Health insurance usaa Practice Exam
What is the main purpose of health insurance?
a) To provide coverage for long-term care
b) To help cover medical expenses
c) To provide savings for retirement
d) To help pay for insurance premiums
Answer: b) To help cover medical expenses
Which of the following is NOT a type of health insurance plan?
a) Health Maintenance Organization (HMO)
b) Preferred Provider Organization (PPO)
c) Exclusive Provider Organization (EPO)
d) Medicare Advantage Plan
Answer: d) Medicare Advantage Plan
What is a deductible in a health insurance plan?
a) The amount paid for medical services before insurance coverage kicks in
b) The amount the insurance company will pay for medical services
c) The maximum amount the insurance company will pay for medical care
d) The monthly premium that is paid by the insured
Answer: a) The amount paid for medical services before insurance coverage kicks in
What is co-insurance?
a) A fixed amount the insured pays for covered medical services
b) The percentage of medical expenses that the insured shares after the deductible is met
c) The monthly payment for an insurance policy
d) The amount the insurance company reimburses the insured
Answer: b) The percentage of medical expenses that the insured shares after the deductible is met
What is an HMO (Health Maintenance Organization)?
a) A plan that allows you to choose any doctor without a referral
b) A plan that covers medical services outside of the network
c) A type of health insurance plan that requires members to choose a primary care physician (PCP)
d) A government-funded health insurance program
Answer: c) A type of health insurance plan that requires members to choose a primary care physician (PCP)
Which of the following is a feature of a PPO (Preferred Provider Organization)?
a) Requires a referral to see a specialist
b) Offers a network of preferred providers for lower costs
c) Offers coverage only within the state
d) Does not cover preventive care services
Answer: b) Offers a network of preferred providers for lower costs
Which of the following is covered under most health insurance policies?
a) Cosmetic surgery
b) Emergency care
c) Routine eye exams
d) Fertility treatments
Answer: b) Emergency care
What does an out-of-pocket maximum mean in health insurance?
a) The total amount the insurance company will pay
b) The highest amount an individual will pay for covered services during a plan year
c) The co-payment for prescription drugs
d) The monthly premium that must be paid by the insured
Answer: b) The highest amount an individual will pay for covered services during a plan year
Which of the following is true about Medicaid?
a) It is available only to people over 65 years old
b) It is a federal program that provides health coverage to low-income individuals
c) It is the same as Medicare
d) It requires premium payments for all recipients
Answer: b) It is a federal program that provides health coverage to low-income individuals
What is the role of a primary care physician (PCP) in an HMO plan?
a) The PCP is a specialist who provides services for specific conditions
b) The PCP coordinates care and provides referrals to specialists
c) The PCP only handles emergency situations
d) The PCP is responsible for setting the premium rates
Answer: b) The PCP coordinates care and provides referrals to specialists
Which health insurance plan requires referrals for specialist care?
a) PPO
b) HMO
c) POS (Point of Service)
d) FFS (Fee-for-Service)
Answer: b) HMO
What is the difference between an EPO and a PPO plan?
a) EPOs require referrals for all types of care; PPOs do not
b) EPOs have a broader network of providers than PPOs
c) EPOs offer coverage only in emergencies outside the network; PPOs offer more flexibility
d) PPOs have higher premiums than EPOs
Answer: c) EPOs offer coverage only in emergencies outside the network; PPOs offer more flexibility
What is the purpose of the Affordable Care Act (ACA)?
a) To provide free healthcare for all citizens
b) To ensure that healthcare services are available only to the wealthy
c) To expand healthcare coverage and reduce healthcare costs for Americans
d) To eliminate all private insurance plans
Answer: c) To expand healthcare coverage and reduce healthcare costs for Americans
Which of the following is NOT typically covered by health insurance?
a) Hospital stays
b) Preventive care
c) Medical prescriptions
d) Elective cosmetic surgery
Answer: d) Elective cosmetic surgery
What is a waiting period in health insurance?
