Medical Insurance 2023

Emma visits her doctor's office and pays a flat fee of $15 for the consultation. What is this fee called?

• Deductible

• Out of pocket maximum

• Co-pay

• Co-insurance

Scarlett is reviewing her insurance plan and wants to know what the term is for the amount of money that she or her employer pays to the insurance company every month or year as part of the insurance plan?

• Deductible

• Premium

• Out of pocket maximum

• Co-insurance

Emma is reviewing her health insurance plan and wants to know what the term is for the amount of money she must pay before her insurance benefits kick in and co-insurance starts. What is this term?

• Deductible

• Co-pay

• Out of pocket maximum

• Co-insurance

Oliver has an insurance plan where after he pays the deductible, the insurance covers 80% of his medical expenses, and he is responsible for the remaining 20%. What is this 20% called?

• Deductible

• Out of pocket maximum

• Co-insurance

• Co-pay

Scarlett recently reviewed her health insurance plan and learned that when she reaches this amount, her health insurance will pay 100% of the costs of her medical services, as long as they are included in her plan.

• deductible

• co-insurance

• co-pay

• out of pocket maximum

Benjamin received a document from his insurance company detailing what they will cover for his recent medical expenses. What is this document called?

• EOB

• COB

• RA

• MA

Assume that John Smith got an X-ray through Dr. Jones, a participating provider in Mr. Smith’s HMO. The allowed charge for such an X-ray is $75, but Dr. Jones’s usual fee is $100. John Smith’s copayment due for each office visit is $15. How much can Dr. Jones collect from Mr. Smith?

• 25
• 10
• 15
• 0
• 75

Michael is reviewing his healthcare options. Which of the following Medicare programs covers hospital charges? (a)  

• Part A

• Part B

• Part C

• Part D

• both Parts A and B

Liam is exploring different health insurance plans. Which of the following is a federal health insurance plan?

• preferred provider organization (PPO)

• health maintenance organization (HMO)

• indemnity

• Medicare

Elijah is researching different insurance programs for a school project. Which of the following is the insurance program that provides for the medically indigent?

• Medicare

• Medicaid

• Blue Cross

• TRICARE

• HMO