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Health Insurance Practice Questions and Answers Latest Version with Certified Solutions
Who pays the premium in a health insurance plan?✔✔ The policyholder or the employer, depending on the plan.
What does a deductible mean in a health insurance policy?✔✔ The amount the insured must pay out of pocket before the insurance company starts paying.
What is a copayment in health insurance?✔✔ A fixed amount the insured pays for a covered healthcare service, usually at the time of service.
What does coinsurance refer to in health insurance?✔✔ The percentage of costs the insured pays after meeting the deductible.
Why is it important to check if a healthcare provider is in-network? 1 / 2
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✔✔ Because in-network providers usually cost less and the insurance covers more of the expense.
What is an out-of-pocket maximum?✔✔ The most a person has to pay during a policy period before the insurance pays 100% of covered services.
How does Medicaid differ from Medicare?✔✔ Medicaid is for low-income individuals and families, while Medicare is primarily for people aged 65 and older.
What type of health insurance plan requires a referral to see a specialist?✔✔ Health Maintenance Organization (HMO).
What does the term "pre-existing condition" mean in health insurance?✔✔ A health problem that existed before the start of the health insurance coverage.
Why do some health insurance plans have a network of providers?
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