CCMA NHA Chapter 1 Insurance Questions and Answers | Latest Version | 2025/2026 | Correct & Verified

CCMA NHA Chapter 1 Insurance Questions and Answers | Latest Version | 2025/2026 | Correct & Verified Which type of insurance provides payment for medical services received by an individual? Health insurance. What is the purpose of a deductible in an insurance plan? It is the amount the patient must pay out-of-pocket before insurance begins to cover costs. What does co-payment mean in health insurance? A fixed amount the patient pays for a covered service at the time of care. What is coinsurance in an insurance plan? The percentage of the cost of covered services the patient pays after the deductible is met. Which term describes the maximum amount a patient will pay out-of-pocket in a year? Out-of-pocket maximum. 2 What is a premium in health insurance? The amount paid, usually monthly, to maintain health coverage. Which insurance plan allows members to choose any provider without referrals? Preferred Provider Organization (PPO). Which insurance plan requires a primary care provider and referrals for specialists? Health Maintenance Organization (HMO). What does Medicaid provide? Health coverage for low-income individuals and families. What does Medicare provide? Health coverage for individuals age 65 or older and certain younger people with disabilities. Which part of Medicare covers hospital stays? Medicare Part A. 3 Which part of Medicare covers medical services and outpatient care? Medicare Part B. Which part of Medicare allows private insurance plans to provide coverage? Medicare Part C. Which part of Medicare covers prescription drugs? Medicare Part D. What is the term for a list of medications covered by an insurance plan? Formulary. What is the purpose of pre-authorization in insurance? Approval from the insurance company before a specific service is performed. What is an explanation of benefits (EOB)? A statement from the insurance company showing what was paid, denied, or patient responsibility.