HEALTH INSURANCE TEST STUDY GUIDE EXAM QUESTIONS

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HEALTH INSURANCE TEST STUDY GUIDE EXAM QUESTIONS

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -32 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: Life insurance

Answer:

Financial payment to beneficiary in the event of death.Benefit can vary, depending on needs of family and individual.Employers offer life insurance to in the amount of employee's annual salary.Policies can be purchased.

Question 2: Co-pay

Answer:

shared cost...... set amount

Question 3: Affordable Healthcare Act "Obamacare"

Answer:

Lifetime maximum benefit can be overreached.Everyone can get health insurance.Enacted January 1, 2014 Took effect March 31, 2014 Found online at Healthcare exchange.Sliding scale.... how much you make decides how much you pay.Good for low income families.Some plans county specific(medicare, medicaid etc.)

Question 4: Co-insurance

Answer:

Shared percent...... a percent of the total bill.

Question 5: Affordable Healthcare Act Penalties

Answer:

2014: $95 or 1% of your income

2015: $325 or 2% of income

2016: $695 or 2.5% of income

Question 6: Medicaid

Answer:

Health coverage for people with low income or limited resources (programs between federal and state government)

Question 7: EOB (Explanation of Benefits)

Answer:

Statement from the insurance company.What's covered by insurance plan.How much you owe (coinsurance and deductible)

Question 8: Pre-existing condition

Answer:

Insurance companies used to deny coverage for previous health conditions a person had before they purchased the plan (Affordable Healthcare Act prohibits this)

Question 9: Catastrophic

Answer:

Emergency coverage from unexpected medical costs.Limit on regular doctor visits.Lower premium and increased deductible

Question 10: Vision insurance

Answer:

Covers part of all of fees for optician and optometrist services (check ups, glasses, contact lenses, and surgery)

Question 11: Lifetime maximum benefit

Answer:

Highest amount in which the insurance company will pay.

Question 12: Types of Life Insurance

Answer:

Term Life Insurance, and Whole life insurance.

Question 13: Out of pocket maximum

Answer:

Max limit on how much you pay for services after 100% of fees are paid.

Question 14: Premium

Answer:

Amount paid regularly (monthly). High premiums have low deductibles.

Question 15: HDHP (High Deductible Health Plan)

Answer:

Higher deductible, and lower monthly premiums

Question 16: Deductible

Answer:

Money you pay yourself for health services before insurance begins to pay for your costs.

Question 17: Whole Life insurance

Answer:

Policy that allows holder of policy to draw on the insurance as a pension, and hove money go to beneficiary at the time of death.

Question 18: Plans

Answer:

Cover most or all of the cost of health care

Question 19: Dental Insurance

Answer:

Covers part or all of fees for dental services. (Annual checkups, orthodontics, and oral surgery.)

Question 20: Medicare (Part A)

Answer:

Inpatient care in hospitals, nursing facilities, and some home health.

Question 21: Medicare

Answer:

Government funded for 65+, disabilities, and ESRD (end-stage renal disease)

Question 22: POS (Point of Service/ Open ended HMO)

Answer:

HMO/PPO hybrid In network service and out of network is covered Question 23: Medicare: DRG (Diagnosis-related grouping)

Answer:

Reimbursement based on diagnosis

Question 24: Medicare (Part B)

Answer:

Optional coverage

Question 25: PPO (Preferred Provider Organization)

Answer:

Can go out of network (doesn't cover a lot of the expenses) Larger network of providers No PCP required No referral Question 26: Health insurance:

Answer:

Made up of third party payer assumes most health care costs.