Health Insurance Flashcards

If J's Major Medical policy has a $2,000 deductible and an 80/20 Coinsurance clause, how much would J pay if hospitalized and billed $10,000?

To qualify for a tax-exempt Health Savings Account, what must S be enrolled in?

Does leukemia fall under the coverage of a Critical Illness plan?

Which of the following statements BEST describes dental care indemnity coverage?

What policy feature allows an insured to defer current health charges to the following year's deductible?

What does the hospitalization expense cover in a Basic Medical Expense policy?

What is the term for the provision in a Major Medical policy that requires the insured to pay part of the medical expenses?

What is one of the primary reasons for using deductibles in health policies?

Major Medical benefits normally have a maximum limit.

Who must fund a Health Reimbursement Arrangement (HRA)?

Medical Expense Insurance Overview

J's Major Medical policy features a $2,000 deductible and an 80/20 coinsurance clause. If hospitalized with a $10,000 bill, J pays $3,600 ($2,000 deductible + 20% of remaining $8,000).

Health Savings Accounts (HSAs)

To qualify for a tax-exempt Health Savings Account, an individual must be enrolled in a high-deductible health plan (HDHP), cannot have other health insurance (except accident, disability, dental, vision, long-term care), must not be eligible for Medicare, and cannot be a tax-dependent.

Critical Illness Coverage

Critical Illness plans cover specific severe conditions, including leukemia, which is a type of cancer.

Dental Care Indemnity Coverage

Dental care indemnity plans reimburse patients for services rendered only after the insurance carrier has received the invoice.

Carryover Provision

The Carryover provision allows health expenses incurred in the last three months of the year to be applied towards the deductible of the following year.

Basic Medical Expense Policy

Hospitalization expenses under a Basic Medical Expense policy typically cover hospital room and board.

Major Medical Policies

Coinsurance is the provision in a Major Medical policy that requires the insurer to pay a portion of medical expenses, leaving the remaining balance to be paid by the insured.

Deductibles in Health Policies

Deductibles are employed in health policies to help minimize the overuse of medical services.

Major Medical Benefits Limitations

While Major Medical benefits provide substantial coverage, there typically exists a maximum limit on the benefits.

Health Reimbursement Arrangements (HRAs)

Health Reimbursement Arrangements must be established and funded solely by the employer.

Test your knowledge of medical expense insurance with these flashcards. Review key concepts such as deductibles, coinsurance, and health savings accounts to better understand how health insurance works.