleep. There are two types of pressures that are measured:
  1. systolic pressure, created by the contraction of the heart muscle, and
  2. diastolic pressure, when the heart is at rest between beats.

Blood vessels

Tubular canals through which blood pass. Examples are arteries, veins, or capillaries.

Bone marrow

Soft, spongy tissue in the center of large bones that produces white blood cells, red blood cells, and platelets.

Bone marrow aspiration and biopsy

The removal and analysis of a sample of bone marrow, usually through a needle inserted into the hip bone. A pathologist will examine the sample for normal and possibly abnormal cells.

Bone marrow transplantation (BMT)

Treatment in which healthy bone marrow replaces bone marrow that has been affected by a disease or by treatment for a disease. Usually the patient receives high dose chemotherapy and possibly radiation to kill cancer. In the process the patient's ability to fight infection is also damaged. The donated bone marrow is infused into the patient to restore the immune system. The marrow may come from the patient prior to the procedure or from a suitable donor.

Bone scan

A procedure where an image of the bones is produced by injection of a radioisotope and subsequent scan for the isotope absorbed by the bones. It is usually used to determine if cancer has spread to the bones.

Brachial Artery

An artery on the inside of the arm, midway between the elbow and the shoulder, which carries blood away from the heart.

Burn

Injury, or effect caused by fire or excessive or intense heat. Burns or blistering of the skin may be caused by dry heat (fire), moist heat (steam or hot liquids, electricity or corrosive chemicals) when in contact with the skin.

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C

Caesarean birth

Delivery of the baby through an incision in the abdomen and uterine walls (also called C-section).

Calcium

A mineral needed for strong bones, which is found primarily in dairy products.

Cancer

A general term for more than 100 diseases that are characterized by uncontrolled, abnormal growth of cells. Cancer cells can spread through the bloodstream and lymphatic system to other parts of the body. Malignant tumor - a cancerous growth of tissue that can cause death if not treated quickly.

Carotid artery

An artery in the neck carrying blood from the heart to the brain.

CAT scan

see Computerised tomography

Catheter

A flexible tube inserted into the body to transport fluids into or out of the body.

Cell

The basic building block of all living tissues.

Central nervous system

The control centre for the body, including the brain and spinal cord.

Cerebrovascular disease

A disease which affects an artery's ability to supply blood to the brain.

Cervical cancer

Cancer of the cervix.

Cervix

Mouth of the uterus (womb). In the first stage of labour, the cervix thins and opens to allow the baby to move into the vagina (birth canal).

Chemotherapy

The use of drugs to treat cancers. The drugs sometimes impair normal tissues as well.

Chiropractic

Treatment by manipulation of the spine, performed by a member of the British Chiropractic Association or Scottish Chiropractic Association.

Chromosomes

Found in the nuclei of cells, chromosomes are a strand of DNA and related proteins which contains genetic information that carries the genes and determines the hereditary characteristics of offspring.

Chronic condition

A disease or injury which has at least one of the following characteristics:

  1. has no known cure, or recurs
  2. leads to permanent disability
  3. is caused by changes to your body
  4. requires you to be specially trained or rehabilitated
  5. needs prolonged supervision, monitoring and treatment

Chronic illness or condition

A set of symptoms or disorders that has persisted for a long period of time. It is a continuing disease process with progressive deterioration.

Combination chemotherapy

The use of more than one drug to treat cancer.

Commencement date

The date shown as such on your policy certificate.

Colorectal cancer

Cancer in the large intestine.

Colorectal screening

A test performed by a clinician to detect colorectal cancer.

Complementary medicine

The practice of medicine without the use of drugs, which may involve self-awareness. Examples include chiropractors, homeopaths, medical herbalists and acupuncturists (see alternative medicine).

Compresses

A material, such as cloth, applied under pressure to an area of skin and held in place for a period of time. A compress can be cold, hot, moist or dry.

Computerised tomography

An X-ray procedure that uses a computer to produce detailed 3-dimensional or cross sectional pictures of the body. Also called CAT or CT scan. Depending on the part of the body scanned, this may involve drinking a substance to outline the digestive system (contrast), having contrast injected into the rectum, and/or an iodine contrast intravenously prior or during the scan.

Condition

A mode or state of being. The state of being fit: the physical status of the body as a whole, or of one of its parts. A condition can also describe, refer or be used to indicate abnormality.

Conjunctivitis

Inflammation of conjunctiva, that is the delicate membrane that lines inside the eyelid and covers the eyeball.

Contact dermatitis

Contact dermatitis is a reaction, which occurs when skin comes in contact with certain substances. Two mechanisms exist by which substances can cause skin inflammation - Irritation (Irritant contact dermatitis) or Allergic reaction (Allergic contact dermatitis). Common irritants include soap, detergents, acids, alkalis and organic solvents (as are present in nail varnish remover). Contact dermatitis is most often seen around the hands or areas that touched or were exposed to the irritant or allergy cause. Contact dermatitis of the feet also exists but differs in that it is due to the warm, moist conditions in the shoes and socks.

