Introduction & Initial Questions

Which objective correctly describes the goal of todays lesson?

• Understand the importance of having health insurance

• Memorize all medical billing codes

• Design a new hospital pricing system

• Learn how to perform surgery

When comparing costs for an overnight hospital stay for two people: one uninsured and one insured. Which statement best reflects why the uninsured person might pay more out-of-pocket?

• Uninsured patients automatically receive the lowest total bill from hospitals

• Insurance plans typically negotiate discounts and share costs, reducing the patient’s share

• Hospitals are legally required to forgive all uninsured bills

• Insured patients are never responsible for any portion of medical costs

What is a premium?

• The amount you pay to buy an insurance policy

• A specified amount of money that the insured must pay before an insurance company will pay a claim

• An arrangement by which a company provides a guarantee of compensation for a specified loss

• Measures that are taken for disease prevention

Who typically pays for health care expenses once you have met your deductible?

• You pay for all health care expenses

• Your insurance pays for all health care expenses

• You and your insurance company share the cost of health care expenses

• No one pays; once you meet your deductible, your health care expenses are free

What happens when you have reached your health care deductible and out-of-pocket maximum?

• You will continue to pay 100% of your healthcare costs out-of-pocket

• You will pay 50% of your healthcare costs out-of-pocket, which includes co-pays

• The insurance company pays all covered costs for the rest of the year, with no annual limit

• The insurance company pays for all covered costs for the rest of your life

Which answer uses the terms premium, deductible, and out-of-pocket maximum correctly?

• You pay a monthly premium for your health insurance. You pay for health services until you meet your deductible. Once you meet your out-of-pocket maximum, your insurance pays the rest of your health care costs for that year.

• You pay a monthly deductible for your health insurance. You and your health insurance company share health care costs by paying separate premium costs. Once you meet your out-of-pocket maximum, your insurance company pays your health care costs except for your copays.

• You pay a monthly premium for your health insurance. Your insurance will cover a specific percentage of your health insurance costs up to an out-of-pocket maximum. Once you have reached your maximum limit, your only out-of-pocket expense is your deductible.

• You pay a monthly deductible for your health insurance. When you use your health insurance, you will pay your premium out-of-pocket. Once you meet your out-of-pocket maximum for the year, your insurance will pay the remaining amount of your health care costs.

Which statement best describes a high deductible health plan (HDHP)?

• A plan with low monthly premiums but higher out-of-pocket costs before insurance coverage starts

• A plan that covers all medical costs without any deductible

• A plan only available to families, not individuals

• A short-term plan that cannot be paired with any savings account

What is the primary purpose of a health savings account (HSA) when paired with an HDHP?

• To invest only in stocks for retirement

• To set aside pre-tax money to pay qualified medical expenses

• To pay insurance premiums for any plan type

• To borrow money at high interest for medical bills

Why might a medical provider prefer setting up a payment plan with you instead of sending your bill to collections?

• They legally cannot use collections for medical debt

• They often recover more of the bill and avoid collection fees

• Payment plans always charge higher interest to patients

• Collections guarantees immediate full payment to the provider