#1
Which of the following is a characteristic feature of a health insurance policy?
Coverage for routine dental check-ups
Coverage for cosmetic surgeries
Coverage for pre-existing conditions
Coverage for adventure sports injuries
#2
What does the term 'co-payment' refer to in health insurance?
A fixed amount paid by the insured for covered services
The total amount the insurance company pays for a claim
The annual limit on out-of-pocket expenses
The percentage of medical costs covered by insurance
#3
Which of the following services is typically not covered by health insurance?
Emergency room visits
Prescription drugs
Elective cosmetic surgeries
Preventive care services
#4
Which of the following is NOT a factor typically considered in determining health insurance premiums?
Age
Gender
Marital status
Occupation
#5
Which of the following is typically NOT covered by a standard health insurance policy?
Hospitalization
Routine physical exams
Emergency room visits
Elective cosmetic surgery
#6
Which of the following is typically not covered by dental insurance?
Routine check-ups
Emergency dental treatment
Cosmetic dental procedures
Orthodontic treatment
#7
In a health insurance policy, what is 'deductible'?
The portion of covered expenses the insured must pay before the insurance company starts paying
The amount the insurance company pays for each medical service
The limit on the total benefits paid over the policy period
The monthly premium paid by the insured
#8
What is the 'network' in the context of health insurance?
The group of healthcare providers who have agreements with the insurance company
The total number of insured individuals under the policy
The geographic area covered by the insurance policy
The types of medical services covered by the insurance policy
#9
What is the 'grace period' in a health insurance policy?
The time period during which the insured can cancel the policy without penalty
The time period after the premium due date when coverage remains active
The time period during which pre-existing conditions are covered
The time period after a claim is filed for the insurer to process it
#10
Which of the following statements about 'coinsurance' is true?
It is the fixed amount the insured pays for covered services
It is the percentage of covered expenses paid by the insured after meeting the deductible
It is the maximum amount the insured must pay out-of-pocket during a policy period
It is the amount the insured pays to enroll in the insurance plan
#11
What is 'pre-authorization' in health insurance?
The process of verifying eligibility for insurance coverage
The process of obtaining approval from the insurance company before certain medical services
The process of reviewing claims after they have been submitted
The process of selecting a primary care physician
#12
What is 'coordination of benefits' (COB) in health insurance?
The process of coordinating coverage between multiple insurance policies
The process of coordinating medical treatment with insurance companies
The process of coordinating medical care between healthcare providers
The process of coordinating medical expenses with the insured's employer
#13
Which of the following is a feature of a High-Deductible Health Plan (HDHP)?
Lower premiums and higher deductibles
Higher premiums and lower deductibles
No deductible but higher out-of-pocket maximum
No premiums but high copayments
#14
What is 'out-of-pocket maximum' in a health insurance policy?
The maximum amount the insured can pay for covered services in a year
The minimum amount the insured must pay before the insurance company starts covering expenses
The maximum amount the insurance company pays for covered services
The maximum number of visits allowed to healthcare providers in a year
#15
What is 'underwriting' in the context of health insurance?
The process of filing a claim with the insurance company
The process of determining the risk and setting premiums for the policyholder
The process of renewing the insurance policy
The process of selecting healthcare providers within the insurance network
#16
In health insurance, what does 'lifetime maximum' refer to?
The maximum amount the insured must pay out-of-pocket in a year
The maximum amount the insurance company pays for covered services over the insured's lifetime
The maximum number of visits allowed to healthcare providers in a lifetime
The maximum duration of coverage under the policy
#17
What is the purpose of a 'guaranteed renewability' provision in health insurance?
To allow the insured to renew the policy at a fixed premium
To guarantee coverage for pre-existing conditions
To provide coverage for a specific period with no changes
To automatically enroll the insured in the policy each year
#18
In health insurance, what is the purpose of 'catastrophic coverage'?
To provide coverage for routine medical expenses
To provide coverage for major medical expenses after a high deductible is met
To limit coverage for certain high-risk individuals
To provide coverage for alternative medical treatments