Constipation

The inability to pass bowel movements easily.

Consultation

An audience, interview or a conference, usually with one medical specialist or consultant A consultation will arrive at a recommended course of action which includes explanations of the reasoning process.

Contractions

The tightening and shortening of the uterine muscles. During labour, contractions cause dilation and thinning of the cervix and aid in the descent of the baby into the birth canal.

Cough suppressant

A drug used to control a dry, nagging cough.

Course of treatment

All treatments undertaken for a medical condition over a period of time, provided that the period between each treatment does not exceed six months.

CT scan

see Computerised tomography.

Cure

In the general sense - when there is no sign of the disease or re-occurrence or likelihood of return of the disease. Where adequate time has passed so that the chances of recurrence are extremely small. A general rule of thumb will be a symptom free period of 5 years.

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D

Day care treatment

Treatment requiring admission to hospital for an operation and use of a hospital bed, but not needing an overnight stay.

Day-patient

A patient who receives treatment in a hospital and, out of medical necessity, occupies a bed or is charged for accommodation, but who does not remain overnight and requires a period of recovery under medical supervision.

Decongestants

Drugs used to relieve nasal congestion as occurs during upper respiratory infections.

Dehydration

Dehydration occurs when a person's body water content has decreased to a dangerously low level. Water accounts for 60% of a man's weight and 50% of a woman's.

Dental Care

Coverage may include routine diagnostic and preventive services and one or more of the following treatment services: restorative, crown and bridge, endodontic, oral surgery, periodontal, prosthetic, and orthodontic.

Dependant child/children

An unmarried child, who lives:

  1. with you or his or her other parent, or
  2. away from your home for the purpose of attending his or her place of full time education

Dermatitis

Dermatitis is an inflammation of the upper layers of the skin causing rash, blisters, scabbing, redness and swelling. There are many different types of dermatitis.

Diabetes

A condition where the pancreas produces insufficient or no insulin, a hormone which controls sugar levels in the blood. Without insulin, the blood cannot absorb sugar into cells for energy and into liver and fat cells for storage.

Diagnostic

The process of identifying a disease by its characteristic signs, symptoms and laboratory findings. The earlier the diagnosis is made the better the chance of a cure.

Diaphragm

The thin muscle below the lungs and heart that separates the chest from the abdomen.

Dilating

The opening of the cervix caused by uterine contractions.

Diphtheria

A serious bacterial infection that causes a sore throat and fever and may lead to further complications or fatal diseases. Diphtheria is extremely rare in the United Kingdom due to the virtually 100% effective immunisation rate.

Disability

A limitation of physical or mental functional capacity resulting from sickness or injury. It may be partial or total.

Discharge

Flow of fluid from a body cavity such as the nose, vagina, or nipple.

Disease

An alteration in the state of the body or some of its organs, interrupting or disturbing the performance of the vital functions, and causing or threatening pain and weakness.

DNA

Deoxyribonucleic acid. The part of the cell that contains and controls all genetic information.

Down's syndrome

A disorder caused by an extra chromosome of the genes causing mental and physical developmental disabilities in the offspring.

Dressing

An application such as a bandage, remedy, etc. to a sore or wound.

Drug

Any animal, vegetable, or mineral substance used to make up a medicine. The UK Medical Journal medical definition for a drug, is any substance, other than a food or device, that is intended for use in the diagnosis, cure or prevention of disease, or is intended to affect the structure or function of the body

Drug resistance

The failure of cells or bacteria to respond to drugs.

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E

Eczema

An inflammation of the skin which then causes itching. It is often accompanied by scaling or blisters and is sometimes caused by an allergy.

Eligibility date

The date on which an individual member of a specified group becomes eligible to apply for insurance under the group health insurance plan.

Eligible employees

Those members of a group who have met the eligibility requirements under a group health insurance plan

Embolism

Obstruction of a blood vessel by a transported clot, such as a mass of bacteria.

Embryo

Term used for the baby during the first 8 weeks of life in the uterus.

Emphysema

A disease in the lungs in which the alveoli (tiny air sacs) become damaged, usually due to smoking.

Endodontic treatment

Endodontic treatment is more commonly known as root canal treatment. It is necessary when the soft inner tissue of the tooth, the pulp, becomes inflamed or infected. Endodontic treatment involves removal of the damaged pulp. The canals are then cleaned, filled and sealed to preserve the tooth.

Epidural anaesthetic

An injection of an anaesthetic into the epidural space surrounding the fluid-filled sac around the spine. It partially numbs the abdomen and legs.

