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Health Insurance and Coverage Policies Quiz

#1

Which of the following is NOT a type of health insurance plan?

Flexible Spending Account (FSA)
Explanation

FSA is a tax-advantaged financial account, not a health insurance plan.

#2

What does Medicaid primarily provide coverage for?

Low-income individuals and families
Explanation

Medicaid provides health coverage to low-income individuals and families.

#3

What is the role of a health insurance premium?

To pay for the administrative costs of the insurance company
Explanation

Premiums are payments made by the insured to the insurer to maintain coverage.

#4

Which of the following is NOT typically covered by health insurance?

Cosmetic surgery for aesthetic purposes
Explanation

Most health insurance plans do not cover cosmetic surgery for aesthetic purposes.

#5

Which of the following is true about Medicare?

Medicare is available to individuals of any age who have certain disabilities
Explanation

Medicare is a federal health insurance program for people 65 or older and certain younger people with disabilities.

#6

What is the primary purpose of health insurance?

To provide financial protection against unexpected medical expenses
Explanation

Health insurance aims to protect individuals from the financial burden of unexpected medical costs.

#7

What does COBRA stand for in the context of health insurance?

Consolidated Omnibus Budget Reconciliation Act
Explanation

COBRA allows employees to continue their health insurance coverage after leaving their job.

#8

Which of the following is true about a deductible in health insurance?

It is the amount the insured must pay out-of-pocket before the insurance company pays for covered services.
Explanation

Deductible is the initial amount an individual pays before insurance coverage kicks in.

#9

What is the main purpose of a health insurance claim?

To request reimbursement for medical expenses from the insurance company
Explanation

Claims are requests for payment of covered medical expenses.

#10

What is the purpose of a Health Savings Account (HSA) in the context of health insurance?

To save money for qualified medical expenses tax-free
Explanation

HSAs allow individuals to save for medical expenses tax-free.

#11

What is the 'out-of-pocket maximum' in health insurance?

The maximum amount of money the insured individual has to pay for covered services during a policy period
Explanation

Out-of-pocket maximum is the highest total amount the insured is required to pay for covered services.

#12

Which of the following statements best describes the purpose of a Health Reimbursement Arrangement (HRA)?

To reimburse employees for medical expenses not covered by their health insurance
Explanation

HRAs reimburse employees for certain out-of-pocket medical expenses not covered by insurance.

#13

In health insurance, what does the term 'coinsurance' refer to?

The percentage of covered medical expenses that the insured individual must pay after the deductible is met
Explanation

Coinsurance is the cost-sharing between the insured and the insurer after meeting the deductible.

#14

What is 'prior authorization' in the context of health insurance?

The requirement for insured individuals to obtain approval from the insurance company before certain medical services are provided
Explanation

Prior authorization is the approval required before certain medical services are covered by insurance.

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