Health Insurance Basics

You have reached your deductible of $2000, but you have not reached your maximum out-of-pocket limit of $4000 and your co-insurance begins. Your co-insurance is 20%. How much do you have to pay if you go to the doctor and the visit is $150?

• $150
• $30
• $120
• $0

You have reached your $5000 out-of-pocket limit. You need to go to the emergency room and it cost $1700. How much will your insurance pay?

• $1700
• $0
• $1360

a fixed amount you pay for a service

• co-insurance
• co-pay
• premium
• claim

cost of your insurance that you pay each month

• co-pay
• deductible
• premium
• co-insurance

The amount you owe before your health insurance begins to reimburse a claim.

• deductible
• premium
• owed amount

Insured

• The policy holder or subscriber
• Fee paid for the health insurance
• A person designated to receive the benefits of an insurance policy
• The insurance company

Co-payment

• Coordination of benefits
• Portion of the cost of service to be paid by the insured (a set dollar amount)
• Term of conditions not covered by the insurance company
• Provider bill for service

Health insurance policy

• Insurance which covers your health, teeth and eyes
• A law which allows you insurance even if you lose your job
• A contract between you and an insurance company
• A policy you purchase only for children

Provider

• Federal program that provides insurance for the elderly
• A health professional who provides services
• Treatment of conditions not covered by the insurance company
• Comprehensive health benefit program

Group Insurance

• Insurance coverage offered to employees by the employer
• Insurance policy an individual must purchase on their own
• Insurance offered by the government
• Insurance offered to a special group of people