Episode

A noteworthy happening or series of happenings occurring in the course of continuous events, as an episode of illness; a separate but not unrelated incident.

Evaporation

A method to draw moisture out of the skin.

Examination

The medical examination of an applicant for life or health insurance.

Excess

The sum you agree to pay towards the total cost of each medical claim. For example, if you chose an excess of £100 and the costs for all your treatment for a medical condition totaled £500, you would pay £100 and the insurance company would pay the remaining £400. The higher the excess you decide to take the lower the cost of the premium. Some insurance companies do not apply your elected excess for certain treatments, for example complementary medicine such as a chiropractor or osteopath.

Excision

A surgical procedure to remove tissue.

Exclusions (exceptions)

Disorders, diseases, or treatments listed as uncovered services (not reimbursable) in an insurance policy and / or charges, services, or supplies that are not covered. A plan will not provide or pay for excluded items. Exclusions are specific conditions or circumstances for which the policy will not provide benefits.

Expiry date

The date shown on your policy certificate.

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F

Family policy

A policy that insures both the policyholder and his or her immediate dependents (usually spouse and children).

Fasting plasma glucose

A test for sugar levels obtained from blood samples taken after an overnight fast.

First stage of labour

The part of labour when the cervix dilates to 10 centimetres.

Flu

See Influenza

Foetus

Term for an unborn baby from the end of the 8th week after conception until birth.

Forceps

An instrument used to aid in childbirth.

Frostbite

Damage to the tissues from exposure to temperature below 32° Fahrenheit (0° Centigrade). An initial pins and needles sensation is followed by numbness. After that, the skin appears white, cold and hard, and finally becomes red and swollen.

Fracture

Fracture is a breakage of a bone.

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G

Gastrointestinal tract

Parts of the digestive system that include the mouth, oesophagus, stomach, small and large intestines, rectum and anus (excluding the liver, gall bladder, and pancreas).

Gene

The part of DNA that is responsible for determining a person's characteristics and that carries information from old cells to new cells.

General practitioner (GP)

A registered medical or dental practitioner in general practice.

Genital

(Genitalia) The male and female reproductive organs, primarily the external sex organs.

Germs

See Micro-organisms

Gestation

The length of time a developing baby is carried in the uterus after conception, usually about 40 weeks.

Gestational diabetes

A diabetic condition that occurs during pregnancy and often goes away after the baby's birth.

Glands

Groups of cells. "Glands" generally refer to secreting glands and lymph nodes. Secreting glands manufacture and release chemical substances such as hormones and enzymes. Lymph nodes play an important part in fighting infections.

Glaucoma

A condition where abnormally high pressure of the fluid in the eye causes damage.

Groin

The area where the thigh meets the hip.

Group

Coverage of a number of individuals under one contract. The most common "group" is employees of the same employer.

Group certificate

The document provided to each member of a group plan. It shows the benefits provided under the group contract issued to the employer or other insured.

Gum disease

See periodontal disease.

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H

Haematologist

A doctor or consultant who specialises in the treatment of blood diseases.

Haematology

The study of blood, blood-producing organs, and blood disorders.

Haemorrhoids

Inflammation of the veins surrounding the anus.

Hamstring

Muscles located at the back of the thigh that bend the knee and swing the leg backward from the hip.

Hay fever

The popular name for runny nose or allergic rhinitis. An allergic reaction of the immune system upon exposure to foreign substances. Can be offset by the use of anti histamines.

Hazardous pursuits

Any pursuit or activity where it is recognised there is an increased risk of serious injury or it can be reasonably expected to aggravate an existing injury. For example, rock climbing, mountaineering, pot-holing, hang-gliding, parachuting, parascending, paragliding, skiing of any sort, snow boarding, bob-sleighing, motor sports and contact sports. The sports listed here are for general guidance. Please consult your policy for named exclusions.

HDL

A high-density lipoprotein which removes excess cholesterol from the bloodstream.

Heart murmur

Heard through a physician's stethoscope, it is the sound of turbulent blood passing through the heart. Heart murmurs are possible indications of abnormal blood flow and may be caused by a disorder of a heart valve (structure which opens to allow blood to flow away from the heart, and closes to prevent back flow into the heart). Many murmurs are benign (of no significance).

Heartburn

A burning sensation in the oesophagus due to stomach acids backing up into the lower oesophagus.

Health care specialist

A health care provider who is not a primary care physician.

Health history

A form used by underwriters to assist in evaluating groups or individuals to determine whether they are acceptable risks.

Hepatitis

Inflammation of the liver often caused by a virus.

Hepatitis B

A viral infection which attacks the liver and causes inflammation. Hepatitis B is primarily transmitted sexually, however it may be spread by exchange of blood e.g. by needle sharing with drug users, razor sharing, or blood transfusions which occurred prior to 1985 when tests for the virus became available.

