Medical Insurance & Coding Ch. 9:
Exam Questions and Answers (Latest
Update 2026)
Medicare Part C (Medicare Advantage Plans) -
correct answer ✅it offers more comprehensive benefits to replace
Part A & B. it offers benefits that A&B don't offer like dental &
vision plans.
Policy -
correct answer ✅The product offered by an insurance company,
defining benefits that may be paid.
Benefits -
correct answer ✅In the insurance industry, the services or items
covered in an insurance policy.
Claim -
correct answer ✅In the insurance industry, a request for payment
of covered benefits.
Dependents -
correct answer ✅In relation to health insurance, an individual who
receives insurance benefits due to a relationship to subscriber.
,Medical Insurance & Coding Ch. 9:
Exam Questions and Answers (Latest
Update 2026)
Guarantor -
correct answer ✅In relation to healthcare, the person who is
financially responsible for paying a medical bill.
Premium -
correct answer ✅In the insurance industry, a monthly payment
made to purchase insurance coverage.
Deductible -
correct answer ✅Amount you must pay before you begin receiving
any benefits from your insurance company.
Copayment -
correct answer ✅An amount of money that is paid at the time of
medical service.
Coinsurance -
correct answer ✅A type of insurance in which the insured pays a
share of the payment made against a claim. ( 70 - 30% )
, Medical Insurance & Coding Ch. 9:
Exam Questions and Answers (Latest
Update 2026)
Patient Protection and Affordable Care Act (ACA) -
correct answer ✅A federal law enacted in 2010 with the goals of
making insurance affordable to more people, expanding Medicaid
coverage, & supporting care practices that improve patient health
& lower costs.
Out-of-Pocket Maximum -
correct answer ✅A predetermined amount after which the
insurance company will pay 100% of the cost of medical services.
Explanation of Benefits (EOB) -
correct answer ✅A paper document from a payer that shows how
the amount of a benefit was determined. Always goes to the
patient.
Remittance Advice (RA) -
correct answer ✅An explanation of benefits (EOB) transmitted
electronically by a payer to a provider.
Allowable Amount -
correct answer ✅The maximum amount that a plan will pay for a
specific procedure.
Exam Questions and Answers (Latest
Update 2026)
Medicare Part C (Medicare Advantage Plans) -
correct answer ✅it offers more comprehensive benefits to replace
Part A & B. it offers benefits that A&B don't offer like dental &
vision plans.
Policy -
correct answer ✅The product offered by an insurance company,
defining benefits that may be paid.
Benefits -
correct answer ✅In the insurance industry, the services or items
covered in an insurance policy.
Claim -
correct answer ✅In the insurance industry, a request for payment
of covered benefits.
Dependents -
correct answer ✅In relation to health insurance, an individual who
receives insurance benefits due to a relationship to subscriber.
,Medical Insurance & Coding Ch. 9:
Exam Questions and Answers (Latest
Update 2026)
Guarantor -
correct answer ✅In relation to healthcare, the person who is
financially responsible for paying a medical bill.
Premium -
correct answer ✅In the insurance industry, a monthly payment
made to purchase insurance coverage.
Deductible -
correct answer ✅Amount you must pay before you begin receiving
any benefits from your insurance company.
Copayment -
correct answer ✅An amount of money that is paid at the time of
medical service.
Coinsurance -
correct answer ✅A type of insurance in which the insured pays a
share of the payment made against a claim. ( 70 - 30% )
, Medical Insurance & Coding Ch. 9:
Exam Questions and Answers (Latest
Update 2026)
Patient Protection and Affordable Care Act (ACA) -
correct answer ✅A federal law enacted in 2010 with the goals of
making insurance affordable to more people, expanding Medicaid
coverage, & supporting care practices that improve patient health
& lower costs.
Out-of-Pocket Maximum -
correct answer ✅A predetermined amount after which the
insurance company will pay 100% of the cost of medical services.
Explanation of Benefits (EOB) -
correct answer ✅A paper document from a payer that shows how
the amount of a benefit was determined. Always goes to the
patient.
Remittance Advice (RA) -
correct answer ✅An explanation of benefits (EOB) transmitted
electronically by a payer to a provider.
Allowable Amount -
correct answer ✅The maximum amount that a plan will pay for a
specific procedure.
