#1
What is the primary purpose of health insurance?
To cover medical expenses and protect against high costs
ExplanationProvides financial coverage for medical costs and safeguards against excessive expenses.
#2
Which government program provides health insurance coverage primarily for people aged 65 and older?
Medicare
ExplanationGovernment program offering health coverage targeted at individuals aged 65 and above.
#3
Which of the following is NOT typically covered by standard health insurance plans?
Cosmetic surgery
ExplanationMedical procedure not commonly covered by standard health insurance plans.
#4
What is the purpose of a health insurance deductible?
To specify the maximum amount the insured must pay before coverage begins
ExplanationDeductible sets the maximum amount the insured pays before insurance coverage starts.
#5
Which of the following is a type of managed care plan that combines features of HMOs and PPOs?
Medicare Advantage
ExplanationManaged care plan blending features of HMOs and PPOs.
#6
What is the name of the federal health insurance program for low-income individuals and families?
Medicaid
ExplanationFederal program providing health insurance for low-income individuals and families.
#7
Which part of Medicare covers hospital stays and inpatient care?
Part A
ExplanationMedicare section addressing hospital stays and inpatient medical care.
#8
What is the purpose of the 'Medigap' policy in Medicare?
To cover expenses not paid by original Medicare
ExplanationPolicy designed to fill gaps in coverage left by original Medicare.
#9
What does COBRA stand for in the context of health insurance?
Consolidated Omnibus Budget Reconciliation Act
ExplanationFederal law allowing individuals to maintain health coverage after job loss.
#10
What does the term 'out-of-pocket maximum' refer to in health insurance?
The maximum amount the insured must pay for covered services in a year
ExplanationMaximum amount an insured person pays for covered services in a year.
#11
What is the 'donut hole' in Medicare Part D coverage?
A gap in prescription drug coverage
ExplanationA period where Medicare Part D doesn't cover prescription drug costs fully.
#12
Which of the following is NOT a factor that influences health insurance premiums?
Ethnicity
ExplanationEthnicity is not a determinant of health insurance premium rates.
#13
What is the difference between HMO and PPO health insurance plans?
HMO plans typically have lower out-of-pocket costs
ExplanationHMO plans generally offer lower out-of-pocket expenses compared to PPO plans.
#14
In the context of health insurance, what does 'network' refer to?
A group of doctors, hospitals, and other healthcare providers that have agreements with an insurance company
ExplanationCollaboration of healthcare providers with agreements with an insurance company.
#15
What is the purpose of a Health Reimbursement Arrangement (HRA)?
To reimburse employees for eligible medical expenses
ExplanationHRA reimburses employees for qualified medical expenses.