Hepatitis B vaccine

An immunisation performed primarily by a needle injection which creates antibodies to fight the Hepatitis B virus if the virus later enters the body.

Herpes

Small, painful blisters that erupt on the skin. The herpes simplex virus causes painful blisters around the lips, and genital herpes causes blisters on the sex organs.

Hickman® Catheter

A line that is inserted into a large vein near the heart - used for delivery of medications and transfusions. (Hickman is a registered trade mark of C.R.Bard, Inc.)

High blood pressure

A condition forcing your heart to pump blood through your circulatory system at a force much greater than is necessary to maintain a steady flow. Known also as hypertension.

Histamine

A chemical present in cells throughout the body that is released during an allergic reaction.

HIV

Human Immune Deficiency Virus. A virus which can destroy the immune system and lead to AIDS.

Hoarseness

Interference of the normal working of the vocal cords in the larynx (voice box) resulting in a rough, husky, or croaking voice.

Hodgkin's Disease

A malignant disorder of lymph tissue, also known as lymphoma that occurs mostly in individuals between the ages of 15 and 35. If detected early, it has a high remission rate.

Home health care

Medically supervised care and treatment in the home of a patient whose physician certifies that without such care, confinement in a hospital or extended care facility would be required. Typically, care and treatment are provided in accordance with an approved home health care benefit and must begin within a specified period of time after discharge from a hospital.

Homeopathy

Treatment by the administration of medicines, which in a healthy person would induce the symptoms similar to those being treated, performed by a member of the British Homeopathic Society.

Hormone

A chemical substance produced by a gland or organ.

Hormone

A chemical substance produced by a gland or organ. These are made up of various chemicals made by living cells, which influence the development, growth, sex, etc. of a person and are carried around the body in the blood. There are different types of hormones such as male and female hormones and of course growth hormones.

Hormone replacement therapy

Oestrogenic hormones prescribed orally, transdermally, or bysubcutaneous implant required for the relief of symptoms resulting from cessation of ovarian function, either at the time of natural menopause or following surgical removal of the ovaries.

Hospice

Autonomous, centrally administered program of coordinated in-patient and out-patient services to serve terminally ill patients and their families.

Hospice care

A coordinated program at home and/or on an in-patient basis, offering easing of the patient's pain and discomfort. It provides supportive care, for a terminally ill patient and the patient's family, by a supervised and specialised team under the direction of a licensed or certified hospice-care facility.

Hospital

A hospital or nursing home run by the NHS or registered under the Nursing Home Acts.

Hospital charges

Charges for accommodation, nursing, operating theatres, drugs, dressings, pathology, radiology and any other charges made for treatment by a hospital.

Humidifier

A machine that adds moisture to the air to prevent dryness in the mouth, nose, and throat.

Hypertension

Abnormally high blood pressure.

Hysterectomy

A method where the abdomen is surgically opened to remove part or all of the uterus.

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I

Immune system

An inborn collection of cells and proteins which work to protect against infectious micro-organisms (germs) in the body.

Individual insurance

A policy that provides protection to a policyholder and/or his or her family; sometimes called personal insurance, as distinct from group and blanket insurance.

Individual insurance plan

An insurance policy sold to individuals who are not eligible for medical insurance under a group policy or to persons who need more coverage than is available to them through their group plan.

Inflammation

A soreness, or sensitivity of a tissue. It is a body function in response to injury characterized by pain, heat, redness and swelling. Inflammation usually follows by healing. If not, it become chronic inflammation.

Influenza

Commonly called "the flu", influenza is a virus that infects the respiratory tract and may cause fever, headache, and general body aches, runny nose, sore throat, or cough.

Informed consent

Legally required procedure to ensure that a patient knows about the potential risks and benefits of a treatment before it is started.

Infusion

Administration of fluids or medications into the blood through the veins.

Injection

By the use of a syringe and needle to deliver medications to the body.

Injury

A particular form of hurt, damage, or loss: eg a twisted ankle.

Injury independent of all other means

An injury resulting from an accident, provided that the accident was not caused by an illness.

In-patient

Any person who is admitted to hospital for treatment and who occupies a bed with the expectation that the individual will remain in the hospital for a period of 24 hours or more.

In-patient services

The care provided while a bed patient in a covered facility.

Insulin

A hormone which promotes the transfer of sugar into the body cells for energy production.

Intestines

The major part of the digestive track forming a long tube divided into two main sections: the small intestine and the large intestine, extending to the anus.

Intravenous

Fluid providing nutrition, water or medication injected into a vein.

Irritation

A state of over excitation and undue sensitivity - a good example would be a rash on the back of the hand.

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J

Jaundice

A yellowing of the skin and whites of the eyes usually caused by diseases of the liver or bile ducts.

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L

Labour

Contractions of the uterus which cause the cervix to thin and dilate, and the baby to descend into the birth canal and to be pushed out of the vagina.

