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CCHI – Insurance Exam (68 Terms in this set) with
Complete Solution Latest Update.
Affordable Care Act (ACA)/ Health Care Reform; Obamacare - ✔✔✔The comprehensive
federal health care reform law enacted in March 2010.
Health Insurance - ✔✔✔A contract that requires an individual's health insurer to pay
some or all of their health care costs in exchange for a premium.
Health Insurance Marketplace/ Exchange - ✔✔✔State- or federally run and regulated
market where an individual can shop, compare, and buy health care coverage.
Eligibility requirements - ✔✔✔Conditions that must be met in order for an individual or
group to be considered eligible for insurance coverage.
Open enrollment (period) - ✔✔✔A period of time each year when an individual can
purchase or change health coverage.
Medicaid - ✔✔✔Health insurance provided by the government to some low-income
people, families and children, pregnant women, the elderly, and people with disabilities.
In some states the program covers all adults below a certain income level. Medicaid
programs must follow federal guidelines, but coverage and costs may be different from
state to state.
Children's Health Insurance Program (CHIP) - ✔✔✔Health insurance provided by the
government to children in families that earn too much money to qualify for Medicaid. In
some states, CHIP covers parents and pregnant women. Each state works closely with its
state Medicaid program. In many cases, if an individual qualifies for Medicaid your
children will qualify for either Medicaid or CHIP.
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Medicare - ✔✔✔A federal health insurance program, administered by the Social Security
Administration, that provides health care for most people over 65 and certain other
eligible individuals.
Health plan - ✔✔✔A benefit an individual's employer, union or other group sponsor
provides to that individual to pay for their health care services.
Secondary coverage - ✔✔✔When a person is covered under more than one health
insurance plan, this term describes the health insurance plan that provides payment on
claims after the primary coverage (i.e. main plan).
Managed care - ✔✔✔A general term used to describe a variety of health care and
health insurance systems that attempt to guide a patient's use of benefits, typically by
requiring that a patient coordinate his or her health care through a primary care
physician, or by encouraging the use of a specific network of healthcare providers. The
management of health care is intended to keep costs -and monthly premiums- as low as
possible. Examples of managed care plans include:
• Health maintenance organizations (HMOs),
• Preferred provider organizations (PPOs),
• Exclusive provider organizations (EPOs), and
• Point of service plans (POSs).
Premium - ✔✔✔The amount that must be paid for an individual's health insurance or
plan. The individual and/or their employer usually pay it monthly, quarterly or yearly.
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CCHI – Insurance Exam (68 Terms in this set) with
Complete Solution Latest Update.
Affordable Care Act (ACA)/ Health Care Reform; Obamacare - ✔✔✔The comprehensive
federal health care reform law enacted in March 2010.
Health Insurance - ✔✔✔A contract that requires an individual's health insurer to pay
some or all of their health care costs in exchange for a premium.
Health Insurance Marketplace/ Exchange - ✔✔✔State- or federally run and regulated
market where an individual can shop, compare, and buy health care coverage.
Eligibility requirements - ✔✔✔Conditions that must be met in order for an individual or
group to be considered eligible for insurance coverage.
Open enrollment (period) - ✔✔✔A period of time each year when an individual can
purchase or change health coverage.
Medicaid - ✔✔✔Health insurance provided by the government to some low-income
people, families and children, pregnant women, the elderly, and people with disabilities.
In some states the program covers all adults below a certain income level. Medicaid
programs must follow federal guidelines, but coverage and costs may be different from
state to state.
Children's Health Insurance Program (CHIP) - ✔✔✔Health insurance provided by the
government to children in families that earn too much money to qualify for Medicaid. In
some states, CHIP covers parents and pregnant women. Each state works closely with its
state Medicaid program. In many cases, if an individual qualifies for Medicaid your
children will qualify for either Medicaid or CHIP.
Page 1 of 10
, 2
Medicare - ✔✔✔A federal health insurance program, administered by the Social Security
Administration, that provides health care for most people over 65 and certain other
eligible individuals.
Health plan - ✔✔✔A benefit an individual's employer, union or other group sponsor
provides to that individual to pay for their health care services.
Secondary coverage - ✔✔✔When a person is covered under more than one health
insurance plan, this term describes the health insurance plan that provides payment on
claims after the primary coverage (i.e. main plan).
Managed care - ✔✔✔A general term used to describe a variety of health care and
health insurance systems that attempt to guide a patient's use of benefits, typically by
requiring that a patient coordinate his or her health care through a primary care
physician, or by encouraging the use of a specific network of healthcare providers. The
management of health care is intended to keep costs -and monthly premiums- as low as
possible. Examples of managed care plans include:
• Health maintenance organizations (HMOs),
• Preferred provider organizations (PPOs),
• Exclusive provider organizations (EPOs), and
• Point of service plans (POSs).
Premium - ✔✔✔The amount that must be paid for an individual's health insurance or
plan. The individual and/or their employer usually pay it monthly, quarterly or yearly.
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