Health Insurance Glossary E

Effective Date

The date health insurance coverage begins.

Eligible Dependent

A dependent of a covered person (spouse, child, or other dependent) who meets all requirements specified in the contract to qualify for coverage and for who premium payment is made.

Eligible Expenses

The lower of the reasonable and customary charges or the agreed upon health services fee for health services and supplies covered under a health plan.

Employee Assistance Programs (EAPs)

Mental health counseling services that are sometimes offered by insurance companies or employers. Typically, individuals or employers do not have to directly pay for services provided through an employee assistance program.

Endorsement

A document that is attached to a slip, cover note or policy which evidences one or more changes in the terms of the insurance or reinsurance contract to which it refers.

Enrollee

The person who is the primary insured. Under an individual or family policy, this person is the applicant. Under an employer-sponsored group health policy, this person is the employee.

Episode of Care

The health care services given during a certain period of time, usually during a hospital stay.

Evidence of Insurability

Proof of physical condition. This may be provided through physician records or by the results of an examination.

Excess

The amount or proportion of some or all losses arising under an insurance or reinsurance contract that is the insured or reassured must bear. If the loss is less than the amount of the excess then the insured/reassured must meet the cost of it (unless there is other insurance in place to cover the excess).

Exclusion

A term in an insurance or reinsurance contract that excludes the insurer or reinsurer from liability for specified types of loss. An exclusion may apply throughout a policy or it may be limited to specific sections of it. In certain circumstances an exclusion may be limited or removed altogether following the payment of an additional premium.

Exclusions and Limitations

Medical services that are either not covered or limited in benefit by a health insurance insurance policy.

Exclusion Period

A period of time when an insurance company can delay coverage of a pre-existing condition. Sometimes this is called a pre-existing condition waiting period.

Ear infection in children

A middle ear infection, also known as otitis media, occurs when a child's ear becomes infected, swollen, and painful due to fluid trapped behind the eardrum. These infections are common in children, with over four out of five experiencing them before age two. While adults can also get middle ear infections, antibiotics are typically not necessary for treatment.

Eating disorders

An eating disorder is a mental health condition that influences eating habits, often significantly impacting one's life. Individuals with an eating disorder may experience distressing thoughts or emotions, leading them to control their eating or weight as a coping mechanism. The positive news is that eating disorders can be effectively treated.

Echocardiogram

An echocardiogram is a diagnostic test that examines the structure and function of the heart. It utilises sound waves (ultrasound) to generate moving images. This test can identify issues such as heart muscle injury or heart valve disease, and it can also track the heart's performance over time.

Ectopic pregnancy

An ectopic pregnancy occurs when a fertilised egg implants outside the uterus lining. Sadly, the fertilised egg cannot survive in this location, and it's not feasible to save the pregnancy.

Effects of smoking

Smoking stands as the leading cause of preventable illness in the UK. Annually, nearly 78,000 individuals in the UK lose their lives due to smoking-related reasons, with many others enduring poor health consequences as a result of smoking.

Electrocardiogram (ECG)

An electrocardiogram (ECG) is a diagnostic test that records the heart's rhythm and electrical activity. It aids in detecting any potential issues with the heart's function.

Endometrial ablation

Endometrial ablation, also known as womb ablation, is a surgical procedure aimed at treating heavy menstrual bleeding (menorrhagia). During the procedure, a significant portion of the lining of the uterus is either destroyed or removed. This can result in a cessation of periods altogether or a reduction in their intensity.

Endometriosis

Endometriosis is a condition characterised by the presence of cells resembling those typically found in the uterine lining (endometrium) appearing in other areas of the body, commonly in the pelvis. During menstruation, these cells can accumulate and shed similar to the uterine lining, leading to painful inflammation in surrounding tissues.

Epidural injections

Epidural steroid injections are a treatment option to alleviate pain in the back or legs caused by sciatica. This procedure typically involves receiving an injection in the back during a minor hospital procedure.

Epidurals for surgery and pain relief

An epidural involves injecting medication into the back to block sensation in the lower half of the body, commonly used during surgery alongside a general anaesthetic. It's also utilised for pain management during and after medical procedures or operations.