#1
What is the deductible in health insurance?
The amount you pay for covered health care services before your insurance plan starts to pay.
ExplanationInitial amount paid by the insured before insurance coverage begins.
#2
What does the term 'co-payment' refer to in health insurance?
The fixed amount you pay for a covered health care service, usually when you receive the service
ExplanationFixed fee paid by the insured for each covered service.
#3
What is a premium in health insurance?
The amount you pay to have health insurance coverage
ExplanationCost paid regularly for health insurance coverage.
#4
What is a Health Maintenance Organization (HMO) in health insurance?
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO
ExplanationHealth insurance plan limiting coverage to affiliated doctors.
#5
What is the 'out-of-pocket maximum' in health insurance?
The most you have to pay for covered services in a plan year
ExplanationMaximum amount paid by the insured in a plan year.
#6
What is a Preferred Provider Organization (PPO) in health insurance?
A plan that offers more choices of doctors and hospitals
ExplanationHealth insurance plan with broader provider choice.
#7
What is a pre-existing condition in health insurance?
A medical condition that existed before applying for or enrolling in a health insurance plan
ExplanationMedical condition predating insurance enrollment.
#8
What is a Health Savings Account (HSA) in health insurance?
A savings account used in conjunction with a high-deductible health plan (HDHP) that allows you to save money on a pre-tax basis to pay for qualified medical expenses
ExplanationTax-advantaged account for medical expenses.
#9
What is the purpose of a Health Reimbursement Account (HRA) in health insurance?
An employer-funded account that helps employees pay for qualified medical expenses not covered by their health plans
ExplanationEmployer-funded account for medical expenses.
#10
What is the difference between coinsurance and copayment in health insurance?
Copayment is a fixed amount you pay for a covered health care service, usually when you receive the service; coinsurance is the percentage of covered expenses you pay after meeting your deductible
ExplanationFixed fee vs. percentage of covered expenses.
#11
What is the Affordable Care Act (ACA) and how does it impact health insurance?
The ACA is a law that provides tax credits to individuals and families to help them afford health insurance purchased through the Health Insurance Marketplace
ExplanationLegislation providing tax credits for health insurance.
#12
What is a waiting period in health insurance?
The time a policyholder must wait before receiving coverage for pre-existing conditions
ExplanationDuration before coverage for pre-existing conditions.