a) The period during which no medical services are covered
b) The time before a person can enroll in a health insurance plan
c) The time between when an individual applies for insurance and when coverage begins
d) The time it takes for the insurance company to process a claim
Answer: c) The time between when an individual applies for insurance and when coverage begins
Which of the following is true about the Affordable Care Act (ACA)?
a) It requires employers with fewer than 50 employees to provide health insurance
b) It prohibits health insurance companies from denying coverage due to pre-existing conditions
c) It mandates that all citizens must have private health insurance
d) It reduces the availability of Medicaid benefits
Answer: b) It prohibits health insurance companies from denying coverage due to pre-existing conditions
Which is an example of a health insurance premium?
a) The amount paid out-of-pocket for a medical procedure
b) The monthly payment made to an insurance company for coverage
c) The amount paid for a hospital stay
d) The deductible paid before coverage begins
Answer: b) The monthly payment made to an insurance company for coverage
What is a “network” in the context of health insurance?
a) The list of healthcare providers who are part of the insurance plan’s network and offer discounted services
b) The group of people who use the same insurance company
c) The total amount of premiums paid by the insured
d) The total number of claims filed in a year
Answer: a) The list of healthcare providers who are part of the insurance plan’s network and offer discounted services
What is COBRA in health insurance?
a) A government program that provides healthcare for low-income individuals
b) A tax on insurance premiums
c) A federal law that allows employees to continue their employer-sponsored health insurance after leaving a job
d) A program for short-term health coverage
Answer: c) A federal law that allows employees to continue their employer-sponsored health insurance after leaving a job
What is the primary difference between Medicare and Medicaid?
a) Medicare is for people aged 65 and older, while Medicaid is for low-income individuals
b) Medicare provides benefits only for emergency care
c) Medicaid is a private insurance program
d) Medicare is funded by states, while Medicaid is funded by the federal government
Answer: a) Medicare is for people aged 65 and older, while Medicaid is for low-income individuals
What does “out-of-network” mean in health insurance?
a) A provider that is not included in the insurance plan’s approved list of healthcare providers
b) A provider that only works with PPO plans
c) A provider that is covered in all types of insurance plans
d) A healthcare service that requires no out-of-pocket payment
Answer: a) A provider that is not included in the insurance plan’s approved list of healthcare providers
What is a PPO plan typically known for?
a) Low monthly premiums
b) Required referrals for specialist care
c) Flexibility to see any doctor, in or out of the network
d) Limited access to healthcare providers
Answer: c) Flexibility to see any doctor, in or out of the network
What is “preventive care” in health insurance?
a) Medical services that are required during a medical emergency
b) Treatments to manage existing health conditions
c) Healthcare services aimed at preventing illnesses or detecting them early
d) Surgery or medical procedures for serious conditions
Answer: c) Healthcare services aimed at preventing illnesses or detecting them early
What is a “high-deductible health plan” (HDHP)?
a) A plan with a low deductible and high premiums
b) A plan with a high deductible and lower premiums, often paired with Health Savings Accounts (HSAs)
c) A plan that covers only catastrophic medical events
d) A government-subsidized health plan
Answer: b) A plan with a high deductible and lower premiums, often paired with Health Savings Accounts (HSAs)
Which of the following is a common feature of most health insurance policies?
a) Coverage for cosmetic surgery
b) Pre-existing condition exclusions
c) Coverage for routine dental check-ups
d) Coverage for out-of-network care with no additional costs
Answer: b) Pre-existing condition exclusions
What is the “individual mandate” under the Affordable Care Act?
a) A requirement for individuals to buy health insurance or face a penalty
b) A rule allowing employers to offer insurance to workers
c) A regulation that limits the number of health insurers in a market
d) A requirement for individuals to buy insurance from a state marketplace
Answer: a) A requirement for individuals to buy health insurance or face a penalty
Which of the following is a common factor in determining health insurance premiums?
a) Age of the insured
b) The location of the insured
c) The level of coverage desired
d) All of the above
Answer: d) All of the above
Which of the following would NOT be considered a health insurance claim?
