#1
What does the term 'deductible' refer to in health insurance?
The amount the insured person pays out of pocket before the insurance coverage begins.
The total cost of medical services covered by insurance.
The premium paid for the insurance policy.
The maximum limit on the insurance coverage.
#2
What is the purpose of a 'copayment' in health insurance?
A fixed amount paid by the insured for covered services, usually at each visit.
The maximum limit on the insurance coverage.
The total cost of medical services covered by insurance.
The percentage of covered medical expenses paid by the insured after meeting the deductible.
#3
What does the term 'pre-existing condition' mean in health insurance?
A medical condition that arises after the purchase of the insurance policy.
A condition that is excluded from coverage due to being present before the policy's effective date.
A type of preventive care covered by insurance.
The period during which the insured can make changes to the policy without penalty.
#4
What is the purpose of 'out-of-pocket maximum' in health insurance?
The maximum limit on the insurance coverage.
The total cost of medical services covered by insurance.
The maximum amount the insured has to pay for covered expenses in a policy period.
A fixed amount paid by the insured for each covered service.
#5
What does 'subrogation' mean in health insurance?
The process of assessing and classifying the risk of insuring an individual or group.
The right of the insurance company to recover costs from a third party responsible for the injury or illness.
The waiting period before certain benefits become effective.
The percentage of covered medical expenses paid by the insured after meeting the deductible.
#6
Which of the following is a common exclusion in health insurance policies?
Emergency room visits
Prescription drugs
Pre-existing conditions
Preventive care
#7
What is the 'coinsurance' provision in a health insurance policy?
The percentage of covered medical expenses paid by the insured after meeting the deductible.
A fixed amount the insured pays for each covered healthcare service.
The maximum out-of-pocket limit on covered expenses.
The premium paid for the insurance policy.
#8
What is the 'in-network' vs. 'out-of-network' distinction in health insurance?
The types of medical conditions covered by the insurance policy.
The distinction between preventive and diagnostic care.
Whether the healthcare provider is within the insurance company's approved list or not.
The duration for which the policy provides coverage.
#9
In health insurance, what does the term 'pre-authorization' mean?
The process of assessing and classifying the risk of insuring an individual or group.
Approval from the insurance company before certain medical services or procedures are performed.
The waiting period before certain benefits become effective.
A fixed amount the insured pays for each covered healthcare service.
#10
What is the purpose of the 'grace period' in health insurance?
The period during which the insured can make changes to the policy without penalty.
The time after the due date during which the premium can be paid without the policy lapsing.
The waiting period before certain benefits become effective.
The period for which the policy provides coverage.
#11
What does the term 'catastrophic coverage' refer to in health insurance?
Coverage for major medical expenses after a high deductible is met.
The process of assessing and classifying the risk of insuring an individual or group.
A type of preventive care covered by insurance.
The percentage of covered medical expenses paid by the insured after meeting the deductible.
#12
What does the term 'underwriting' mean in the context of health insurance?
The process of assessing and classifying the risk of insuring an individual or group.
The process of filing a claim with the insurance company.
The maximum limit on the insurance coverage.
The total cost of medical services covered by insurance.
#13
In health insurance, what does the term 'grace period' refer to?
The period during which the insured can make changes to the policy without penalty.
The time after the due date during which the premium can be paid without the policy lapsing.
The waiting period before certain benefits become effective.
The period for which the policy provides coverage.
#14
What does the term 'explanation of benefits (EOB)' mean in health insurance?
A document that provides details about covered medical expenses.
The process of filing a claim with the insurance company.
The time after the due date during which the premium can be paid without the policy lapsing.
The period during which the insured can make changes to the policy without penalty.
#15
What is the significance of the 'guaranteed renewable' provision in health insurance?
The policy cannot be canceled by the insurer as long as premiums are paid.
The waiting period before certain benefits become effective.
The percentage of covered medical expenses paid by the insured after meeting the deductible.
The maximum limit on the insurance coverage.
#16
What is the 'open enrollment period' in health insurance?
The time during which individuals can enroll in a health insurance plan without a qualifying event.
The period after a claim is filed when the insurance company reviews and approves the claim.
The total cost of medical services covered by insurance.
The maximum limit on the insurance coverage.
#17
In health insurance, what does 'COBRA' stand for?
Consolidated Omnibus Budget Reconciliation Act
Coverage Options for Beneficiaries and Retirees Act
Comprehensive Outpatient Benefits and Reimbursement Agreement
Consumer Options for Benefits and Retirement Assistance