#1
What is a deductible in health insurance?
The amount the policyholder must pay before the insurance coverage kicks in
ExplanationInitial out-of-pocket cost borne by the insured.
#2
What is the Affordable Care Act (ACA) also known as?
Obamacare
ExplanationLegislation expanding healthcare access.
#3
What is the purpose of a Health Maintenance Organization (HMO) in health insurance?
To focus on preventive care and manage overall health
ExplanationEmphasis on preventive healthcare services.
#4
What is a Health Maintenance Organization (HMO) in health insurance?
A network of healthcare providers that coordinate and provide care
ExplanationCollaborative provider network for coordinated care.
#5
What is the purpose of a Health Savings Account (HSA) commonly used for in the context of health insurance?
To pay for eligible medical expenses with pre-tax dollars
ExplanationTax-advantaged account for medical expenses.
#6
In health insurance, what does 'co-payment' refer to?
A fixed amount the insured pays for a covered healthcare service
ExplanationSet fee paid by the insured for specific services.
#7
What is the 'coinsurance' in health insurance?
The percentage of costs of a covered healthcare service the insured must pay
ExplanationShared cost percentage between the insured and the insurer.
#8
What does the term 'out-of-pocket maximum' mean in health insurance?
The maximum amount the insured has to pay for covered services in a policy year
ExplanationLimit on total annual personal expenses.
#9
What is 'guaranteed issue' in health insurance?
The requirement for insurers to offer coverage regardless of health status
ExplanationMandatory coverage availability for all applicants.
#10
In health insurance, what is 'essential health benefits'?
Basic health services that must be covered by insurers
ExplanationFundamental services included in insurance plans.
#11
What is 'medically underwritten' health insurance?
Policies issued based on the applicant's medical history
ExplanationInsurance based on individual health assessment.
#12
What is the purpose of a Health Reimbursement Account (HRA) in health insurance?
To reimburse employees for qualified medical expenses
ExplanationEmployee medical expense reimbursement mechanism.
#13
What is a Health Savings Account (HSA) commonly used for in the context of health insurance?
To pay for eligible medical expenses with pre-tax dollars
ExplanationTax-advantaged account for medical expenses.
#14
What is 'underwriting' in health insurance?
The process of determining the risk of insuring a particular individual
ExplanationEvaluation process to assess insurance risk.
#15
What does 'COBRA' stand for in the context of health insurance?
Consolidated Omnibus Budget Reconciliation Act
ExplanationLegislation enabling continued coverage.
#16
What is 'adverse selection' in health insurance?
The tendency for individuals with higher health risks to seek insurance
ExplanationImbalance in insurance risk pool.
#17
What does 'catastrophic health insurance' typically cover?
Major medical expenses after a high deductible is met
ExplanationProtection for significant healthcare costs.
#18
What is the purpose of the Health Insurance Marketplace created by the ACA?
To help individuals and families find affordable health insurance
ExplanationPlatform for accessible insurance options.
#19
What is 'catastrophic health insurance' designed for?
Coverage for major medical expenses after a high deductible is met
ExplanationInsurance for significant healthcare costs post-deductible.
#20
What is the role of a Health Insurance Marketplace (Exchange) in the United States?
To provide information and facilitate the purchase of insurance plans
ExplanationFacilitates information and plan purchases.