Health Insurance Exam-Illinois Questions and Answers 100% Pass
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Course
Health Insurance Exm-Illinois
Institution
Health Insurance Exm-Illinois
Health Insurance Exam-Illinois
Questions and Answers 100% Pass
What is a health insurance policy?
A health insurance policy is a contract between an insurer and the insured that outlines the
terms of coverage, including benefits, costs, and exclusions.
What does the term "network" refer t...
Health Insurance Exam-Illinois
Questions and Answers 100% Pass
What is a health insurance policy?
✔✔ A health insurance policy is a contract between an insurer and the insured that outlines the
terms of coverage, including benefits, costs, and exclusions.
What does the term "network" refer to in health insurance?
✔✔ A network refers to a group of healthcare providers that have agreed to provide services at
negotiated rates for an insurance plan's members.
What are essential health benefits under the ACA?
✔✔ Essential health benefits are a set of healthcare service categories that must be covered by
certain plans under the Affordable Care Act, including emergency services, hospitalization, and
preventive services.
How does a high-deductible health plan (HDHP) work?
✔✔ An HDHP has higher deductibles and lower premiums, making it a cost-effective option for
individuals who want to save on monthly costs and are able to pay higher out-of-pocket expenses
when accessing care.
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,What is the role of an insurance broker?
✔✔ An insurance broker assists individuals and businesses in finding the right insurance
coverage by comparing different policies and providers.
What does it mean to "waive" coverage?
✔✔ To waive coverage means that an individual chooses not to accept health insurance benefits,
often signing a document to formalize their decision.
What is a formulary in health insurance?
✔✔ A formulary is a list of prescription drugs covered by a health insurance plan, often
categorized by tiers that determine cost-sharing levels.
How do preventive services benefit policyholders?
✔✔ Preventive services, such as vaccinations and screenings, help detect health issues early,
often at no additional cost to the policyholder, thereby promoting overall health and reducing
long-term costs.
What is a lifetime limit in health insurance?
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, ✔✔ A lifetime limit is a cap on the total benefits an insurer will pay for a covered individual
during their lifetime, which was prohibited under the ACA.
What are Health Savings Accounts (HSAs)?
✔✔ HSAs are tax-advantaged savings accounts that allow individuals to set aside money for
qualified medical expenses, typically associated with high-deductible health plans.
What is the purpose of coordination of benefits (COB)?
✔✔ COB is a process used to determine the order in which multiple health insurance plans will
pay benefits, ensuring that the total reimbursement does not exceed the actual medical expenses.
What are the differences between Medicare and Medicaid?
✔✔ Medicare is a federal health insurance program primarily for individuals aged 65 and older,
while Medicaid is a state and federal program providing health coverage to low-income
individuals and families.
What does "underwriting" refer to in health insurance?
✔✔ Underwriting is the process by which an insurance company assesses risk and determines
the eligibility and premium rates for potential policyholders based on their health and lifestyle.
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