Source checked November 12, 2026. Editorial team. Not professionally reviewed.
Premium and deductible
Premium is the cost of the policy. A deductible is an amount described by the policy that affects what the owner pays before reimbursement. Ask how the deductible applies, which costs count and when it resets. These short explanations do not replace the definitions in the policy or applicable law.
Reimbursement and benefit schedule
Reimbursement is a payment under the policy for eligible costs. NAIC explains that some companies use a benefit schedule while others reimburse a percentage of an amount spent. Ask which method your document uses and how it treats exclusions, deductibles and limits.
Exclusion and waiting period
An exclusion is something the policy does not cover under its terms. A waiting period is a period before specified benefits begin. Neither can be understood from the name alone. Read the definitions, scope and exceptions in the actual document, then ask the insurer about unclear wording.
Unknown and optional
Unknown means the answer has not been established in your document-reading process. It is neither a positive coverage decision nor a denial. Optional means a feature may require a separate choice and cost; check the actual quote. These are the labels used by our original policy desk, not regulatory classifications.