Lapse

Termination of a policy upon the policyholder's failure to pay the premium within the time required.

Laryngitis

An inflammation of the larynx (voice box) usually caused by infection and resulting in hoarseness.

Lesions

A broad term for an abnormality of the body which can be either an infection, abscess (an open, fluid filled sore), wound, or tumour.

Ligaments

Fibrous, slightly elastic tissue which binds the bones together and prevents excessive movement of the joint.

Limitations (or limited benefits)

Statements in a brochure showing services or supplies that are not fully covered, only partially paid by a plan, or covered only if the service or supply provided meets certain specified criteria. (e.g. psychiatric in-patient treatment available for a maximum of 28 days).

Limited policy

A contract that covers only certain specified diseases or accidents.

Long term care

The range of maintenance and health services to the chronically ill or physically or mentally disabled. Services may be provided on an in-patient (for example, rehabilitation facility, nursing home, or psychiatric hospital), out-patient, or at home basis.

Lumbar puncture

Also called a spinal tap - involves the removal of the fluid in the spine for examination.

Lymph

The almost colorless fluid that bathes body tissues and carries cells that help fight infection.

Lymphoma

A subset of cancers that begin in the lymph system. One such subset is known as Hodgkin's Disease.

Lymph nodes

Small, bean-shaped organs located along the lymphatic system. Nodes filter out bacteria or cancer cells that may travel through the lymphatic system. Also called lymph glands.

Lymphatic system

The tissues and organs (including the bone marrow, spleen and lymph nodes) that produce and store cells that fight infection and the network of vessels that carry lymph.

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M

Magnetic resonance imaging (MRI)

A test that uses a magnetic field sensor and computers to create 3-dimensional images of the body. It is similar to computerised tomography (CT scan) but uses magnets instead of x-rays.

Malignant

A cancerous growth that does not spread to other parts of the body (see Cancer).

Mammogram

A form of breast x-ray used to detect breast cancer. Mammography is extremely safe as it uses low amounts of radiation.

Maternity care

Prenatal and postnatal care and delivery by a covered hospital, physician, or other covered practitioner, including, in many cases, nurse midwives.

Maximum benefits

The highest amount the insurance company will pay for medical claims during a specified period. This amount is set either on a yearly basis or for the lifetime of the policy.

Medical care

Diagnostic and treatment measures provided by health care professionals to persons who are sick, injured, or concerned about their health.

Medical condition

Any disease, illness or injury and/or associated symptoms.

Medicine

A compound or agent, such as a drug, used to treat disease injury or pain. The science of diagnosing, treating or preventing disease and other damage to the body or mind.

Member

Any person covered under a health plan (enrollee or eligible dependent).

Menopause

Menopause occurs when the production of female hormones, (oestrogen and progesterone) is reduced, resulting in physical and psychological changes. This usually occurs between the ages of 45 and 55.

Micro-organisms

Single-celled living organisms too small to be seen by the naked eye. Some micro-organisms cause infections. (micro-organisms are better known as germs).

Mid wife

A woman who assists other women during childbirth.

Miscarriage

A spontaneous abortion.

Muscles

Bundles of specialised cells that can contract and relax to create movement for the body itself and the organs within it.

Musculoskeletal

Relating to or involving the muscles and the skeleton.

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N

Nerves

Bundle of nerve fibres that carry information back and forth in the body, usually to and from the brain or spinal cord.

No claims discount

The discount awarded annually to a policyholder for not making a claim during the previous policy year. Maximum discounts vary between individual healthcare providers. Please note: not all private medical healthcare policies offer this benefit.

NHS

The National Health Service or National Health Trust.

Nurse

See registered nurse.

Nursing at home

The attendance of a registered nurse, under the supervision of a specialist, in your home, to provide nursing services for treatment when covered by a policy.

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O

Obese

Obesity occurs when a person has too much body fat. Obesity is not the same as being overweight; a person is considered obese when they weigh 20% or more of the maximum desirable weight for their height.

Occupational hazards

Occupations that expose the insured to greater than normal physical dangers by the very nature of the work in which the insured is engaged, and the varying periods of absence from the occupation that can be expected due to the disability. Ensure that you have notified you insurance company of your correct occupation and or any future change of occupation.

Oesophagus

The tube through which food passes from the mouth to the stomach.

Oncologist

A doctor who specializes in the study, diagnosis, treatment and rehabilitation of individuals with cancer.

Oncology

The study of the development, diagnosis, treatment, and prevention of cancer.

Operating table

The table on which the patient lies during a surgical operation.

Operating theatre

A room in a hospital equipped for the performance of surgical operations.

Oral

By mouth, generally with reference to administering medicine.

Organism

A generic word for any living species, animal or plant.

