The Ultimate Health Insurance Quiz

Staff

4 Min Quiz

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About This Quiz

The cost of health care in the United States is staggering, and health insurance, which pays some of the bills, is an often complicated benefit that none of us like until we need it. Take this quiz to see how much you know about health insurance.

Which government program helps elderly Americans pay their health care costs?

While Social Security and WIC, the food and nutrition program for Women Infants and Children, are government-sponsored social programs, Medicare is the health insurance program that helps senior citizens pay for health care.

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Which program helps the poor pay for the cost of health care?

Medicaid is the health insurance program for the poor.

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Which is an example of group health insurance?

Employer-paid health insurance is much cheaper than most other types of health care coverage because of the number of people enrolled in the plan.

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Which of the following adequately describes the main difference between group health insurance and individual health insurance?

Because a number of people are enrolled in group health insurance, costs are kept low, while individual plans are expensive.

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Of the groups listed below, which would most likely purchase an individual health insurance plan?

Union workers and other municipal employees generally have employer- or union-sponsored group health plans. Those who are self employed must purchase individual health plans.

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In health insurance, what is meant by the term "network?"

In the health insurance industry, a network is a group of doctors, hospitals and other health care providers contracted to provide services to insurance companies for less than their usual fees.

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Which of the following is a form of an out-of-pocket expense?

A co-pay is a flat fee that an individual pays for health care services. The insurance company covers the rest.

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Which is not an example of a pre-existing condition?

Many individual plans exclude preexisting conditions when customers purchase health insurance. Technically speaking, a preexisting condition is any major medical problem like cancer, diabetes or asthma that is excluded from coverage because the person had that condition before purchasing their health insurance.

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Which is the major difference between an indemnity care plan and a managed care plan?

In indemnity, or "fee-for-service" health plans, the customer pays a percentage of their health care costs, while the insurance companies pick up the rest. Because of this, patients are free to choose their health care professionals and don't have to participate in a network of doctors.

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What's the main benefit of a managed care plan?

Managed care plans provide patients with lower health care costs because these services are part of a network of doctors, hospitals and other providers.

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What's a formulary?

Anyone who has tried to get a prescription filled only to be told that the insurance company will not pay for the drug knows what a formulary is. A formulary is a list of drugs an insurance company will not pay for. Most of the time the insurance company wants you to buy a less expensive generic drug.

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What does "HMO" mean?

An HMO, or Health Management Organization, provides a fixed fee for services instead of charging for each visit or procedure. Those services are provided by doctors, clinics and other health care providers under contract with the HMO.

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What's a high-risk pool?

High-risk pools are state-sponsored insurance programs for individuals denied coverage by private insurers because of health problems.

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Of the following, which doctor might not be considered a primary care provider?

A primary care physician is usually a general practitioner, internist or even a pediatrician who acts as the primary doctor for an person's health care needs. The primary-care provider refers patients to specialists, such as a cardiologist.

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Which of the following statements best describes "reasonable and customary?"

"Reasonable and customary" are the average fees paid in a specific geographic area. If the fee is higher than what the insurance company considers "reasonable and customary," the patient pays the difference.

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Which of the following best describes an arrangement by employers to allow employees to set aside pre-tax money for medical expenses?

Many employers allow their employees to contribute cash to a flexible health care spending account. The money is taken out of an employee's paycheck pre-tax.

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Which of the following provides supplemental insurance to cover the expenses that Medicare and other health care companies do not?

AFLAC is a company that provides supplemental insurance to cover some costs that regular health insurance will not cover.

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Of the following patients, who would most likely need long-term care insurance?

Nursing home patients would most likely need long-term health insurance to pay for chronic health problems and care.

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Why would you need to use COBRA?

The Consolidated Omnibus Budget Reconciliation Act, or COBRA, is the federal law that allows people who leave their job, including the unemployed, to continue with their former employer's health coverage for up to 18 months.

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Which word or term below best describes the amount you must pay each year before your health plan begins paying?

While a rider is an amendment to a health insurance plan and a co-payment is what a person pays when they visit the doctor, a deductible is what a patient pays before their health insurance kicks in.

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