Health Insurance Glossary P

Permanent Insurance

Coverage that can be continued relatively indefinitely (such as to age 65 for most permanent health insurance policies) as long as the policyholder makes scheduled premium payments and refrains from actions that would invalidate the policy (such as misrepresentations on the application).

Policy

The insurance agreement or contract

Policy Year

The twelve month period beginning with the effective date or renewal date of the policy.

Policyholder

The insured person named on the insurance policy.

Portability

The ability for an individual to transfer from one health insurer to another health insurer with regard to pre-existing conditions or other risk factors.

Pre-Admission Review

A review of an individual's health care status or condition, prior to an individual being admitted to a hospital or inpatient health care facility. Pre-admission reviews are often conducted by case managers or insurance company representatives (usually nurses) in cooperation with the individual, his or her physician or health care provider, and hospitals.

Pre-Admission Testing

Medical tests that are completed for an individual prior to being admitted to a hospital or inpatient health care facility.

Pre-Authorization

Under a pre-authorization provision of a health insurance policy, the insured must contact the health insurance company prior to a hospitalization or surgery, and receive authorization for the service.

Pre-Certification

This is a requirement that a insured person call their health insurance company and advise them a doctor has stated certain medical treatment is required. This is done before receiving treatment from the doctor or hospital. A health insurance policy will normally list the medical conditions that require pre-certification before receiving treatment. When pre-certification is not received, benefits will be reduced or possibly not covered.

Pre-existing Condition

A health problem that existed before the date your insurance became effective. Each health insurance company uses its own particular definitions of pre-existing condition. However, the following statement is in line with most insurance company provisions: "A pre-existing condition is a medical condition that would cause a normally prudent person to seek treatment during the twelve months prior to the beginning of coverage.".

Premium

The amount you or your employer pays in exchange for health insurance coverage.

Preventive Care

An approach to health care which emphasizes preventive measures and health screenings such as routine physicals, well-baby care, immunizations, diagnostic lab and x-ray tests, pap smears, mammograms and other early detection testing. The purpose of offering coverage for preventive care is to diagnose a problem early, when it is less costly to treat, rather than late in the stage of a disease when it is much more expensive, or too late to treat.

Prior authorization

Review of need for health care items or services before services are rendered or products are provided. This refers to a decision made by the health plan to cover or not cover the charges before the services are provided.

Provider

Any person (doctor or nurse) or institution (hospital, clinic, or laboratory) that provides medical care.

Professional Indemnity Insurance

Commonly known as malpractice insurance, is designed to protect healthcare professionals from potential financial losses arising from claims of negligence, malpractice, or errors in their professional services.

Pain behind the knee (posterior pain)

Pain located behind the knee is also known as posterior knee pain, with "posterior" indicating "behind." In addition to pain, swelling may occur, either localized to the back of the knee or extending into the calf. Severe swelling may hinder proper bending of the leg.

Painful periods (dysmenorrhoea)

Painful periods, also known as dysmenorrhea, entail abdominal discomfort during menstruation. While common, the severity varies, with some experiencing mild pain while others endure significant discomfort that interferes with daily activities, necessitating time off work or school. Self-care measures can provide relief, but if pain is severe and significantly impacts quality of life, it is advisable to consult a GP for assistance.

Pancreatitis

Pancreatitis occurs when inflammation affects the pancreas, impairing its function. This condition can manifest suddenly, termed acute pancreatitis, or develop due to sustained damage, known as chronic pancreatitis. Pancreatitis is frequently associated with factors such as gallstones or excessive alcohol consumption.

Panic disorder

Panic disorder is a subtype of anxiety disorder characterised by recurrent, unexpected panic attacks, often accompanied by persistent anxiety about experiencing further attacks. Treatment typically involves a combination of talk therapies and medications to effectively manage symptoms of panic disorder.

Patellar tendinopathy

Patellar tendinopathy is a condition characterised by knee pain, often resulting from overuse or repetitive stress on the patellar tendon, which connects the kneecap (patella) to the shin bone (tibia). This condition is commonly associated with sports activities involving jumping, such as basketball, netball, volleyball, and running.

