Health · Chapter 13 · Covered Losses
The Five Covered Loss Categories
Definition
Health insurance addresses at least five distinct loss categories: (1) Medical expense — reimbursement for hospital, surgical, physician, and outpatient costs; (2) Disability — income replacement for wages lost to a disabling disease or injury; (3) Dental expense — diagnostic, preventive, and accident-necessitated care; (4) Accidental injury — benefits for accidents, including AD&D; (5) Long-term care — care for those who've lost the ability to complete daily tasks.
In plain English
Match the product to the loss: bills → medical expense · paycheck → disability · teeth → dental · accident → AD&D · daily living → LTC.
Exam tip
Disability plans cap benefits at 60%–70% of gross earnings (individually funded benefits are income-tax-free) and use an elimination (waiting) period that acts as a "time-deductible." LTC covers organic causes only — dementia, Alzheimer's, Parkinson's — NOT psychological conditions like anxiety or depression.
Related terms