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.
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.
Which is the major difference between an indemnity care plan and a managed care plan?
Indemnity care plans cost less than managed care plans.
Those enrolled in an indemnity care plan can go out of network, while those that are covered by managed care plan cannot.
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.
Indemnity care plans cost more than managed care plans.
Indemnity care plans are solely catastrophic in nature, while managed care plans are not.
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.
An insurance company's list of in-network doctors.
An insurance company's list of out-of-network doctors.
An insurance company's list of customers who do not pay their bills.
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.
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.
Which of the following statements best describes "reasonable and customary?"
The median cost of a medical procedure.
Prevailing cost of a medical service in the United States.
Prevailing cost of a medical service in a given geographic area.
"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.
If you get laid off and lose your company's benefits.
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.