#1
What does a deductible refer to in health insurance?
The amount of money you pay out of pocket before your insurance coverage kicks in
ExplanationInitial payment by the insured before insurance coverage starts
#2
What is the purpose of a copayment in health insurance?
To share the cost of medical services with the insurance provider
ExplanationSharing medical service costs with the insurer
#3
What does the term 'out-of-pocket maximum' mean in health insurance?
The maximum amount of money you can spend on healthcare expenses in a year
ExplanationMaximum yearly expenditure for healthcare costs
#4
What is the difference between a health insurance premium and a deductible?
A premium is the cost of insurance coverage while a deductible is the amount you must pay out of pocket before coverage starts
ExplanationCoverage cost vs. initial out-of-pocket payment
#5
What is the difference between an HSA and an FSA?
HSAs are portable, while FSAs are not.
ExplanationPortability of savings accounts
#6
What is a Health Maintenance Organization (HMO)?
A network of healthcare providers that offer medical services for a fixed monthly premium
ExplanationProvider network offering fixed premium medical services
#7
What is the difference between coinsurance and copayment?
Coinsurance is a percentage of the medical bill while copayment is a fixed amount
ExplanationPercentage vs. fixed payment for medical expenses
#8
What is the 'grace period' in health insurance?
The period after the due date for premium payment during which the coverage remains active
ExplanationExtension after premium due date maintaining coverage
#9
What is the role of a health insurance broker?
To sell health insurance plans to individuals and businesses
ExplanationSelling insurance plans to individuals and businesses
#10
What is 'prior authorization' in health insurance?
A process where the insurer must approve certain medical services before they are performed.
ExplanationInsurer approval for specific medical services
#11
What is the purpose of a Health Savings Account (HSA)?
To save money for qualified medical expenses with tax advantages
ExplanationTax-advantaged savings for medical costs
#12
What is the Consolidated Omnibus Budget Reconciliation Act (COBRA)?
A federal law that allows individuals to continue their health insurance coverage after leaving their job
ExplanationFederal law enabling continued coverage post-employment
#13
What is the Affordable Care Act (ACA)?
A law that prohibits insurance companies from denying coverage based on pre-existing conditions
ExplanationLegislation preventing coverage denial based on existing conditions
#14
What is the role of a health insurance exchange?
To facilitate the purchase of health insurance plans
ExplanationPlatform for purchasing insurance plans