Health Insurance Policies: Coverage Types, Deductibles, and Cost-Sharing Mechanisms

Flashcard Icon

Flashcard

Learn Mode Icon

Learn Mode

Match Icon

Match

Coming Soon!
Library Icon

Library

View Library
Match Icon

Create

Create More Decks
Flashcard Icon Flashcards
Flashcard Icon Flashcards
Library Icon Library
Match Icon Match (Coming Soon)

Business - Insurance

View Results
Full Screen Icon

jake12testoswi Created by 10 mon ago

Cards in this deck(28)
What type of health insurance policy provides 'first dollar' benefits for specified health care services with limited benefit periods and low coverage limits?
Blur Image
Which health insurance policy is characterized by broad coverage, high benefits, and includes deductibles and coinsurance cost sharing?
Blur Image
What is the term for the amount of expense or loss that must be paid by the insured before a health insurance policy starts paying benefits?
Blur Image
What is a stated dollar amount that applies to a covered loss per occurrence, per insured individual, sometimes referred to as an 'initial deductible'?
Blur Image
Which deductible is applied when a major medical policy supplements basic coverage and is not applied until the basic coverage is exhausted?
Blur Image
What type of deductible is used when a major medical plan supplements basic coverages, and the basic coverage amount satisfies the major medical deductible?
Blur Image
Which deductible requires the insured to satisfy a deductible for each accident or illness?
Blur Image
What type of deductible requires the insured to meet the deductible amount only once during the benefit period?
Blur Image
Which provision allows an insured to defer current health charges to the following year's deductible instead of the current year's deductible?
Blur Image
What is the principle under which the insurance company insures only part of the potential loss, with the policyowners paying the other part?
Blur Image
What is designed to stop the company's loss at a given point, placing a limit on the maximum out-of-pocket expenses an insured must pay?
Blur Image
What term describes an illness or medical condition that existed before a policy's effective date and is usually excluded from coverage?
Blur Image
What are tax-advantaged medical savings accounts available to U.S. taxpayers enrolled in a high-deductible health plan (HDHP)?
Blur Image
What are employer-funded, tax-advantaged health benefit plans that reimburse employees for out-of-pocket medical expenses and individual health insurance premiums?
Blur Image
What accounts were created to help employees of small employers and self-employed individuals pay for their medical care expenses?
Blur Image
What are tax-advantaged accounts that can be set up through a cafeteria plan of an employer?
Blur Image
What type of health insurance provides a stipulated daily, weekly, or monthly indemnity during hospital confinement, payable on an unallocated basis?
Blur Image
Which policies restrict benefits to specified accidents or diseases, such as travel policies and dread disease policies?
Blur Image
What type of policies provide a variety of benefits for a specific disease such as cancer or heart disease?
Blur Image
What insurance product typically makes a lump sum cash payment if the policyholder is diagnosed with one of the specific illnesses on a predetermined list?
Blur Image
Which policies cover hospital room and board, miscellaneous hospital expenses, medicines, use of operating room, and supplies?
Blur Image
What benefits cover expenses for occupancy of the room and bed, general nursing care, food and beverages, and personal hygiene items?
Blur Image
Which policies pay for the costs of surgeons' services, including surgeon's fees, anesthesiologist, and the operating room?
Blur Image
What approach assigns a dollar amount to every surgical procedure by the insurer?
Blur Image
Which approach uses a stated dollar-per-units amount, known as the conversion factor, to determine the benefit?
Blur Image
What approach compares the surgical expense to what is deemed reasonable and customary for the geographical area where the surgery was performed?
Blur Image
Which policy combines the features of basic expense coverage and major medical coverage, covering practically all medical expenses?
Blur Image
What ensures that no agency, institution, or physician providing a service for which payment is required under a policy governed by State law is denied payment because services were rendered through a physician assistant?
Blur Image

Ask Our AI Tutor

Get Instant Help with Your Questions

Need help understanding a concept or solving a problem? Type your question below, and our AI tutor will provide a personalized answer in real-time!

How it works

  • Ask any academic question, and our AI tutor will respond instantly with explanations, solutions, or examples.
Flashcard Icon
  • Browse questions and discover topic-based flashcards
  • Practice with engaging flashcards designed for each subject
  • Strengthen memory with concise, effective learning tools