#1
Which of the following is a common type of health insurance plan?
Health Maintenance Organization (HMO)
ExplanationHMO is a common health insurance plan that manages and coordinates healthcare services for its members.
#2
In health insurance terminology, what does the acronym PPO stand for?
Preferred Provider Organization
ExplanationPPO stands for Preferred Provider Organization, a type of health insurance plan with a broad network of providers and no requirement for specialist referrals.
#3
In health insurance terminology, what does the acronym POS stand for?
Point of Service
ExplanationPOS in health insurance stands for Point of Service, indicating a plan that allows flexibility in choosing healthcare providers.
#4
What is the main purpose of a deductible in health insurance?
To reduce the overall cost of insurance
ExplanationThe deductible in health insurance aims to reduce the overall cost of insurance by setting a fixed amount to be paid by the insured before coverage kicks in.
#5
In health insurance, what does the term 'co-payment' refer to?
The portion of medical expenses paid by the insured
ExplanationCo-payment in health insurance refers to the portion of medical expenses that the insured individual is required to pay.
#6
What is the essential difference between a Premium and a Deductible in health insurance?
Premium is the maximum amount you have to pay for covered services, while Deductible is the fixed amount you pay before your insurance kicks in.
ExplanationPremium is the maximum cost for covered services, while Deductible is the fixed amount paid by the insured before insurance coverage begins.
#7
What is the purpose of the Coordination of Benefits (COB) provision in health insurance?
To determine the order of payment when an individual is covered by multiple insurance policies
ExplanationCOB provision in health insurance determines the order of payment when an individual has coverage under multiple insurance policies.
#8
What is the primary function of a Health Maintenance Organization (HMO) in health insurance?
To manage and coordinate healthcare services for its members
ExplanationHMO's primary function in health insurance is to manage and coordinate healthcare services for its members.
#9
What is the 'grace period' in health insurance?
The time allowed for premium payment after the due date without coverage lapse
ExplanationThe grace period in health insurance is the time allowed for premium payment after the due date without coverage lapse.
#10
What is the main advantage of a Health Savings Account (HSA) in health insurance?
Tax advantages for saving money to cover medical expenses
ExplanationThe main advantage of HSA in health insurance is the tax advantages for saving money to cover medical expenses.
#11
What is a Health Savings Account (HSA) commonly used for in the context of health insurance?
Saving for future medical expenses
ExplanationHSA is commonly used for saving money to cover future medical expenses, offering tax advantages for such savings.
#12
Which federal program provides health coverage for individuals aged 65 and older in the United States?
Medicare
ExplanationMedicare is the federal program providing health coverage for individuals aged 65 and older in the United States.
#13
Which of the following is NOT typically covered by a standard health insurance policy?
Cosmetic surgeries
ExplanationCosmetic surgeries are not typically covered by standard health insurance policies.
#14
What is the purpose of the Affordable Care Act's (ACA) individual mandate?
To require individuals to maintain health insurance coverage or pay a penalty
ExplanationThe ACA's individual mandate requires individuals to maintain health insurance coverage or face a penalty.
#15
Which of the following is a characteristic of a High Deductible Health Plan (HDHP)?
Low premiums and high out-of-pocket costs
ExplanationHDHPs are characterized by low premiums and high out-of-pocket costs in health insurance.
#16
What is the primary purpose of the Consolidated Omnibus Budget Reconciliation Act (COBRA) in health insurance?
To protect employees by allowing them to continue health coverage after job loss
ExplanationCOBRA in health insurance protects employees by allowing them to continue health coverage after job loss.
#17
What does the term 'exclusion' mean in the context of health insurance?
Specific conditions or treatments that are not covered by the insurance policy
ExplanationExclusion in health insurance refers to specific conditions or treatments not covered by the insurance policy.