In the context of health insurance, the document that evidences coverage under an individual plan is called a

• A. Certificate
• B. Endorsement
• C. Rider
• D. Policy

Answer: (D)

The document that evidences coverage under an individual health insurance plan is the policy. The policy is the actual contract between the insurer and the insured, detailing the covered benefits, exclusions, limits, premiums, and how long the coverage lasts. Endorsements and riders are attachments that modify or add to the policy after it’s issued, so they change terms but aren’t the basic evidence of the coverage itself. A certificate, meanwhile, is typically used to show evidence of coverage for members of a group plan, not for an individual plan. So for an individual plan, the binding document that proves coverage is the policy.