a) A request for medical treatment
b) A bill from a hospital for services
c) A request for a prescription refill
d) A reimbursement for out-of-pocket medical expenses
Answer: c) A request for a prescription refill
What is a “copayment” in health insurance?
a) The fixed percentage of medical expenses paid by the insured
b) The amount paid for specific medical services at the time of care
c) The annual limit of the insured’s healthcare spending
d) The deductible amount that must be paid before coverage kicks in
Answer: b) The amount paid for specific medical services at the time of care
What is the main function of the Affordable Care Act’s Health Insurance Marketplace?
a) To offer insurance plans for people with pre-existing conditions
b) To provide a place where individuals can compare and purchase insurance plans
c) To offer free insurance plans for low-income individuals
d) To help insurance companies raise premiums
Answer: b) To provide a place where individuals can compare and purchase insurance plans
Which of the following types of health insurance plans generally offer the most flexibility in choosing healthcare providers?
a) Health Maintenance Organization (HMO)
b) Preferred Provider Organization (PPO)
c) Point of Service (POS)
d) Exclusive Provider Organization (EPO)
Answer: b) Preferred Provider Organization (PPO)
What does the term “pre-existing condition” refer to in health insurance?
a) A condition that developed after enrollment in the plan
b) A condition for which the insured has already received medical treatment before applying for insurance coverage
c) A condition that is covered under the insurance policy
d) A condition that automatically qualifies the insured for Medicaid
Answer: b) A condition for which the insured has already received medical treatment before applying for insurance coverage
What is the purpose of the Medicare Part D program?
a) To provide coverage for outpatient services
b) To cover prescription drug costs
c) To provide hospitalization coverage
d) To offer dental and vision care coverage
Answer: b) To cover prescription drug costs
Which of the following is a characteristic of a Health Savings Account (HSA)?
a) It is used only for dental and vision expenses
b) Contributions are made on a tax-free basis and can be used to pay for qualified medical expenses
c) It is only available to people over 65
d) It is a type of insurance plan that guarantees full coverage for medical services
Answer: b) Contributions are made on a tax-free basis and can be used to pay for qualified medical expenses
Which of the following is true about short-term health insurance?
a) It provides comprehensive health coverage for a year or more
b) It is designed for people who are between long-term coverage options, like those in transition between jobs
c) It includes coverage for pre-existing conditions
d) It is required under the Affordable Care Act for all individuals
Answer: b) It is designed for people who are between long-term coverage options, like those in transition between jobs
What is a “preventive care” benefit in health insurance?
a) Services that treat existing conditions
b) Medical services aimed at detecting or preventing illness or injury before they occur
c) Services that are only available for emergency situations
d) Treatments for patients with chronic conditions
Answer: b) Medical services aimed at detecting or preventing illness or injury before they occur
Which of the following is covered by Medicaid?
a) Preventive dental care
b) Private medical insurance for the wealthy
c) Healthcare for individuals with low income, including children and pregnant women
d) Exclusive healthcare services for people with disabilities only
Answer: c) Healthcare for individuals with low income, including children and pregnant women
Under the Affordable Care Act (ACA), what is one of the essential health benefits that must be covered by insurance plans?
a) Cosmetic surgery
b) Maternity and newborn care
c) Elective plastic surgery
d) Alternative medicine
Answer: b) Maternity and newborn care
Which of the following is a feature of a High Deductible Health Plan (HDHP)?
a) It has a higher premium and lower deductible
b) It usually comes with lower premiums but higher deductibles
c) It offers comprehensive coverage with no deductible
d) It only covers emergency care
Answer: b) It usually comes with lower premiums but higher deductibles
What is “coordination of benefits” in health insurance?
a) A process where a healthcare provider determines what services are covered under an individual’s health insurance plan
b) A method to determine the order in which multiple health insurance policies will pay benefits when an individual is covered under more than one plan
c) A requirement for insurers to cover the same benefits equally across different plans
d) A policy that guarantees the highest level of benefits from each insurer
Answer: b) A method to determine the order in which multiple health insurance policies will pay benefits when an individual is covered under more than one plan
Which of the following is NOT a typical service covered by a health insurance plan?
