Quiz - How Well Do You Understand Your Health Insurance?

Question 1 of 10

Which statement best describes a health insurance premium?

The cost you pay for health care services after you meet your deductible.

The fee you have to pay in the months you receive covered health care services.

The monthly fee you have to pay to have health insurance coverage, even if you do not use any health care services.

The amount you pay when your medical bills exceed a certain dollar amount.

Question 2 of 10

Which of the following is the best definition of the term “annual health insurance deductible”?

The amount that is deducted from your paycheck to pay for your policy.

The amount of health expenses you can subtract from income on your yearly tax return.

The amount of covered health care expenses you must pay out-of-pocket each year before your insurance will begin to pay.

The maximum total amount you will pay out-of-pocket for covered health care in a year, after which insurance covers 100% of costs.

Question 3 of 10

Which statement describes the difference between a copayment and coinsurance?

A copayment is a fixed dollar amount you pay for a covered health care service (e.g., an office visit or prescription drug), while coinsurance is a percentage of the cost for a covered service.

A copayment is a percentage of the total bill, while coinsurance is always a fixed amount.

Copayments apply only to hospital care, while coinsurance applies only to prescription drugs.

Copayments and coinsurance mean the same thing and can be used interchangeably.

Question 4 of 10

Your health insurance plan has a $1,000 deductible for hospital care and a $250 per-day copayment once the deductible is met. You are hospitalized for 4 days, and the hospital charges negotiated with the insurance company (the “allowed amount”) total $6,000. How much would you be responsible for paying?

$1,000

$2,000

$4,000

Question 5 of 10

Which statement describes a Health Savings Account (HSA)?

An account used for paying premiums and medical expenses under your health plan.

A savings account that lets you set aside pre-tax money to pay for eligible medical expenses.

A program that replaces your health insurance once your deductible is met.

A fund controlled by insurers to reduce your out-of-network charges.

Question 6 of 10

When you receive care from an out-of-network medical professional or facility, what costs might you be responsible for? (“Out of network” refers to a doctor, hospital, or facility that does not have a contract with your health insurance plan.)

Only the standard copayment that applies to in-network visits.

Nothing, because medical professionals and facilities must accept all insurance plans.

Higher copays and other cost-sharing and possibly the full difference between the care provider’s charge and the insurer’s allowed amount.

Only the additional deductible amount for out-of-network services.

Question 7 of 10

Under federal “surprise billing” protections, patients are generally shielded from higher out-of-network charges when they receive:

Emergency care from an out-of-network medical professional or facility.

Any service from an out-of-network medical professional as long as it is at an in-network hospital.

Non-emergency procedures performed by out-of-network medical professional or facility the patient chose in advance.

Prescription drugs not covered by the health insurance plan.

Question 8 of 10

What does it mean when a health care professional says that a test, procedure, or medication requires “prior authorization” in order for insurance to cover it?

The care provider will check your coverage automatically and schedule the service once that check is complete.

Your doctor must send information and wait for the insurance company to approve the service before it is covered.

You can have the service right away, then the insurance company will approve payment afterward.

You need a referral from your primary care medical professional before the service can be scheduled.

Question 9 of 10

Which of the following best describes a prescription drug “formulary”?

The list of pharmacies you can use to get your prescriptions filled.

The list of prescription drugs that your insurance plan will cover.

Whether the prescription requires prior authorization from your insurance.

How many refills you can get before you need to get a new prescription.

Question 10 of 10

Which of the following are required to publicly post prices for health care services?

Hospitals

Health insurance plans and self-insured employers

Both

None of the above

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Quiz – How Well Do You Understand Your Health Insurance?