Insurance Basics

For people with employer based insurance, ___ is the amount of money taken out of each paycheck for insurance coverage.

• coinsurance

• copay

• premium

• deductible

A patient has met the initial required amount and the insurance begins to cover their claims. The insurer will only cover a specific percentage of the expense. What is the remaining amount the patient must pay, such as 20%, called?

• out of pocket maximum

• coinsurance

• copay

• deductible

What do you call the time period when the patient is paying premiums for coverage but the insurance has not yet started to pay.

• allowed amount

• EOB

• claim

• deductible

Before leaving a primary care office, a patient may be responsible for a specific flat amount of money known as a ___.

• copay

• coinsurance

• deductible

• premium

Amount you must pay towards any insurance claims before you begin receiving any payment from your insurance company_.

• out of pocket maximum

• premium

• claim

• deductible

The likelihood that you will cost the insurance company money is

• risk

• benefit

• insurance

• allowed charge

The higher the deductible the lower the premium, if all the other parts of the insurance policy are the same.

• This statement is correct

• The statement is not correct

The amount a beneficiary pays for an insurance policy itself is the

• allowed amount

• premium

• deductible

• provider charge

Insurance companies create contracts with certain health care providers to provide care to those beneficiaries. What do you call this group of health care providers?

• network

• system

• members

Maggie will need to pay $120 per month in order to purchase a health insurance policy. This monthly payment is known as the:

• deductible

• co‐insurance

• premium

• allowed amount