a) Doctor’s visits
b) Emergency room services
c) Cosmetic surgery
d) Prescription drugs
Answer: c) Cosmetic surgery
What is the purpose of the Medicare Part A program?
a) To provide coverage for prescription drugs
b) To cover hospital and inpatient services
c) To provide coverage for outpatient care
d) To offer dental and vision care coverage
Answer: b) To cover hospital and inpatient services
Which health insurance plan offers coverage for services received both in-network and out-of-network, but at different cost levels?
a) HMO
b) PPO
c) EPO
d) HDHP
Answer: b) PPO
In a PPO plan, what does “in-network” mean?
a) The healthcare provider is part of the plan’s approved list and offers services at a discounted rate
b) The provider is part of the plan but charges higher rates than out-of-network providers
c) The provider is not part of the plan and requires out-of-pocket payment
d) The provider must be a government employee
Answer: a) The healthcare provider is part of the plan’s approved list and offers services at a discounted rate
What does the term “premium” refer to in health insurance?
a) The out-of-pocket cost for services covered by the insurance
b) The amount the insurance company pays to healthcare providers
c) The monthly fee paid by the insured to maintain coverage
d) The deductible amount that must be paid before insurance starts covering costs
Answer: c) The monthly fee paid by the insured to maintain coverage
Under the Affordable Care Act (ACA), which of the following cannot be used as a reason to deny an individual health insurance coverage?
a) Age
b) Gender
c) Pre-existing medical conditions
d) Employment status
Answer: c) Pre-existing medical conditions
What is the primary purpose of an out-of-pocket maximum in health insurance?
a) To set a limit on the total amount that can be paid in insurance premiums
b) To establish the maximum amount an individual must pay for covered medical services in a plan year
c) To determine how much the insurance company will reimburse for covered services
d) To calculate the amount of tax credit for insurance premiums
Answer: b) To establish the maximum amount an individual must pay for covered medical services in a plan year
What is the “network” in a health insurance plan?
a) A list of healthcare providers and hospitals that have agreed to offer services at discounted rates to plan members
b) The insurance company’s customer service number
c) A group of insurance plans offered under one company
d) The amount the insured pays for medical services
Answer: a) A list of healthcare providers and hospitals that have agreed to offer services at discounted rates to plan members
What is a Health Maintenance Organization (HMO)?
a) A health insurance plan that allows members to receive services outside of the network for a higher fee
b) A health insurance plan that covers medical expenses only after reaching a high deductible
c) A managed care plan that requires members to choose a primary care physician and get referrals for specialist care
d) A plan that offers flexible choices for healthcare providers without the need for a referral
Answer: c) A managed care plan that requires members to choose a primary care physician and get referrals for specialist care
Which type of plan typically provides the lowest out-of-pocket costs but has the most restrictions on healthcare provider choices?
a) PPO
b) HMO
c) EPO
d) POS
Answer: b) HMO
What is the main objective of the Health Insurance Portability and Accountability Act (HIPAA)?
a) To make health insurance more affordable for the public
b) To protect patient information and privacy
c) To provide subsidies to insurance companies
d) To regulate healthcare providers’ fees
Answer: b) To protect patient information and privacy
Under the Affordable Care Act (ACA), what is the “individual mandate”?
a) A requirement for individuals to have health insurance or pay a penalty
b) A requirement for employers to offer health insurance
c) A mandate for insurance companies to cover pre-existing conditions
d) A rule that all insurance policies must include maternity care
Answer: a) A requirement for individuals to have health insurance or pay a penalty
What is an “insurance premium”?
a) The out-of-pocket cost for healthcare services covered by the plan
b) The monthly or annual amount paid by the insured to maintain health insurance coverage
c) The amount paid to a healthcare provider for a service
d) The portion of the healthcare service cost paid by the insurance company
Answer: b) The monthly or annual amount paid by the insured to maintain health insurance coverage
Which of the following does NOT qualify as an essential health benefit under the ACA?