Patellofemoral pain syndrome

Patellofemoral pain syndrome (PFPS) refers to a knee condition characterized by pain at the front of the knee, which may occur behind or around the kneecap (patella). This condition is believed to result from stress on the joint between the kneecap and the thigh bone (femur).

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection affecting the upper reproductive organs, including the uterus, ovaries, and fallopian tubes. Symptoms of PID commonly include lower abdominal pain, abnormal vaginal discharge, and bleeding between periods or after intercourse.

Peptic ulcers

Peptic ulcers are lesions that can form on the lining of the stomach, small intestine, or esophagus. They typically arise due to damage from stomach acid. Seeking prompt treatment for peptic ulcers can help minimise the risk of complications.

Pericarditis

Pericarditis refers to inflammation of the pericardium, the sac surrounding and safeguarding the heart. The primary symptom is chest pain, often alleviated by sitting up and leaning forward.

Physiotherapy

Physiotherapy, also known as physical therapy, is designed to restore or maintain movement and function within the body. It aids in the recovery from illness and injury, manages long-term health conditions, and can also prevent injury or health issues.

Physiotherapy for lower back pain

Physiotherapy is a therapeutic approach aimed at enhancing the movement and functionality of joints and muscles. It is effective in alleviating lower back pain, restoring normal movement, and decreasing the likelihood of recurrence. Physiotherapists employ various techniques to address lower back pain and provide guidance on back care practices.

Plantar fasciitis (heel pain)

Plantar fasciitis, a prevalent source of heel pain, can require up to 12 months for complete resolution. However, there are several strategies to alleviate pain and aid in the healing of the plantar fascia during this period.

Pneumonia

Pneumonia involves inflammation of lung tissues, typically resulting from an infection. While most individuals recover effectively from pneumonia, it can be a serious condition requiring medical intervention. In severe cases, hospitalisation may be necessary for pneumonia treatment.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a prevalent condition affecting the ovaries, characterised by irregular periods, unwanted facial and body hair, acne, and difficulties conceiving. Treatment for PCOS aims to alleviate symptoms, prevent complications, and enhance fertility.

Posterior cruciate ligament (PCL) injury

A posterior cruciate ligament (PCL) injury involves damage to one of the ligaments within the knee joint. The PCL connects the thigh bone (femur) to the back of the shin bone (tibia). Such an injury can manifest as a partial or complete tear of the ligament, or as ligament stretching.

Postnatal depression

Postnatal depression is a form of depression that affects many individuals after childbirth, leading to profound feelings of sadness. However, receiving appropriate assistance and support can greatly improve your well-being.

Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health condition triggered by experiencing or witnessing a traumatic event. Symptoms may encompass flashbacks and nightmares related to the event. While it's normal to experience negative emotions or thoughts following trauma, persistent symptoms that disrupt daily life could indicate PTSD.

Premenstrual dysphoric disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) represents a severe manifestation of premenstrual syndrome (PMS), characterized by emotional and physical symptoms emerging in the days or weeks before menstruation. Treatments for PMDD encompass talking therapies, prescription medications, and in some cases, surgery.

Prostate cancer

Prostate cancer occurs when cells in the prostate gland grow uncontrollably. It can sometimes grow slowly, but in other cases, it can grow rapidly and spread to other parts of the body, including the bones.

PSA testing for prostate cancer

The PSA test is a blood test used to assess the presence of prostate cancer by measuring the levels of prostate-specific antigen (PSA) in the blood. PSA is produced by both normal and cancerous prostate cells, and elevated levels may indicate cancer. However, the test is not foolproof, and it's essential to weigh the risks and benefits before deciding to undergo PSA testing.

Psoriasis

Psoriasis is a skin condition characterised by raised patches of red, scaly skin known as plaques. Symptoms of psoriasis often fluctuate over time. While there is no cure for psoriasis, various treatments and self-care measures can help manage symptoms effectively.

Psoriatic arthritis

Psoriatic arthritis is a condition characterised by inflammation and pain in the joints, often associated with psoriasis affecting the skin. While there is no cure for psoriatic arthritis, numerous treatments are available to manage the condition effectively, alleviating symptoms and minimising joint damage.

Pulmonary embolism

A pulmonary embolism occurs when a blood vessel in the lungs becomes blocked, posing a serious and potentially life-threatening condition requiring prompt diagnosis and treatment.