Health Insurance Basics

What is the monthly cost of your insurance called?

• co-pay

• deductible

• premium

• co-insurance

What is a fixed amount you pay for a service, such as $25 for office visits?

• co-insurance

• co-pay

• premium

• claim

The amount you must pay before your health insurance begins to pay is called

• deductible

• premium

• owed amount

• co-insurance

What is a co-payment (co-pay)?

• 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

What is a provider?

• federal program that provides insurance for the elderly

• a health professional, such as a doctor or specialist, who provides services

• treatment of conditions not covered by the insurance company

• comprehensive health benefit program

What does HMO stand for?

• Health Maintenance Organization

• Health Managed Organization

• Health Maintained Operation

• Health Managed Operation

A 30 year old woman broke her arm and went to the ER for treatment. Her health insurance plan has a $1,500 deductible. What does this mean?

• She can deduct $1,500 from the hospital bill, but must pay the rest.

• The hospital will only charge her $1,500.

• She is responsible for paying, $1,500 of her medical expenses before her insurance starts to pay.

• Her insurance company will only pay $1,500 and she must pay the rest.

What does PPO stand for?

• Preferred Plan Operation

• Preferred Provider Organization

• Preferred Practice Organization

• Preferred Participation Operation

What is the definition of out-of-pocket maximum?

• The amount of money your pockets can hold.

• The deductible you have to pay for insurance.

• The maximum amount you can pay out of pocket before insurance pays the rest.

• The amount of money you pay to your insurance company every month.

Valerie had to go to the doctor 3 times with the co-payments being $25 each time she went. Her premium is $200/month. What was her medical bill for the month?

• $275

• $200

• $25

• $225