Primary care Physician Or Primary care provider (PCP) Is know as a?
What is a Gatekeeper
What is a deductible?
_____ + _____ is made of comprehensive coverage
What is both major and basic?
This federal law requires employers with 20+ employees to offer continued group coverage under certain conditions.
What is the Consolidated Omnibus Budget Reconciliation Act (COBRA)?
This type of dental service includes routine checkups, x-rays, and cleaning
What are Diagnostic/Preventative Services
These are the 3 different basic medical policies.
This is a percentage of claims the insured must pay after the deductible has been met
What is co-insurance
This government program provides health coverage for active duty or retired U.S military members and their dependents, offering plans like Standard, Prime, and ______ For Life.
What is TRICARE?
When benefits are based on the average fee charged by all providers in a given geographical area, it is called
Usual, Customary, Reasonable (UCR)
Services like filings, periodontal treatments, and root canals fall under this category of dental care
What are basic services
This plan requires you to use specific doctors and hospitals within their network, often requiring a PCP
What is an HMO (Health Maintenance Organization)
This is the maximum a policy will pay for a covered loss per year.
What is an Annual Limit
Newborn Coverage begins ____
What is the moment of birth?
COBRA allows continued group health coverage for how many months after job loss (under normal circumstances)?
What is 18 months?
This specialized dental field focuses on irregularities and misalignment of teeth
What is orthodontics
This plan is more flexible than an HMO, allowing you to see a doctor without a referral, but you pay less if you use in network providers.
What is a PPO (Preferred Provider Organization)
A maximum of 2 or 3 deductibles will satisfy the deductible requirement for the entire family per calendar year. Is known as a?
Family Deductible
What Pays directly to the insured a specified dollar amount per day during hospitalization?
Hospital Indemnity
What is the period called when no benefits are paid at the start of a disability?
What is the elimination period?
What is a temporary coverage that provides limited benefits for a short period of time, typically 30 days to 12 months?
Short-Term Medical
This is the "best of both worlds" plan; it lets you choose doctors freely, unlike an HMO, but generally cost less than a PPO
What is a POS (Point of Service) Plan?
A health plan has a $500 deductible, 80/20 coinsurance, and a $2,000 out-of-pocket max. After meeting the deductible, how much would the insured pay for a $6,000 covered bill?
What is $1,500?
This policy pays benefits if the insured person dies from an accident or suffers serious accidental injuries like losing a limb or eyesight, but specifically excludes losses due to sickness
What Accidental Death and Dismemberment
What is a common exclusion in most health insurance policies that prevents coverage for injuries sustained during war?
What is the war or act of war exclusion?
This is the maximum a policy will pay for a covered loss per claim.
What is Per-cause ?