#1
Which of the following is true regarding a deductible in health insurance?
It is the amount the insured pays out-of-pocket before the insurance starts covering costs.
ExplanationAmount paid by insured before coverage.
#2
What does COBRA stand for in health insurance?
Consolidated Omnibus Budget Reconciliation Act
ExplanationLegislation governing continued coverage.
#3
Which federal program provides health coverage for individuals aged 65 and older?
Medicare
ExplanationHealth coverage for seniors.
#4
Which of the following is NOT typically covered under a standard health insurance policy?
Cosmetic surgery
ExplanationNon-covered service: Cosmetic surgery.
#5
Which of the following is NOT a factor typically considered when determining health insurance premiums?
Ethnicity
ExplanationNon-considered factor: Ethnicity.
#6
Which of the following is NOT a type of health insurance plan?
Premium Protection Organization (PPO)
ExplanationNon-existent plan: Premium Protection Organization.
#7
In health insurance, what does 'co-payment' refer to?
The fixed amount paid by the insured for covered services.
ExplanationFixed payment for covered services.
#8
Which type of health insurance plan typically offers the greatest flexibility in choosing healthcare providers?
Preferred Provider Organization (PPO)
ExplanationPlan with broad healthcare provider choice.
#9
What is 'out-of-pocket maximum' in health insurance?
The most the insured will have to pay for covered services in a plan year.
ExplanationMaximum cost for covered services.
#10
What does 'exclusion' mean in health insurance?
Services not covered by the insurance policy.
ExplanationNon-covered services.
#11
What is the purpose of a Health Savings Account (HSA)?
To save money for medical expenses on a tax-free basis.
ExplanationTax-free savings for medical expenses.
#12
What is a 'pre-existing condition' in the context of health insurance?
A medical condition that existed prior to the start of a new health insurance policy.
ExplanationExisting condition before policy start.
#13
What is the 'grace period' in health insurance?
The period after the premium due date during which coverage remains active.
ExplanationPeriod after due date for active coverage.
#14
What is 'coinsurance' in health insurance?
The percentage of costs paid by the insured after reaching the deductible.
ExplanationPercentage of costs after deductible.
#15
Which government agency regulates health insurance plans offered through the Affordable Care Act (ACA) marketplace?
Department of Health and Human Services (HHS)
ExplanationRegulator of ACA marketplace plans.
#16
What is 'prior authorization' in health insurance?
The requirement for insured individuals to seek approval from the insurance company before receiving certain medical services or treatments.
ExplanationApproval requirement for certain services.
#17
What is the purpose of a Flexible Spending Account (FSA) in health insurance?
To allow employees to set aside pre-tax dollars to pay for eligible medical expenses.
ExplanationPre-tax savings for medical expenses.
#18
What is 'reinsurance' in health insurance?
An insurance policy purchased by an insurance company to limit its own risk of excessive loss.
ExplanationInsurance to limit own risk of excessive loss.