a) Emergency services
b) Maternity and newborn care
c) Cosmetic surgery
d) Prescription drug coverage
Answer: c) Cosmetic surgery
What is the “Medicaid Expansion” under the Affordable Care Act (ACA)?
a) A program providing subsidies to private insurers
b) An expansion of Medicaid to cover all individuals under 138% of the federal poverty level in participating states
c) A requirement for Medicaid recipients to pay a monthly premium
d) A reduction in Medicaid eligibility for people aged 65 and older
Answer: b) An expansion of Medicaid to cover all individuals under 138% of the federal poverty level in participating states
What is the function of the Centers for Medicare & Medicaid Services (CMS)?
a) To set premiums for private health insurance plans
b) To oversee and administer the nation’s healthcare programs, including Medicare and Medicaid
c) To monitor the financial status of insurance companies
d) To enforce insurance regulations in the workplace
Answer: b) To oversee and administer the nation’s healthcare programs, including Medicare and Medicaid
What does the term “out-of-pocket maximum” refer to in health insurance?
a) The maximum monthly premium a person will pay
b) The maximum amount an individual has to pay for covered services in a policy year, after which the insurer pays 100%
c) The deductible that must be met before any insurance coverage applies
d) The highest amount an individual must pay for services outside the insurer’s network
Answer: b) The maximum amount an individual has to pay for covered services in a policy year, after which the insurer pays 100%
What is the purpose of the Federal Employees Health Benefits Program (FEHBP)?
a) To provide health insurance coverage for low-income individuals
b) To offer health insurance coverage to federal employees, retirees, and their families
c) To support state Medicaid programs
d) To offer free health insurance for children
Answer: b) To offer health insurance coverage to federal employees, retirees, and their families
What is the “cost-sharing” reduction under the ACA?
a) A program that reduces the monthly premiums for low-income individuals
b) A program that reduces the out-of-pocket costs for healthcare services for low-income individuals purchasing insurance through the marketplace
c) A subsidy that helps employers offer insurance to their employees
d) A tax deduction for healthcare expenses
Answer: b) A program that reduces the out-of-pocket costs for healthcare services for low-income individuals purchasing insurance through the marketplace
In which of the following scenarios would someone be eligible for Medicare?
a) A 25-year-old individual with a pre-existing condition
b) An individual who is disabled and has received Social Security Disability Insurance (SSDI) for 24 months
c) A person who does not pay taxes
d) A child under 18 years old with a chronic illness
Answer: b) An individual who is disabled and has received Social Security Disability Insurance (SSDI) for 24 months
What is a “High Deductible Health Plan” (HDHP)?
a) A health insurance plan that requires low premiums and higher deductibles, typically paired with a Health Savings Account (HSA)
b) A plan that offers comprehensive coverage for outpatient services
c) A government-sponsored insurance plan for those with chronic health conditions
d) A type of health insurance that requires no deductible for most services
Answer: a) A health insurance plan that requires low premiums and higher deductibles, typically paired with a Health Savings Account (HSA)
What is the function of the “Health Insurance Marketplace”?
a) To provide a place for employers to purchase group health insurance
b) To help individuals and families compare and purchase health insurance plans
c) To track the cost of medical procedures across the country
d) To offer subsidies to private insurance companies
Answer: b) To help individuals and families compare and purchase health insurance plans
What does the term “coinsurance” refer to in a health insurance plan?
a) A flat fee paid by the insured for medical services
b) A percentage of the cost of a medical service that the insured is required to pay after meeting the deductible
c) The total amount paid by the insurance company for a medical service
d) The amount the insurance company pays directly to healthcare providers
Answer: b) A percentage of the cost of a medical service that the insured is required to pay after meeting the deductible
Under the ACA, what is prohibited for insurers when offering health insurance coverage?
a) Charging higher premiums based on health status or gender
b) Offering insurance plans with low premiums and high deductibles
c) Offering free preventive services
d) Offering specialized care for children
Answer: a) Charging higher premiums based on health status or gender
What is the primary function of an “employer-sponsored health plan”?
