Quiz Question ECO-336
Study online at https://quizlet.com/_huu1o8
1. Which of the following is the best definition of the term "health insurance
premium"?: The amount health insurance companies charge each month for coverage
2. Is a health insurance premium something you must pay every month, re-
gardless 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?: Must pay every month, regardless of whether you use services
3. Which of the following is the best definition of the term "annual health
insurance deductible"?: The amount of covered health care expenses you must pay yourself each year
before your insurance will begin to pay
4. 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, the bill (after insurance discounts are applied) comes
to $6,000. How much of that hospital bill will you have to pay yourself?: $2,000
5. Which of the following best describes the "annual out-of-pocket limit" under a
health insurance policy?: The most you will have to pay in deductibles, copays and coinsurance for covered
care received in network for the year
6. Which of the following best describes a "health insurance formulary"?: The list
of prescription drugs your health plan will cover
7. Which of the following best describes a health plan "provider network"?: The
hospitals and doctors that contract with your health plan to provide services for an agreed-upon rate of fee schedule
8. 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: False
9. 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 tested 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
the test?: $88
10. If your health insurance 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: True
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Study online at https://quizlet.com/_huu1o8
1. Which of the following is the best definition of the term "health insurance
premium"?: The amount health insurance companies charge each month for coverage
2. Is a health insurance premium something you must pay every month, re-
gardless 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?: Must pay every month, regardless of whether you use services
3. Which of the following is the best definition of the term "annual health
insurance deductible"?: The amount of covered health care expenses you must pay yourself each year
before your insurance will begin to pay
4. 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, the bill (after insurance discounts are applied) comes
to $6,000. How much of that hospital bill will you have to pay yourself?: $2,000
5. Which of the following best describes the "annual out-of-pocket limit" under a
health insurance policy?: The most you will have to pay in deductibles, copays and coinsurance for covered
care received in network for the year
6. Which of the following best describes a "health insurance formulary"?: The list
of prescription drugs your health plan will cover
7. Which of the following best describes a health plan "provider network"?: The
hospitals and doctors that contract with your health plan to provide services for an agreed-upon rate of fee schedule
8. 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: False
9. 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 tested 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
the test?: $88
10. If your health insurance 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: True
1/2
