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Healthcare Insurance Coverage and Administration Quiz

#1

Which of the following is NOT a type of healthcare insurance plan?

EKG
Explanation

EKG is a medical test, not an insurance plan.

#2

What does COBRA stand for in the context of healthcare insurance?

Consolidated Omnibus Budget Reconciliation Act
Explanation

COBRA refers to the legislation allowing individuals to continue health coverage after job loss.

#3

Which of the following is an example of a managed care organization?

Kaiser Permanente
Explanation

Kaiser Permanente is a well-known managed care organization.

#4

Which federal agency oversees the implementation and enforcement of the Affordable Care Act (ACA)?

Department of Health and Human Services (HHS)
Explanation

HHS is responsible for overseeing the ACA.

#5

Which of the following is NOT a factor typically considered in determining health insurance premiums?

Marital status
Explanation

Marital status is not typically a factor in health insurance premium calculations.

#6

Which of the following statements about Medicare is true?

It primarily provides coverage for hospital stays and medical services for people aged 65 and older.
Explanation

Medicare focuses on healthcare coverage for seniors.

#7

What is the purpose of a Health Savings Account (HSA)?

To allow individuals to save for qualified medical expenses on a tax-free basis
Explanation

HSAs enable tax-free savings for medical expenses.

#8

What is the purpose of pre-authorization in healthcare insurance?

To obtain approval from the insurance company before receiving certain medical services
Explanation

Pre-authorization is seeking approval for specific medical services.

#9

What does the term 'out-of-pocket maximum' refer to in healthcare insurance?

The maximum amount an insured individual is required to pay for covered medical expenses during a policy period
Explanation

Out-of-pocket maximum is the limit on personal expenditure for covered medical expenses.

#10

What is a Health Maintenance Organization (HMO)?

A type of healthcare insurance plan that requires members to choose a primary care physician and obtain referrals to see specialists
Explanation

HMOs emphasize primary care and specialist referrals.

#11

Which of the following is a characteristic of a High Deductible Health Plan (HDHP)?

It requires higher deductibles and out-of-pocket expenses but typically has lower premiums.
Explanation

HDHPs have higher costs at the point of service but lower premiums.

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