a) To provide financial assistance to healthcare providers
b) To offer health insurance coverage to employees and their families as part of their compensation package
c) To manage the healthcare services provided by government programs
d) To provide tax deductions for business expenses
Answer: b) To offer health insurance coverage to employees and their families as part of their compensation package
Which of the following is an example of a “mandatory” health insurance benefit under the ACA?
a) Chiropractic care
b) Fertility treatments
c) Mental health and substance abuse services
d) Cosmetic surgery
Answer: c) Mental health and substance abuse services
Which of the following healthcare services are typically covered under a standard health insurance plan?
a) Experimental treatments and clinical trials
b) Emergency medical services and hospitalization
c) Cosmetic procedures
d) Health-related travel expenses
Answer: b) Emergency medical services and hospitalization
What is the term “out-of-network” in health insurance?
a) Healthcare providers that are outside the insurer’s network and usually involve higher out-of-pocket costs for the insured
b) Providers who specialize in rare medical treatments
c) Healthcare services that are excluded from the insurance policy
d) Providers who offer services covered under Medicaid
Answer: a) Healthcare providers that are outside the insurer’s network and usually involve higher out-of-pocket costs for the insured
Which of the following is a key feature of an “Exclusive Provider Organization” (EPO) plan?
a) The plan allows individuals to seek treatment from any provider at any time
b) The plan requires members to obtain referrals from a primary care physician before seeing a specialist
c) The plan only covers care provided within the network and does not cover out-of-network care
d) The plan is available only to government employees
Answer: c) The plan only covers care provided within the network and does not cover out-of-network care
What is a “premium tax credit” under the ACA?
a) A tax credit provided to individuals who have health insurance coverage through their employer
b) A tax subsidy to help lower-income individuals and families afford health insurance purchased through the Marketplace
c) A tax rebate for individuals who do not use healthcare services during the year
d) A credit for businesses that provide health insurance to their employees
Answer: b) A tax subsidy to help lower-income individuals and families afford health insurance purchased through the Marketplace
What does “Medicare Part A” primarily cover?
a) Prescription drugs
b) Hospital inpatient care
c) Outpatient services
d) Dental and vision care
Answer: b) Hospital inpatient care
What is the key feature of a “Preferred Provider Organization” (PPO) plan?
a) It requires members to choose a primary care physician (PCP)
b) It only covers in-network services
c) It allows members to see any specialist without a referral
d) It requires members to use specific hospitals for emergency services
Answer: c) It allows members to see any specialist without a referral
Which of the following is a feature of an “Accountable Care Organization” (ACO)?
a) It focuses on providing a limited number of healthcare services
b) It is a network of doctors and hospitals working together to improve care for patients
c) It only covers emergency room visits
d) It offers only mental health services
Answer: b) It is a network of doctors and hospitals working together to improve care for patients
Under which program are low-income individuals eligible for government-subsidized health insurance coverage?
a) Medicaid
b) Medicare
c) Social Security Disability Insurance
d) Veterans Health Administration
Answer: a) Medicaid
What is a Health Savings Account (HSA)?
a) A government-provided fund for health expenses
b) A tax-advantaged account for individuals with high-deductible health plans to save for medical expenses
c) A government-funded insurance plan
d) An employer-sponsored insurance program
Answer: b) A tax-advantaged account for individuals with high-deductible health plans to save for medical expenses
Which of the following describes a “Catastrophic Health Insurance Plan”?
a) It covers all health expenses for individuals under 30 years old
b) It provides minimal coverage with low premiums and a high deductible, primarily for emergency care
c) It covers only preventive health services
d) It is an insurance plan for individuals with serious, long-term illnesses
Answer: b) It provides minimal coverage with low premiums and a high deductible, primarily for emergency care
What does “Medicare Advantage” (Part C) provide?
a) Prescription drug coverage only
b) A private health plan that includes coverage for Medicare benefits
c) Basic hospital insurance
d) Coverage for services outside the U.S.
