#1
What is a deductible in health insurance?
The amount you pay for covered health care services before your insurance plan starts to pay
ExplanationUpfront payment for healthcare services before insurance coverage kicks in
#2
What does the term 'co-payment' mean in health insurance?
A fixed amount you pay for a covered health care service, usually when you receive the service
ExplanationFixed payment for covered healthcare service at the time of service
#3
What is the purpose of coinsurance in health insurance?
To share the costs of covered health care services between you and your insurance company
ExplanationCost-sharing arrangement between the insured and the insurance company
#4
What is an exclusion in health insurance policy terms?
Specific conditions or circumstances for which the insurance policy will not provide coverage
ExplanationConditions not covered by the insurance policy
#5
What is the difference between an insurance premium and a deductible?
The amount you pay for covered health care services before your insurance plan starts to pay
ExplanationUpfront payment vs. ongoing payment for healthcare services
#6
What is a pre-existing condition in health insurance?
A health condition that existed before the effective date of an insurance policy
ExplanationHealth condition predating insurance policy
#7
What is the role of a health insurance broker?
To help individuals and businesses find suitable health insurance coverage from different insurers
ExplanationAssisting in finding suitable insurance coverage
#8
What is the purpose of a grace period in health insurance?
A specified period during which coverage continues even if the premium is not paid
ExplanationCoverage continuation despite unpaid premium for a set period
#9
What is a health insurance network?
A group of healthcare providers, including doctors and hospitals, that have contracted with an insurance company
ExplanationProvider group contracted with an insurance company
#10
What is an HMO (Health Maintenance Organization) in health insurance?
A type of health insurance plan that offers a network of doctors, hospitals, and other providers
ExplanationInsurance plan with a network of healthcare providers
#11
What is the purpose of a health savings account (HSA) in relation to health insurance?
A tax-advantaged savings account that can be used to pay for qualified medical expenses
ExplanationTax-advantaged account for medical expenses
#12
What is the difference between an in-network and out-of-network provider in health insurance?
A health care provider who has not contracted with the insurance company
ExplanationProvider not in agreement with the insurance company
#13
What is a waiting period in health insurance?
A specified period during which coverage for certain conditions is not provided
ExplanationPeriod without coverage for specific conditions
#14
What does the term 'out-of-pocket maximum' mean in health insurance?
The maximum amount of money you can spend on covered services in a policy period
ExplanationMaximum expenditure on covered services in a policy period
#15
What is the significance of a health insurance formulary?
A list of prescription drugs covered by a specific health insurance plan
ExplanationList of covered prescription drugs by an insurance plan
#16
In health insurance, what is a 'rider'?
An optional add-on to an insurance policy that provides additional coverage for specific conditions or treatments
ExplanationOptional additional coverage for specific conditions or treatments