Which of the following is not a type of healthcare insurance plan?
HMO
PPO
EPO
POS
#2
Which government program provides health coverage for eligible individuals who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease?
Medicaid
CHIP
Medicare
TRICARE
#3
What is the purpose of a copayment in health insurance?
To cover the entire cost of a healthcare service
To share the cost of a healthcare service between the insurance company and the insured individual
To reimburse the insured individual for medical expenses
To provide financial assistance for prescription drugs
#4
What does the term 'premium' refer to in health insurance?
The amount an insured individual pays out of pocket for healthcare services
The fixed amount an individual pays each month for health insurance coverage
The percentage of covered healthcare costs an individual pays after meeting the deductible
The maximum amount an insured individual pays for covered services in a plan year
#5
Which of the following is not a factor typically considered when determining health insurance premiums?
Age
Gender
Occupation
Blood type
#6
What does COBRA stand for in the context of healthcare insurance?
Consolidated Omnibus Budget Reconciliation Act
Continuation of Benefits and Regulations Act
Comprehensive Options for Beneficiary Reimbursement Act
Coverage and Benefits Regulation Agreement
#7
Which of the following is true about a deductible in health insurance?
It's the maximum amount you pay for covered healthcare services each year
It's the fixed amount you pay for a covered healthcare service, usually when you receive the service
It's the minimum amount you must pay for covered healthcare services before the insurance starts paying
It's the percentage of costs of a covered healthcare service you pay, after you've paid your deductible
#8
What does the term 'network' refer to in health insurance?
The group of healthcare providers contracted to provide services to plan members
The process of connecting healthcare databases for information exchange
The software used by insurance companies to manage claims
The list of medications covered by the insurance plan
#9
What is the main difference between an HMO and a PPO?
HMOs typically require members to select a primary care physician and get referrals for specialists, while PPOs do not.
PPOs have a higher monthly premium compared to HMOs.
HMOs have a larger network of healthcare providers compared to PPOs.
PPOs have lower out-of-pocket costs for members compared to HMOs.
#10
What is the purpose of a formulary in health insurance?
To outline the coverage limits of the insurance plan
To determine the premium amount for the insurance plan
To provide a list of covered prescription drugs and their tier placement
To specify the process for filing a claim with the insurance company
#11
In health insurance, what does the term 'out-of-pocket maximum' refer to?
The highest amount of money you have to pay for covered services in a plan year
The maximum number of times you can visit a doctor within a plan year
The additional costs you pay for services not covered by insurance
The monthly premium you pay for the insurance plan
#12
What does the term 'pre-existing condition' mean in the context of health insurance?
A medical condition that arises after purchasing a health insurance plan
A medical condition that existed before applying for or enrolling in a health insurance plan
A condition that only affects individuals under the age of 18
A condition that is not covered by any health insurance plan
#13
What is the primary purpose of health insurance exchanges?
To provide healthcare services directly to patients
To regulate the pharmaceutical industry
To facilitate the purchase of health insurance plans
To conduct medical research
#14
What does the term 'in-network provider' mean in health insurance?
A healthcare provider who is not covered by the insurance plan
A healthcare provider who accepts the insurance plan's negotiated rates
A healthcare provider who only accepts cash payments
A healthcare provider who specializes in a specific medical condition
#15
What is the purpose of Medicaid in the United States?
To provide health coverage to individuals aged 65 and older
To provide health coverage to low-income individuals and families
To provide health coverage to military personnel and their families
To provide health coverage to individuals with pre-existing conditions