#1
Which of the following is a key factor considered during health insurance underwriting?
Income level
ExplanationUnderwriting considers income level to assess risk and determine premiums.
#2
What is the purpose of the 'grace period' in health insurance premium payments?
A period to allow the insured to pay premiums after the due date without coverage interruption
ExplanationGrace period permits premium payment after the due date without losing coverage.
#3
What is 'guaranteed issue' in the context of health insurance?
A requirement for all insurance plans to accept every applicant regardless of health status
ExplanationGuaranteed issue mandates insurance acceptance regardless of health status.
#4
What is 'catastrophic health insurance' designed for?
Coverage of major medical expenses after a high deductible is met
ExplanationCatastrophic insurance covers significant medical costs after a high deductible.
#5
What does the term 'pre-existing condition' refer to in health insurance?
An illness or condition that existed before the insurance coverage began
ExplanationPre-existing conditions are medical issues present before obtaining insurance.
#6
What is the purpose of the 'elimination period' in health insurance?
The waiting period before coverage starts for certain conditions
ExplanationElimination period is the waiting time before specific conditions are covered.
#7
In health insurance, what does the term 'deductible' refer to?
The amount the insured pays for covered healthcare services before the insurance plan starts to pay
ExplanationDeductible is the initial amount paid by the insured before insurance coverage kicks in.
#8
What is 'adverse selection' in the context of health insurance?
The tendency of individuals with higher health risks to seek and maintain health insurance coverage
ExplanationAdverse selection is when higher-risk individuals are more likely to seek insurance.
#9
What is the primary purpose of 'underwriting' in health insurance?
To assess and evaluate the risk of insuring a particular individual
ExplanationUnderwriting evaluates the risk associated with insuring individuals.
#10
What is the difference between 'coinsurance' and 'copayment' in health insurance?
Copayment is a percentage of covered expenses, while coinsurance is a fixed amount paid at the time of service
ExplanationCopayment is fixed, coinsurance is a percentage, both are patient cost-sharing.
#11
What is the role of 'co-insurance' in health insurance?
The sharing of medical expenses between the insured and the insurance company
ExplanationCo-insurance involves sharing medical costs between insured individuals and insurers.
#12
Which type of health insurance plan typically offers the most flexibility in choosing healthcare providers?
Preferred Provider Organization (PPO)
ExplanationPPO plans offer flexibility in choosing healthcare providers.
#13
In health insurance terminology, what does 'copayment' mean?
A fixed amount the insured pays for a covered healthcare service, usually at the time of service
ExplanationCopayment is a predetermined cost paid by the insured for covered services.
#14
What is the primary purpose of 'risk pools' in health insurance?
To share the financial risk of high healthcare costs among insurance companies
ExplanationRisk pools distribute the financial burden of high healthcare costs among insurers.
#15
What is 'open enrollment' in health insurance?
A specific time frame when individuals can enroll in or make changes to their health insurance plans
ExplanationOpen enrollment allows individuals to enroll or modify health plans within a set period.
#16
What is 'medical underwriting' in health insurance?
The process of determining the eligibility of individuals for insurance coverage based on medical conditions
ExplanationMedical underwriting evaluates individuals' eligibility based on health conditions.