Answer: b) A private health plan that includes coverage for Medicare benefits
What is a “deductible” in health insurance?
a) The monthly fee paid to the insurance company
b) The amount a policyholder must pay out-of-pocket for healthcare services before the insurance company begins to pay
c) The percentage of a claim paid by the insurer
d) The amount a healthcare provider charges for a service
Answer: b) The amount a policyholder must pay out-of-pocket for healthcare services before the insurance company begins to pay
Under the ACA, which of the following is prohibited in the health insurance marketplace?
a) Offering coverage for mental health services
b) Discriminating against individuals with pre-existing conditions
c) Offering government-subsidized insurance
d) Providing wellness programs
Answer: b) Discriminating against individuals with pre-existing conditions
What is the purpose of the “Medicare Savings Program”?
a) To provide free prescription drugs to low-income Medicare beneficiaries
b) To help low-income individuals pay for their Medicare premiums, deductibles, and coinsurance
c) To offer free health services to individuals without health insurance
d) To provide financial aid for non-Medicare recipients
Answer: b) To help low-income individuals pay for their Medicare premiums, deductibles, and coinsurance
What is a “benefit year” in health insurance?
a) A year in which the insurance company assesses a policyholder’s claims
b) A 12-month period during which healthcare services are covered by the policy
c) A year in which the deductible must be met
d) A year in which insurance premiums are calculated and adjusted
Answer: b) A 12-month period during which healthcare services are covered by the policy
Which of the following services is NOT typically covered by most health insurance policies?
a) Routine physical exams
b) Cosmetic surgery
c) Emergency medical care
d) Maternity care
Answer: b) Cosmetic surgery
What does “preventive care” include under most health insurance plans?
a) Elective surgeries
b) Emergency care
c) Routine check-ups, screenings, and vaccinations
d) Cosmetic procedures
Answer: c) Routine check-ups, screenings, and vaccinations
Which of the following is a requirement for an individual to be eligible for Medicaid?
a) Being over 65 years old
b) Having a specific level of income and resources
c) Being employed with a full-time job
d) Having a college degree
Answer: b) Having a specific level of income and resources
Which of the following is considered a “primary care physician” (PCP)?
a) A specialist physician for cancer care
b) A general practitioner or family doctor who provides basic healthcare services
c) A surgeon who performs complex procedures
d) A psychiatrist who provides mental health services
Answer: b) A general practitioner or family doctor who provides basic healthcare services
What is the “Affordable Care Act” (ACA)?
a) A program that provides government-subsidized health insurance to low-income families
b) A law that aimed to reduce healthcare costs and increase insurance coverage for Americans
c) A Medicare expansion program for senior citizens
d) A type of health insurance plan with high premiums and low deductibles
Answer: b) A law that aimed to reduce healthcare costs and increase insurance coverage for Americans
What is the “reinsurance” program in health insurance?
a) A plan where the government directly insures individuals
b) A program that offers additional health coverage for individuals under 26
c) A system in which one insurance company covers the risk for another company
d) A program that reduces the cost of insurance premiums for low-income families
Answer: c) A system in which one insurance company covers the risk for another company
What does “network” refer to in health insurance?
a) A list of doctors, hospitals, and other healthcare providers who are contracted with an insurance company to provide services at discounted rates
b) The geographic area where healthcare services are available
c) The amount an individual must pay out of pocket for health services
d) A program for government employees
Answer: a) A list of doctors, hospitals, and other healthcare providers who are contracted with an insurance company to provide services at discounted rates
Which of the following describes “long-term care insurance”?
a) Insurance that provides coverage for dental procedures and vision services
b) A type of insurance that covers basic hospital stays
c) Insurance designed to cover services needed for individuals with chronic illnesses or disabilities, such as nursing home care
d) Insurance that covers prescription drug costs only
Answer: c) Insurance designed to cover services needed for individuals with chronic illnesses or disabilities, such as nursing home care
What is the purpose of the “Children’s Health Insurance Program” (CHIP)?
a) To offer low-cost health insurance for children in low-income families
b) To cover the elderly population in the U.S.
c) To provide mental health services for children
d) To provide health insurance for military veterans
Answer: a) To offer low-cost health insurance for children in low-income families