Understanding Health Insurance Terms

What is coinsurance in a health insurance policy?

• A fixed amount paid for each medical service

• The percentage of costs the insured pays after the deductible is met

• The total amount paid by the insurer for covered expenses

• The amount paid before the insurance company starts paying

If a health insurance policy has an 80/20 coinsurance clause, what percentage of covered expenses does the insurer pay?

• 20%

• 50%

• 80%

• 100%

What is a deductible in a health insurance policy?

• The percentage of costs the insured pays after the deductible is met

• A fixed amount paid for each medical service

• The amount the insured must pay out-of-pocket before the insurance company pays

• The total amount paid by the insurer for covered expenses

If a health insurance policy has a $1,000 deductible, what does this mean for the insured?

• The insured pays 20% of covered expenses

• The insured pays the first $1,000 of covered expenses each year

• The insurer pays the first $1,000 of covered expenses each year

• The insured pays a fixed amount for each medical service

What are eligible expenses in a health insurance policy?

• Medical costs not covered by the insurance policy

• Medical costs covered by the insurance policy

• The total amount paid by the insurer for covered expenses

• A fixed amount paid for each medical service

Which of the following is an example of an eligible expense under a health insurance policy?

• Cosmetic surgery

• Over-the-counter medications

• Hospital stays

• Gym memberships

What is a copayment in a health insurance policy?

• A fixed amount the insured must pay for a covered service at the time of service

• The percentage of costs the insured pays after the deductible is met

• The amount the insured must pay out-of-pocket before the insurance company pays

• The total amount paid by the insurer for covered expenses

If a health insurance policy requires a $20 copayment, what does this mean for the insured?

• The insured pays 20% of covered expenses

• The insured pays $20 for each covered service at the time of service

• The insurer pays $20 for each covered service

• The insured pays the first $20 of covered expenses each year

Which of the following best describes the relationship between deductibles and coinsurance?

• Deductibles are paid after coinsurance

• Coinsurance is paid after the deductible is met

• Deductibles and coinsurance are the same

• Coinsurance is a fixed amount paid for each service

Which of the following is NOT typically considered an eligible expense under a health insurance policy?

• Prescription medications

• Routine dental care

• Surgeries

• Hospital stays