#1
What does 'HMO' stand for in health insurance?
Health Maintenance Organization
ExplanationHealthcare organization that provides managed care services
#2
Which of the following is not typically covered by health insurance?
Cosmetic surgery
ExplanationConsidered elective and not medically necessary
#3
What is 'Medicaid'?
A health insurance program for low-income individuals and families
ExplanationGovernment program providing healthcare coverage to eligible individuals
#4
What is 'Medicare'?
A health insurance program for elderly individuals
ExplanationFederal health insurance program for people 65 and older
#5
What is 'premium' in health insurance?
The amount you pay for health insurance coverage
ExplanationCost of insurance coverage, often paid monthly
#6
What is 'essential health benefits'?
Services that health insurance plans must cover under the Affordable Care Act
ExplanationMandated services to ensure comprehensive coverage
#7
What is a 'co-pay' in health insurance?
A fixed amount you pay for medical services at the time of treatment
ExplanationDesigned to share costs between the insurer and insured
#8
What is the purpose of a 'deductible' in health insurance?
To establish the minimum amount you must pay before insurance kicks in
ExplanationEncourages cost-sharing and reduces frivolous healthcare use
#9
What is the 'out-of-pocket maximum' in health insurance?
The maximum amount you pay for covered services in a plan year
ExplanationProtects individuals from catastrophic healthcare expenses
#10
What is the 'network' in health insurance?
The geographic area where your insurance coverage is valid
ExplanationDefines where you can receive covered healthcare services
#11
What is 'prior authorization' in health insurance?
A requirement to get approval from your insurance company before receiving certain services or treatments
ExplanationEnsures services are medically necessary before payment
#12
What is the 'open enrollment period' in health insurance?
The period during which individuals can switch health insurance plans
ExplanationAllows for changes to insurance coverage once per year
#13
What is 'coinsurance' in health insurance?
The amount you pay for covered health care services after you've paid your deductible
ExplanationEncourages responsible use of healthcare services
#14
What is 'catastrophic health insurance'?
Insurance with high deductibles and low premiums, mainly covering serious illnesses or injuries
ExplanationDesigned for protection against major health expenses
#15
What is 'medical underwriting' in health insurance?
The process of reviewing an applicant's medical history and deciding whether to offer coverage
ExplanationAssesses risk and determines coverage eligibility
#16
What is 'COBRA' in health insurance?
A provision allowing employees to continue their health insurance coverage after leaving their job
ExplanationHelps maintain health coverage during job transitions
#17
What is 'pre-existing condition' in health insurance?
A medical condition that exists before applying for health insurance coverage
ExplanationCan affect eligibility and cost of health insurance
#18
What is 'healthcare exchange'?
A system where people can compare and purchase health insurance plans
ExplanationMarketplace for buying health insurance