What is a health insurance premium? Can you describe what an annual health insurance deductible is? If you answered, “no,” you’re not alone. The language of health insurance can be complex and confusing, particularly for many long-time uninsured people enrolling in the new insurance marketplaces set up under the Affordable Care Act. Show Take this 10-question quiz and learn how health insurance literate you are compared to a nationally representative survey of U.S. adults who were asked the same questions. Which of the following is the best definition of the term “health insurance premium?” The premium is the monthly fee all enrollees pay in order to have health insurance coverage. 76% of Americans answered this question correctly. Is a health insurance premium something you must pay every month, regardless of whether you use health care services, or do you only have to pay your health insurance premium during months when you use health care services? You must pay insurance premiums every month. 79% of Americans answered this question correctly. Which of the following is the best definition of the term “annual health insurance deductible?" A deductible is one type of “cost-sharing” feature often included in a health insurance policy. 72% of Americans answered this question correctly. Suppose that under your health insurance policy, hospital expenses are subject to a $1,000 deductible and $250 per day copay. You get sick and are hospitalized for 4 days, and the bill (after insurance discounts are applied) comes to $6,000. How much of that hospital bill will you have to pay yourself? You pay the first $1,000 of the discounted (or allowed) charge because of the deductible, plus 4 copays of $250 per day, or another $1,000. That comes to $1,000 + $1,000, for a total of $2,000 that you pay out of pocket. 51% of Americans answered this question correctly. Which of the following best describes the “annual out-of-pocket limit” under a health insurance policy? Health plans sold through the Marketplace and most employer health plans must cap the amount you are required to pay each year in deductibles, copays, and coinsurance for covered services received in network. 67% of Americans answered this question correctly. Which of the following best describes a “health insurance formulary?" The list of what drugs your health plan will cover, and what cost-sharing you owe for different drugs, is called the drug formulary. 33% of Americans answered this question correctly. Which of the following best describes a health plan “provider network?" Most health plans establish a network of providers and provide the highest level of coverage when you get care from them. 76% of Americans answered this question correctly. True or false: If you receive inpatient care at a hospital that participates in your health plan’s provider network, all the doctors who care for you while you’re in the hospital will also be in network. Often doctors who work in a hospital don’t work for the hospital. 41% of Americans answered this question correctly. Suppose your health plan covers lab tests in full if you go to an in-network lab, but only pays 60% of allowed charges if you go out of network. You forget to check and go get your blood test at a lab that turns out to be out of network. The lab bills you $100 for the blood test. Your health insurance allows only a $20 charge for that test. How much would you have to pay out of pocket for that lab test? Your health plan will pay 60% of the $20 allowed charge, or $12. Because the lab is not in network, it is not required to accept the health insurance’s discounted price, which is also called the allowed charge. The lab can bill you for the balance, which is $88. 16% of Americans answered this question correctly. True or false? If your health insurance or health plan refuses to pay for a service that you think is covered and your doctor says you need, you can appeal the denial and possibly get the insurance company to pay the claim. Consumers have the right to formally appeal if they get into a dispute with the health plan about whether services are medically necessary and appropriate and should be covered. Which of the following is not characteristic of a major medical plan?All of the following are characteristics of a major medical expense policy EXCEPT: Elimination period. The elimination period is the period of time between the onset of a disability, and the time you are eligible for benefits. It is typically a characteristic of disability policies, not major medical expense polices.
What are the characteristics of a major medical policy?Major medical insurance is a specific type of health insurance plan that will help cover your medical expenses. It often covers preventive care services, urgent care visits, emergency room visits, prescription medications, and other routine medical expenses.
Which is not a characteristic of group health insurance quizlet?individual members of the group may select the level of benefits for their own coverage. Which is NOT a characteristic of group health insurance? group coverage must be extended for terminated employees up to a certain period of time at the former employees expense.
Which of these is not a function of a medical expense policy?Which benefit is excluded from Medical Expense policies? Medical Expense policies do NOT pay benefits for pain and suffering.
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Which of the following is not true of a major medical health insurance policy
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