The Ultimate Health Insurance Quiz

The Ultimate Health Insurance Quiz
Image: iStockphoto.com/Alex

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?
Medicare
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.
Medicaid
Social Security
WIC

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Which program helps the poor pay for the cost of health care?
Medicare
Medicaid
Medicaid is the health insurance program for the poor.
Social Security
WIC

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Which is an example of group health insurance?
Individual
Employer-paid
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.
Catastrophic
Supplemental

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Which of the following adequately describes the main difference between group health insurance and individual health insurance?
Those enrolled in a group health insurance plan pay less in premiums than those in an individual plan.
Because a number of people are enrolled in group health insurance, costs are kept low, while individual plans are expensive.
Those enrolled in a group health insurance plan pay more in premiums than those in an individual plan.
Those enrolled in a group health insurance plan receive less coverage than those in an individual plan.
Those enrolled in a group health insurance plan can never purchase an individual plan.

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Of the groups listed below, which would most likely purchase an individual health insurance plan?
Union worker
Self-employed
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.
Municipal employee
Private school teacher

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In health insurance, what is meant by the term "network?"
Hospitals owned by the same company.
Physicians who consult with other physicians.
Health care professionals that are part of a health plan's group of providers.
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.
Physicians who charge the same rate for the same type of procedure.

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Which of the following is a form of an out-of-pocket expense?
Co-pay
A co-pay is a flat fee that an individual pays for health care services. The insurance company covers the rest.
Broker
Beneficiary
COBRA

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Which is not an example of a pre-existing condition?
Cancer
Broken leg
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.
Diabetes
Asthma

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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.

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What's the main benefit of a managed care plan?
Lower costs
Managed care plans provide patients with lower health care costs because these services are part of a network of doctors, hospitals and other providers.
Higher costs
More out-of-network doctors
Access to better health care

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What's a formulary?
An insurance company's list of covered drugs.
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.

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What does "HMO" mean?
Health Maintenance Organization
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.
Health Management Organization
Holistic Medicine Organization
Happy Management Organization

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What's a high-risk pool?
A state-run program for the destitute.
A federal government operated program that offers coverage for individuals who cannot get health insurance from another source due to serious illness.
A state-run program that offers health coverage for individuals who cannot get health insurance from another source due to serious illness.
High-risk pools are state-sponsored insurance programs for individuals denied coverage by private insurers because of health problems.
A list of patients that should not be given health insurance because their cases are terminal.

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Of the following, which doctor might not be considered a primary care provider?
Cardiologist
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.
Internist
Pediatrician
General practitioner

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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.
The rate Medicare charges for medical treatment.

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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?
Flexible spending account
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.
Co-payment
Deductible
Rationing

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

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Of the following patients, who would most likely need long-term care insurance?
Those in a rehab center.
Those in a nursing home.
Nursing home patients would most likely need long-term health insurance to pay for chronic health problems and care.
Those in intensive care ward.
Those in an acute care facility.

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Why would you need to use COBRA?
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.
If you start a new job.
If you are self-employed.
If you have group-health insurance.

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Which word or term below best describes the amount you must pay each year before your health plan begins paying?
Deductible
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.
Rider
Single-payer
Co-payment

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You Got:
/20
iStockphoto.com/Alex

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