#1
Which of the following is a key feature of a health insurance policy?
Guaranteed renewal of policy
ExplanationEnsures policyholders can renew coverage without being denied based on health conditions.
#2
What is a premium in health insurance?
The amount paid by the insured for coverage
ExplanationPayment made by the policyholder to the insurer for health insurance coverage.
#3
Which of the following is not typically covered by a basic health insurance policy?
Cosmetic procedures
ExplanationNon-essential, aesthetic procedures usually excluded from basic coverage.
#4
What does the term 'co-payment' mean in health insurance?
A fixed amount paid by the insured for a covered service
ExplanationSpecified amount paid by the policyholder for each covered healthcare service.
#5
What is the 'out-of-pocket maximum' in health insurance?
The maximum amount the insured is required to pay in a year
ExplanationThe capped limit on the total amount the policyholder has to pay for covered expenses in a policy year.
#6
In health insurance, what does 'deductible' refer to?
The portion of covered expenses the insured must pay before the insurance kicks in
ExplanationInitial amount paid by the policyholder before the insurer starts covering costs.
#7
Which of the following is not a type of health insurance plan?
HSA (Health Savings Account)
ExplanationHSA is a savings account, not a health insurance plan.
#8
What is the purpose of a 'grace period' in health insurance?
To extend coverage after missing a premium payment
ExplanationPeriod during which coverage continues even if premium payment is overdue.
#9
What is the purpose of a 'network' in health insurance?
To provide discounted rates for services
ExplanationA group of healthcare providers offering services at reduced rates to insured individuals.
#10
What is the purpose of 'underwriting' in health insurance?
To evaluate and assess risk for coverage eligibility
ExplanationProcess of evaluating an applicant's health and determining coverage eligibility.
#11
What is the main advantage of a high-deductible health plan (HDHP)?
Lower monthly premiums
ExplanationPolicyholder pays lower monthly premiums in exchange for a higher deductible.
#12
What is 'prior authorization' in health insurance?
A requirement for coverage approval before receiving certain medical services or prescriptions
ExplanationApproval needed before certain medical services or prescriptions are covered.
#13
Which of the following is a characteristic of a Health Maintenance Organization (HMO) plan?
Referrals required for specialist visits
ExplanationIn HMO, referrals needed to see specialists.
#14
What is the purpose of 'catastrophic coverage' in health insurance?
To protect against high medical expenses
ExplanationCoverage designed to protect against high, unexpected medical expenses.