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Health Insurance Test

Total questions: 25

Worksheet time: 44mins

Name
Class
Date
1.

A(n) _________ is the amount of money you must pay each year before your insurance company starts paying

a)

life

b)

beneficiary

c)

deductible

d)

health

2.

_______________ requires you to pay either a set amount or a certain percent of medical expenses

a)

co-insurance

b)

co-payment

c)

life term

d)

term life

3.

A(n) ____________ is a predetermined flat fee you pay for health care services

a)

co-insurance

b)

whole life

c)

co-payment

d)

term

4.
You have reached your deductible of $2000, but you have not reached your maximum out-of-pocket limit of $4000 and your co-insurance begins. Your co-insurance is 20%. How much do you have to pay if you go to the doctor and the visit is $150?
a)
$150
b)
$30
c)
$120
d)
$0
5.
You have reached your $5000 out-of-pocket 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
6.
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
7.
Health insurance policy
a)
Insurance which covers your health, teeth and eyes
b)
A law which allows you insurance even if you lose your job
c)
A contract between you and an insurance company
d)
A policy you purchase only for children
8.
Provider
a)
Federal program that provides insurance for the elderly
b)
A health professional who provides services
c)
Treatment of conditions not covered by the insurance company
d)
Comprehensive health benefit program
9.
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
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.
What is the definition of out-of-pocket maximum?
a)
The amount of money your pockets can hold
b)
The deductible you have to pay for insurance
c)

Maximum money you pay out of pocket before insurance pays the rest

d)
The amount of money you pay to your insurance company every month
12.

The government health plan that covers individuals who have a limited or low income is:

a)

Medicare.

b)

TRICARE.

c)

Medicaid.

d)

Social Security.

13.

Coinsurance is the sharing of costs between the individual and the health insurance company. Which of the following statements are also TRUE about coinsurance?

I. the maximum amount an individual must pay is called the out-of-pocket maximum

II. common coinsurance rates are 80/20

III. the total coinsurance paid by individuals is capped

IV. coinsurance is sometimes called a copay or copayment

a)

II, III, and IV

b)

I, III, and IV

c)

I, II, and IV

d)

I, II, and III

14.

Which of the following statements are TRUE?

a)

health care is free if you have health insurance

b)

receiving healthcare services is more affordable if you have health insurance

c)

coinsurance and copayments are waived in the event of a true medical emergency

d)

individuals who purchase their health insurance through an employer are eligible for the Advanced Premium Tax Credit

15.

What is the purpose of health insurance?

a)

To protect individuals and families from unexpected healthcare expenses

b)

To increase the profits of the healthcare industry

c)

To burden individuals and families with healthcare expenses

d)

To reduce the number of uninsured individuals

16.

Your health insurance premium is $100 per month. How much will you pay annually?

a)

$3000

b)

$$1000

c)

$1200

d)

$100

17.

Your health care policy deductible starts over every year.

a)

True

b)

False

18.

If a person has 80/20 co-insurance, what percent does the insurance company pay?

(a)  

19.

An insurance ___________ is a request that the insurance company pay a bill.

a)

claim

b)

cliam

c)

clam

d)

claam

20.

Calculate the following:

Deductible: $500

Co-insurance: 80/20

Out of pocket limit: $3000

If Sandy receives a medical bill for $25,000, what is her TOTAL amount she must pay?

4 lines
21.

Calculate the following:

Deductible: $250

Co-insurance: 70/30

Out of pocket limit: $7000

If Sandy receives a medical bill for $15,000, what is her TOTAL amount she must pay?

4 lines
22.

Calculate the following:

Deductible: $1000

Co-insurance: 90/10

Out of pocket limit: $8000

If Sandy receives a medical bill for $80,000, what is her TOTAL amount she must pay?

4 lines
23.

Calculate the following:

Deductible: $1000

Co-insurance: 90/10

Out of pocket limit: $8000

If Sandy receives a medical bill for $80,000, what is her TOTAL amount she must pay?

4 lines
24.

A formal request from the customer to an insurance company asking for a payment based on the terms of the insurance policy

a)

claim

b)

premium

c)

deductible

d)

policy

25.

Which is TRUE of health insurance?

a)

you can only use only the doctors in your state

b)

you might get a lower standard of care if you don't have insurance

c)

you won't be able to go to a hospital without insurance

d)

selecting in-network doctors instead of out-of-network doctors can save you money