A person who pays premium into the contract for the benefits provided and who also meets eligibility requirements.
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Any person covered under an insurance contract.
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MEDICAL,USA: Individual who is an insured, enrolled participant, member, or enrolled dependent entitled to benefits under a health insurance policy or managed care plan; also referred to as policyholder, subscriber, or employee.
Insurance Encyclopedia
Covered services
1. Specific health care services and supplies for which the insurance plan or federal or state program will provide reimbursement for covered persons under the terms of the plan; these consist of a combination of mandatory and optional services stated in each plan. 2. Services for which supplemental medical insurance (SMI) pays, as defined and limited by statute. Covered services include most physician services, care in outpatient departments of hospitals, diagnostic tests, durable medical equipment, ambulance services, and other health services that are not covered by the hospital insurance program. Also called coverage or covered expenses.
Covered worker
Person who has earnings creditable for Social Security purposes on the basis of services for wages in covered employment and/or on the basis of income from covered self-employment. The number of hospital insurance covered workers is slightly larger than the number of Old Age, Survivors, and Disability Insurance (OASDI)–covered workers because of different coverage status for federal employment.
Coverholder
A person authorised to accept or to issue insurance documents evidencing the acceptance of risks on behalf of Lloyd’s syndicates and other insurers. A coverholder has binding authority. Lloyd’s requires coverholders to comply with prescribed guidelines and undergo a monitoring and review process.