Orthodontic

The dental specialty and practice of preventing and correcting irregularities of the teeth, as by the use of braces.

Osteopathy

Treatment and diagnosis utilising the musculosketetal system performed by a member of the General Osteopathic Council.

Out-patient

A person who receives treatment without being admitted to hospital as either a day-patient or an in-patient.

Out-patient care

Medical services provided to a patient in a hospital as an outpatient, in a physician's office, or in the office of other providers of patient health care services e.g. physical therapist or psychologist.

Out-patient surgery case

A person who has surgery at the hospital and is discharged from the recovery room on the same day.

Ovarian

The usually paired female or hermaphroditic reproductive organ that produces ova.

Ovaries

Reproductive glands in females.

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P

Paediatric

Medical conditions relating to children.

Paediatrics

A branch of medicine dealing with children's diseases.

Pap smear

A process in which a clinician inserts a speculum into the vagina to gather cells from the cervix to test for cancer.

Pathologist

A doctor who specialises in identifying diseases by studying cells and tissues under a microscope.

Pathology

The study and identification of diseases new and existing.

Pelvic examination

An exam by a clinician which includes a Pap smear, a genital exam and a manual exam. During pregnancy, it is performed to measure the size of the uterus and pelvis.

Pelvis

The ring of bones that link the spine and hip bones, and protects abdominal organs such as the uterus in women.

Periodontal disease

Commonly known as gum disease, periodontal disease is a family of related chronic inflammatory diseases that are all bacterial infections. It results in red, swollen gums and can lead to the destruction of the connective tissue and bone that hold teeth in place. The word "periodontal" means "around the tooth". Healthy gums are pale pink, smooth, and firm, and form a peak or cone between adjacent teeth.

Physiotherapy

Treatment by physical means or agents, performed by a physiotherapist who is a State Registered Physiotherapist and a member of the Chartered Society of Physiotherapists and who holds any of these qualifications: FCSP, MCSP or SRP.

Plasma

The liquid part of the blood, lymph, and intracellular fluid in which cells are suspended.

Policy

Your application form, declarations and the operative clause, definitions, conditions, exclusions, schedule, certificate, table of benefits, hospital list and any endorsements.

Policy details

The booklet showing the complete details of a plan's benefits, limitations (or limited benefits), exclusions, and definitions. The brochure is a plan's contractual statement of benefits.

Policy period

The period between the commencement date and the expiry date.

Pre-authorisation/pre-authorised

When you telephone your medical insurance provider regarding planned treatment and the company approves the treatment and confirms that the treatment is eligible for benefit under the policy.

Pre-existing condition

Any illness, injury or condition, or related illness, injury or condition:

  1. for which medical advice or treatment has been sought or received; or
  2. which you were aware of, or ought reasonably to have been aware of; or
  3. which was in existence, but which had been misdiagnosed or for which an accurate diagnosis had not yet been made by a qualified medical practitioner

Premium

The periodic payment made by the policyholder to an insurance company to initiate or to maintain insurance coverage. In essence the amount you pay in exchange for health insurance coverage.

Prescription drugs

Outpatient drugs and medicines which, by United Kingdom Law, cannot be obtained without a doctor's prescription.

Primary diagnosis

The condition considered as the major health problem for the patient for the submitted claim. This condition is always listed first on the insurance claim form.

Private ambulance

A vehicle operated under the registration of the National Association of Private Ambulance.

Prognosis

Prediction of the future course of the disease.

Prostate gland

A chestnut shaped organ in males, which resides below the bladder and in front of the rectum. The prostate gland produces most of the seminal fluid (the fluid that carries the semen during ejaculation).

Prosthesis

An artificial body part which is designed to form a permanent part of your body.

Prosthetic dental treatment

The work involved making full and partial dentures, bridges, crowns, and other dental appliances for patients in accordance with prescriptions and impressions furnished by dentists or dental students.

Protein

Molecules that are made of amino acids. They are found all living organisms and are essential for the growth and repair of animal tissue. Proteins are needed in the diet; they are broken down into amino acids which are absorbed, and rebuilt to form new proteins in the body.

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Q

Qualified nurse

A nurse registered with and holding a valid personal identification number from the United Kingdom Central Council (UKCC) for nursing, midwifery and health visiting.

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R

Radial artery

One of the main arteries of the arm, running down its full length into the hand. Arteries carry blood away from the heart.

Radiation therapy

Treatment with high-energy radiation from X-rays or other sources of radiation such as radioisotopes.

Rash

A group of spots on an area of inflamed skin.

