Plan Types
Which plan type typically offers lower monthly premiums but higher out-of-pocket costs before coverage begins?
Bronze
What is the amount you pay before most insurance benefits begin on a non-copay plan?
Deductible
Annual wellness visits are considered what type of care?
Preventive care
Doctors and facilities contracted with the health plan are called what?
In-network providers
What annual period allows most individuals to enroll in or change plans?
Open Enrollment
What type of plan allows members to contribute to a Health Savings Account (HSA)?
HSA-qualified plan
What is the fixed amount paid for a covered service, like a doctor visit?
Copay
Most preventive services are covered at what percentage when received in-network?
100%
Care received outside the plan's contracted providers is considered what?
Out-of-network care
What event may allow enrollment outside Open Enrollment?
Qualifying Life Event
Which metal level plan generally has the lowest monthly premium among Bronze, Silver, Gold, and Platinum?
Bronze
What term describes a percentage of costs you share after meeting your deductible?
Coinsurance
Mammograms, colonoscopies, and vaccines are examples of what?
Preventive services
Which usually costs less: in-network or out-of-network care?
In-network care
Marriage, birth of a child, and loss of coverage are examples of what?
Qualifying Life Events
What plan category is designed primarily for younger individuals or those who qualify for a hardship exemption?
Catastrophic
What is the maximum amount a member may pay for covered services during a plan year?
Out-of-pocket maximum
Does preventive care generally require the deductible to be met first?
No
What tool can members use to verify if a physician participates in a network?
Provider directory
What documentation may be required to verify a Special Enrollment Period?
Proof of the event
Which BCBS SC ACA type of plan usually offers the highest monthly premium but lower out-of-pocket costs when care is needed?
Gold
True or False: Copays always count toward your out-of-pocket maximum.
True
Why is preventive care important for members?
Early detection and prevention
Why should network participation be verified before enrollment?
To avoid unexpected costs
What is the difference between Open Enrollment and a Special Enrollment Period?
Open Enrollment is the annual enrollment window; a Special Enrollment Period allows enrollment after a qualifying life event.