#1
Which of the following is NOT a common type of health insurance plan?
Individual Retirement Account (IRA)
ExplanationIRAs are retirement accounts, not health insurance plans.
#2
Which of the following factors may influence the cost of health insurance premiums?
The insured's age and gender
ExplanationAge and gender can impact premium rates.
#3
Which federal program provides health insurance coverage for individuals aged 65 and older?
Medicare
ExplanationMedicare provides coverage for seniors.
#4
What is the purpose of a health insurance premium?
To share the cost of covered services between the insurance company and the insured
ExplanationPremiums distribute the cost of coverage.
#5
Which of the following statements is true regarding Medicaid?
It provides health coverage to low-income individuals and families.
ExplanationMedicaid offers coverage to low-income groups.
#6
Which of the following is a type of health insurance plan where the insured can choose any healthcare provider and does not need a referral to see a specialist?
Preferred Provider Organization (PPO)
ExplanationPPO plans offer flexibility with provider choice and specialist visits.
#7
Which federal agency oversees the implementation of the Affordable Care Act (ACA) in the United States?
Department of Health and Human Services (HHS)
ExplanationHHS is responsible for ACA implementation.
#8
What is the purpose of a deductible in a health insurance plan?
To share the cost of covered services between the insurance company and the insured
ExplanationDeductibles help distribute the cost burden between insurer and insured.
#9
What is 'co-insurance' in the context of health insurance?
A percentage of covered expenses paid by the insured after the deductible is met
ExplanationCo-insurance involves the insured sharing a portion of costs after meeting the deductible.
#10
What is the main difference between a copayment and coinsurance in health insurance?
Copayment is a fixed amount paid by the insured for covered services, while coinsurance is a percentage of covered expenses paid by the insured after the deductible is met.
ExplanationCopayment is fixed; coinsurance is a percentage of expenses after meeting the deductible.
#11
Which of the following is a characteristic of a High Deductible Health Plan (HDHP)?
Eligibility to contribute to a Health Savings Account (HSA)
ExplanationHDHPs allow contributions to HSAs.
#12
What is the purpose of a network in a health insurance plan?
To connect insured individuals with healthcare providers who have agreed to provide services at discounted rates
ExplanationNetworks link insured with providers offering discounted services.
#13
Which of the following is true about the Affordable Care Act (ACA) in the United States?
It aims to increase access to affordable health insurance and reduce the uninsured rate.
ExplanationACA targets increased access and reduced uninsured rates.
#14
What is a Health Reimbursement Arrangement (HRA) in the context of health insurance?
A tax-advantaged account funded by an employer to reimburse employees for qualified medical expenses
ExplanationHRAs reimburse employees for medical expenses via employer-funded accounts.
#15
What is the purpose of a Health Savings Account (HSA)?
To save money for qualified medical expenses
ExplanationHSAs are designed for saving funds for medical costs.
#16
What is the purpose of a pre-existing condition clause in health insurance policies?
To limit coverage for conditions that existed before the policy was purchased
ExplanationPre-existing condition clauses restrict coverage for existing health issues.
#17
What is the purpose of a prior authorization requirement in health insurance?
To limit access to certain medical services or treatments
ExplanationPrior authorization restricts access to specific medical services.