Reasonable and customary charges

One of two benefit maximums that plans use as the amount of your medical or dental care expenses they will cover for a particular service. (The other is the "scheduled allowance".) A reasonable and customary charge is the amount a plan considers to be covered based on a profile of charges determined by the plan to be the amount a provider normally charges for a service and that is usually charged by most other providers for the same service in the same geographic area. Health insurance industry accepted methods are used by the plans to establish and periodically update reasonable and customary charges. The actual amount a provider charges for a particular service may be more than the reasonable and customary charge set by the plan for that service. In some cases you may be charged for this shortfall, unless the provider accepts a lesser amount because of policy plan agreements imposed by the insurance company.

Red blood cell

The blood cell that carries oxygen to the cells of the body and removes carbon dioxide.

Red blood cell count

The measurement of the number of red blood cells in a sample of blood.

Referral

Total transfer of a patient's medical care to another physician for treatment limited to a specific disorder.

Referring physician

The physician who sends the patient to another physician or other provider of health care services for consultation or treatment.

Regimen

A combination of drugs and how they are administered.

Registered nurse

A nurse who is registered with any statutory body within the UK.

Regression

A reduction in symptoms or disease process.

Rehabilitation

Treatment aimed at restoring health or mobility, or to allow a person to live an independent life, such as after a heart attack or stroke.

Relapse

The return of symptoms and signs of a disease after a period of improvement.

Related condition

A medical condition which is caused by, or could be the cause of, another condition.

Remission

A term usually applied to a state of treatment with cancer, that is the complete disappearance of cancer cells and associated symptoms. This will generally mean a symptom free period of 5yrs. However, this does not always mean the individual has been totally cured.

Renal disease (Renal failure - end stage)

A chronic kidney disorder that requires long-term hemo dialysis or kidney transplantation because the patient's filtration system in the kidneys has been destroyed.

Rh blood grouping factor (Rhesus)

A blood factor located in red blood cells. Eighty-five percent of the population carry the blood factor and are Rh positive. Fifteen percent are missing the factor from their blood cells and are Rh negative.

Root canal treatment

See endodontic treatment.

Rubella

German measles. A viral infection that is dangerous to the foetus of pregnant women as it may cause various birth defects.

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S

Saliva

The watery fluid secreted into the mouth by the salivary glands that are in the mouth. It keeps the mouth moist, lubricates food to aid in swallowing, makes it possible to taste food, and contains digestive enzyme (a protein that begins the breakdown of food).

Scar tissue

A mark left on damaged tissue after it has healed. It can form on the skin or on internal wounds.

Scheduled allowance

One of two benefit maximums plans use as the amount of your medical or dental care expenses they will cover for a particular service. (The other is the "reasonable and customary charges".) A scheduled allowance is the fixed sum amount that has been assigned to a covered medical or dental service. You may be asked to pay any amount the provider charges above it. Because a plan's scheduled allowance for a particular service applies nationwide, and the amount a provider charges for that service may vary geographically, the scheduled allowance is likely to defray more of the provider's charge in some areas than in others.

Self-inflicted injury

An injury to the body of the insured inflicted by themself.

Shock

A condition that may occur after a severe injury which results in a dangerous reduction of blood flow throughout the body tissues. If untreated, shock could lead to coma and death.

Side effect

A secondary effect caused by the medication taken to cure a condition.

Sonogram

See Ultrasound.

Spasm

An abnormal and uncontrollable contraction of a muscle. A spasm is a cramp.

Specialist

A senior and experienced medical practitioner who is currently registered under the Medical Acts and

  1. holds, or has held, a consultant's appointment in a NHS hospital and holds a Specialist Accreditation issued by the general Medical Council in accordance with EC Medical Directives, or
  2. holds a certificate of Higher Specialist Training Committee of the appropriate Royal College or Faculty, or
  3. Holds alternative qualifications that are accepted by the insurance provider and is personally approved by the insurance provider for the treatment involved

Spinal injury

Where the spine and sometimes the spinal cord are damaged. Spinal injury may result in muscle weakness and paralysis.

Spine

A column of bones and cartilage in the back which begin at the base of the skull and continue to the pelvis.

Spleen

An organ that produces lymphocytes, filters the blood, stores blood cells, and destroys those that are aging. It is located on the left side of the abdomen near the stomach.

Sterilisation

Any procedure by which an individual is made incapable of reproduction; or the elimination of micro-organisms (more commonly referred to as germs).

Sterility

Inability to conceive or produce a child.

Stethoscope

An instrument used to listen to sounds in the body such as those made by the lungs and heart.

Stomach

Located in the upper part of the abdomen and in front the pancreas, the stomach is a sac like organ that connects from the oesophagus to the small intestine. The stomach stores and assists in the breakdown of food.

Strep throat

One of the diseases caused by the streptococcal bacteria. Generally, symptoms include a sore throat, fever, swollen glands, and general body aches. Strep Throat is treated with antibiotics.

Streptococcal bacteria

The most common disease-causing bacteria in humans which can be treated with antibiotics. If left untreated, some types of streptococcal bacteria may give rise to more serious diseases.

