The maximum amount you pay out-of-pocket for covered services in a policy period
The amount you pay for covered healthcare services before your insurance plan starts to pay
The percentage of costs of a covered healthcare service you pay after you've paid your deductible
The monthly fee you pay to have health insurance coverage
#2
Which of the following is not typically covered by health insurance?
Preventive care services
Prescription drugs
Cosmetic surgery
Emergency room visits
#3
What is the purpose of a health insurance premium?
To pay for covered healthcare services
To cover the administrative costs of the insurance company
To provide financial assistance for low-income individuals
To transfer risk from an individual to the insurance company
#4
Which federal program provides health insurance for people age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease?
Medicaid
CHIP
Medicare
Tricare
#5
What is a health insurance network?
A group of healthcare providers who have agreed to provide services to insured individuals at reduced rates
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO
A government-funded healthcare plan for low-income individuals and families
A tax-advantaged savings account available to individuals enrolled in high-deductible health plans
#6
What is a copayment (copay) in health insurance?
A fixed amount you pay for a covered healthcare service, usually when you receive the service
The percentage of costs of a covered healthcare service you pay after you've paid your deductible
The maximum amount you pay out-of-pocket for covered services in a policy period
The monthly fee you pay to have health insurance coverage
#7
What does COBRA stand for in health insurance?
Consolidated Omnibus Budget Reconciliation Act
Continuation of Benefits Rights and Assistance
Consolidated Options for Benefit Rights and Assistance
Comprehensive Option for Benefit Reconciliation Agreement
#8
What is a Health Savings Account (HSA) in relation to health insurance?
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO
A tax-advantaged savings account available to individuals enrolled in high-deductible health plans
A government-funded healthcare plan for low-income individuals and families
A plan that contracts with health care professionals and facilities to provide care at reduced rates
#9
What is the purpose of a pre-existing condition clause in health insurance policies?
To limit the amount of coverage provided for certain medical conditions
To deny coverage for any medical condition that existed before the policy's effective date
To ensure coverage for all medical conditions regardless of when they occurred
To determine eligibility for government-funded healthcare programs
#10
What is the role of a health insurance broker?
To provide medical care to insured individuals
To sell health insurance policies directly to consumers
To help individuals and businesses find suitable health insurance plans
To regulate the health insurance industry
#11
What is a Health Maintenance Organization (HMO) in health insurance?
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO
A plan that contracts with health care professionals and facilities to provide care at reduced rates
A health insurance plan that offers more flexibility in choosing healthcare providers
A government-funded healthcare plan for low-income individuals and families
#12
What is the difference between an HMO and a PPO in health insurance?
HMOs typically require referrals to see specialists, while PPOs allow patients to see specialists without referrals
HMOs have higher out-of-pocket costs compared to PPOs
PPOs usually limit coverage to care from in-network providers, while HMOs offer more flexibility in choosing healthcare providers
There is no difference between HMOs and PPOs
#13
What is a health insurance formulary?
A list of covered healthcare services
A document outlining the terms and conditions of a health insurance policy
A list of prescription drugs covered by a health insurance plan
A form used to enroll in a health insurance plan
#14
What is a Health Flexible Spending Account (FSA) in relation to health insurance?
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO
A tax-advantaged savings account available to individuals enrolled in high-deductible health plans
A plan that contracts with health care professionals and facilities to provide care at reduced rates
An account that allows employees to set aside pre-tax dollars to pay for eligible healthcare expenses
#15
What is a COBRA continuation coverage?
A government-funded healthcare plan for low-income individuals and families
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO
Temporary continuation of health coverage for certain people after employment ends
A tax-advantaged savings account available to individuals enrolled in high-deductible health plans