HEALTHCARE COST TERMINOLOGY

What does the term "premium" refer to?

• The amount you pay only when you receive medical care

• The monthly/quarterly/yearly payment to maintain your health insurance

• The maximum amount you spend out-of-pocket in a year

• A fixed cost per doctor visit

After you meet your deductible, health care costs are typically shared via:

• Premiums

• Out-of-pocket maximum

• Copays or coinsurance

• No further payments required

Which of the following sequences correctly describes how your costs change throughout the year?

• Out-of-pocket max > Deductible > Insurance pays all

• Deductible > Premium > Insurance pays all

• Premium > Shared costs > Deductible > Insurance pays all

• Premium > Deductible > Shared costs > Insurance pays all

The premium ensures you have coverage, but doesn't cover all services by itself--additional costs like deductibles and coinsurance may apply.

• TRUE

• FALSE

The out-of-pocket maximum includes all payments you make, including premiums.

• TRUE

• FALSE

When you reach out-of-pocket maximum, who pays for covered services for the remainder of the year?

• You pay in full

• Insurance pays everything

• You continue sharing costs

• You stop receiving services

Once you've paid your deductible, you no longer need insurance because you don't pay anything else.

• TRUE

• FALSE

What is a deductible?

• A monthly fee for membership in an insurance plan

• A fixed payment per service after reaching deductible

• The limit to what insurance will pay in a year

• The amount you pay before your insurance begins to contribute

Copays are the same as coinsurance

• TRUE

• FALSE

Every year, your deductible and out-of-pocket maximum reset--so you start again at the beginning of the cycle.

• TRUE

• FALSE