Stroke

A sudden and disabling attack caused especially by thrombosis.

Surgery or surgical procedure

(As used by the insurance industry)

  1. Any treatment that breaks the normal skin barrier, such as injections, incisions, and excisions; or
  2. Treatment for burns; or
  3. Treatment for fractures, both open and closed; or
  4. Any procedure fitting the popular definition of surgery

Swollen glands

Enlarged lymph nodes usually due to an infection or allergic reaction. Common sites where glands can be felt are in the neck, armpit, and groin.

Symptom

Physical or mental sign of disease or injury.

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T

Temporary disability

Where an individual is unable to perform his or her usual duties for a limited period of time. It is expected that the individual will fully recover from the disorder and be able to return to the job after a short-term disability leave.

Terminal

An advanced stage of illness or disease with limited life expectancy.

Terminally ill

A term which refers to the status of a person who will normally die within 6 months of a specific illness or sickness. Often refers to the terminally ill requirement for hospice care.

Tetanus

A serious disease affecting the central nervous system. Tetanus (lockjaw) results when a wound is infected with a type of bacteria that thrives without oxygen (particularly in deep wounds). It is a rare disease in the United Kingdom today.

Total disability

An illness or injury that prevents an insured person from continuously performing every duty pertaining to his or her occupation or engaging in any other type of work.

Tetanus-diphtheria booster

A follow-up dose of a vaccine for Tetanus and Diphtheria.

Tranquillisers

Drugs that are sedatives.

Transplant

The transfer of living tissue or organ to another part of the body or to a recipient body.

Treatment

Surgical or medical procedures to cure an acute medical condition or to relieve acute episodes of a chronic or incurable medical condition. Treatment does not include the temporary relief of symptoms of a chronic or incurable condition, or the management or monitoring of a chronic or incurable medical condition. Treatment must be given by or under the control of a specialist to whom you have been referred by your GP.

Trimester

A term used to define a period of three months. In pregnancy, the first trimester is 1-12 weeks; the second trimester is 13-26 weeks, and the third or last trimester is 27-40 weeks delivery.

Tumour

An abnormal or morbid swelling in the body. A location where cells in the body multiply at an increased rate. Some tumours are benign (not cancerous), others are malignant (cancerous).

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U

Ultrasound

Sonogram. A technique in which high-frequency sound waves bounce off internal organs and their echoes are changed into pictures of organs inside the body.

Umbilical cord

The fibrous cord-like structure containing two arteries and a vein and connecting the foetus to the placenta. Oxygen and nutrients from the mother's circulation pass through the umbilical cord to the foetus.

Underwriting

Process by which an insurer determines whether or not, and on what basis, it will accept an application for insurance.

Uninsurable risk

One not acceptable for insurance due to excessive risk.

Uterus

Muscular organ inside which the baby grows during pregnancy term. Also called womb.

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V

Vaccine

An immunisation performed primarily by needle injection which creates antibodies to fight a particular virus.

Vaporiser

A machine that adds moisture to the air to prevent dryness in the mouth, nose, and throat. Vaporisers typically put out hot steam.

Varicose veins

Veins that are twisted and swollen just below the skin. Veins carry blood back to the heart.

Vein

A blood vessel that carries blood to the heart.

Venipuncture

The process in which the vein is punctured to draw a blood sample, to give medication, or to start an intravenous drip.

Viral infection

An infection involving viruses, the smallest known disease causing organism. Viruses can be harmless e.g. warts, or devastating e.g. the AIDS virus.

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W

Waiting period

The length of time an insured must wait from his or her date of enrollment or application for coverage to the date his or her insurance is effective e.g. Norwich Union: Express Care 6, Select Care 6, Trust Care 6, and Personal Care 6 policies.

Waiver

An agreement attached to a policy that exempts from coverage certain disabilities or injuries that are normally covered by the policy.

Waiver (exclusion endorsement)

An agreement, attached to the policy and accepted by the insured, to eliminate a specified pre-existing physical condition or specified hazard.

Waiver of premium

Provision that, under certain conditions, insurance will be kept in full force without further payment of premiums. It is used most often in cases of permanent and total disability.

Wheezing

A whistling noise in the chest which occurs during breathing when the airways are compressed.

White blood cell

A variety of cells that fight infection in the body and are part of the immune system.

White blood cell count

Measurement of the total number of white blood cells in a sample of blood. See Blood count information.

Womb

The common term for uterus, a muscular organ inside which the baby grows during pregnancy.

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121 Healthcare Ltd have checked all the information for accuracy. The monthly subscription rate is subject to final confirmation from your chosen health care supplier. Whilst 121 Healthcare Ltd endeavour to ensure that the information displayed is accurate, we cannot be held responsible for any inaccuracies or errors. All insurance is subject to acceptance by the health care company concerned.