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Health Insurance Plans

Total questions: 39

Worksheet time: 25mins

Name
Class
Date
1.

You have reached your $5000 out-of-pocket maximum limit. You need to go to the emergency room and it cost $1700. How much will your insurance pay?

a)

$1700

b)

$0

c)

$1360

2.

A fixed amount you pay for a service at a healthcare provider's facility:

a)

co-insurance

b)

co-pay

c)

premium

d)

claim

3.

The cost of your insurance you pay each month:

a)

co-pay

b)

deductible

c)

premium

d)

co-insurance

4.

The amount you owe before your health insurance begins to pay for services.

a)

deductible

b)

premium

c)

owed amount

5.
Insured
a)
The policy holder or subscriber
b)
Fee paid for the health insurance
c)
A person designated to receive the benefits of an insurance policy
d)
The insurance company
6.
Group Insurance
a)
Insurance coverage offered to employees by the employer
b)
Insurance policy an individual must purchase on their own
c)
Insurance offered by the government
d)
Insurance offered to a special group of people
7.
HMO
a)
Health Maintenance Organization
b)
Health Managed Organization
c)
Health Maintained Operation
d)
Health Managed Operation
8.

Managed Care Plan

a)

Insurance plans designed specifically to control the cost of healthcare

b)

Also known as PPO

c)

Also known as HMO

d)

A referral to see a specialist

9.
Health Insurance
a)
Portion of the cost of service to be paid by the employer
b)
Protection against financial lost by unplanned health related events
c)
Treatments for conditions not covered by insurance policies
d)
Services rendered by providers
10.
A 30 year woman broke her arm and went to the ER for treatment. Her health insurance plan has a $1,500 deductible. What does this mean
a)
She can deduct $1,500 from the hospital bill, but must pay the rest
b)
The hospital will only charge her $1,500
c)
She is resoponsible for paying, $1,500 of her medical expenses before her insurance starts to pay
d)
Her insurance company will only pay $1,500 and she must pay the rest
11.
PPO
a)
Preferred Plan Operation
b)
Preferred Provider Organization
c)
Preferred Practice Organization
d)
Preferred Participation Operation
12.
Co-insurance and co-payment refer to the
same thing.
a)
True
b)
False
13.

Your health insurance has a $2000 deductible and a $100 per day co-payment for hospital stays. You get sick and are hospitalized for 2 days. The bill comes to $4000. How much of this bill do you have to pay if this is the first time you have used your insurance this year?

a)

$2000

b)

$4000

c)

$2200

d)

$1800

14.

What is an out-of-pocket maximum?

a)

A flat-rate fee you must pay when receiving any kind of health care service

b)

Maximum amount of money your insurance will cover of a certain health care service.

c)

Maximum amount you will have to pay out of pocket in one year for the benefits your insurance covers.

d)

Maximum amount of money the insured party will pay toward prescription medications.

15.

The term used to describe the amount that a policyholder must pay before a health insurance policy pays any benefits

a)

Copayment

b)

Coinsurance

c)

Deductible

d)

Out-of-Pocket Maximum

16.

Services such as annual check-ups, immunizations, and screening exams that are designed to keep people healthy and avoid large medical bills in the future.

a)

Primary Care Physician

b)

Preventative care

c)

Policyholder

d)

Policy limit

17.

Amount you pay for covered health care after you meet your deductible. A percentage of the total cost of care—for example, 20%

a)

Co-pay

b)

Premium

c)

Co-insurance

d)

Deductible

18.

What is a "Provider"?

a)

Federal program that provides insurance for the elderly

b)

Comprehensive health benefit program

c)

Treatment of conditions not covered by the insurance company

d)

A health professional who provides services

19.

Health insurance premiums are charged only when you use health care services

a)

True

b)

False

20.

Insurance companies can chare higher premiums for people with pre-existing conditions.

a)

True

b)

False

21.

The contract which details your insurance coverage.

a)

Premium

b)

Deductible

c)

Co-Pay

d)

Policy

22.

Deductibles are calculated on a(n) ________ basis.

a)

daily

b)

monthly

c)

annual (yearly)

d)

throughout the life of the policy

23.

Deductibles need to be met before Coinsurance begins. True or False?

a)

True

b)

False

24.

The government subsidized insurance for individuals below the poverty line

a)

medicare

b)

medicaid

c)

Obamacare

25.

The government subsidized insurance for senior citizens

a)

medicare

b)

medicaid

c)

Obamacare

26.

The type of insurance plan designed for early detection and treatment of disease, preventative screening and routine exams. Must use providers in the network

a)

HMO

b)

PPO

c)

Managed Care Plan

d)

Government Subsidized Plan

27.

The type of insurance offered by large companies to their employees. require a deductible and co-pays.

a)

HMO

b)

PPO

c)

Managed Care Plan

d)

Government Subsidized Plans

28.

This insurance policy helps pay medical expenses not covered by Medicare.

a)

Medicaid

b)

Medigap

c)

HMO

d)

HIPAA

29.

The health insurance plan providing treatment for workers injured on the job is called ​ (a)   .

Choose from the below words
worker's compensation
TRICARE
Managed care plan
medicare
medicaid
30.

The government health insurance plan for all military personnel and their immediate family is called ​ (a)  

Choose from the below words
TRICARE
worker's compensation
HMO
Medicare
managed care plan
31.

HIPAA stands for

a)

Health Insurance Portability and Accountability Act

b)

High-Impact Prevention and Action Authority

c)

Human Information Protection and Analysis Act

d)

Health Information Protection and Authorization Act

32.

HIPAA has _

a)

five main components

b)

Four areas of focus

c)

Six core objectives

d)

Eight rules of enforcement

33.

HIPAA was passed into law in _.

a)

1996

b)

2001

c)

1994

d)

1998

34.

The Affordable Care Act or Obamacare was signed into law in _,

a)

2010

b)

2014

c)

2012

d)

2013

35.

President Obama was the first US president to try to implement healthcare reform.

a)

True

b)

False

36.

Which of the following is NOT true of the Affordable Care Act?

a)

Provided grants for low-income families to purchase health insurance

b)

Allows young adults to be covered under a parent's policy until the age of 24

c)

Required all insurers charge the same premium to all applicants

d)

Prohibits insurance companies from removing coverage as long as premiums are paid

37.

The co-pay for this insurance plan to see your primary care physician is _.

(a)  

38.

Based on this insurance plan, the in-network deductible for an individual is _.

(a)  

39.

Based on this insurance plan, the co-pay for an office visit and a _ are both $15.

(a)  

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