Set 1
How many types of health insurance options are there?
3
What is a monthly fee for coverage?
premium
The government program that assists lower income families in buying food.
SNAP (EBT)
A fixed fee for covered services is called a what?
Copayment
Which government program provides health insurance primarily for people aged 65 or older?
Medicare
Until what age does the ACA allow young adults to stay on their parent's health insurance plan?
26
No referrals, strict network is part of which plan?
EPO
What does Medicare Part A primarily cover?
Inpatient hospital care
Which part of Medicare covers medically necessary services like doctor visits, outpatient care, and preventive services?
Part B
Which plan type usually requires you to choose a Primary Care Physician (PCP) to act as a "gatekeeper" for your care?
HMO
If you want maximum flexibility to see any doctor, in or out of network, without needing a referral, which plan is best?
PPO
Unlike Medicare, eligibility for Medicaid is primarily based on what factor?
What is the main purpose of "risk pooling" in insurance?
Many pay in to fund expensive care
Which program helps children whose families earn too much for Medicaid
CHIP
What happens if you see a specialist in an HMO without getting a referral from your PCP first?
Insurance may deny payment
What is Medicare Part C also known as?
Medicare Advantage
What percentage under the Affordable Care Act is preventative care (like annual physicals) usually billed to the patient?
100
How is the Medicaid program funded?
Jointly by federal and state governments
Under the Affordable Care Act (ACA), what is the rule regarding pre-existing conditions?
Coverage cannot be denied
Social Security Disability Insurance (SSDI) is primarily based on what factor, unlike Medicaid?
Work History
What does Actual Cash Value (ACV) deduct for that Replacement Cost Value (RCV) does not?
Depreciation
How long is the waiting period to receive Medicare eligibility after a person starts receiving SSDI cash benefits?
2 Years
What happens once you reach your Out-of-Pocket Maximum for the year?
Plan covers 100% of covered services
Explain how Medicare A covers a nursing facility.
It covers it, but only for a limited amount of time.
When looking at a pharmacy formulary, which tier of drugs usually costs the least out-of-pocket?
Tier-1