Health Insurance Coverage and Policy Features Quiz

Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Exclusive Provider Organization (EPO) are common types.

Cosmetic surgery is generally not covered by health insurance.

Copayment is the fixed amount paid for covered services.

Grace period is the time after a missed payment where coverage remains active.

Pre-existing condition is a health issue before policy inception.

Premium is the cost paid for health insurance coverage.

Deductible sets the minimum amount the insured pays before the insurance coverage starts.

Coinsurance is the percentage of costs paid by the insured after reaching the deductible.

A network is a group of providers offering services at reduced rates.

Out-of-pocket maximum is the yearly limit on the insured's payments.

Ethnicity is not a factor affecting health insurance premiums.

EOB is a statement detailing services and insurance coverage amounts.

HDHPs generally have lower monthly premiums.

HMOs require referrals for specialist visits.

Open enrollment is the period for enrolling outside the usual timeframe.

Lifetime maximum is the max amount for covered services over a person's lifetime.

Reimbursement is the payment by the insurance company for covered services.

Prior authorization ensures coverage for medical services before they are performed.

Coordination of benefits avoids overpayment when covered by multiple insurance plans.

HSA advantages include tax-deductible contributions and tax-free earnings.

Catastrophic insurance covers major expenses after a high deductible is met.

Rescission is the retroactive cancellation of a health insurance policy.

Guaranteed issue mandates policies regardless of health status.

Reviewing medical services to ensure necessity and appropriateness.

COBRA allows continuation of employer-sponsored coverage after leaving a job.