Health Insurance Literacy Quiz

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Test your knowledge of the basic skills needed to manage your health insurance successfully. Visit https://www.maximizehealthinsurance.com to stay informed about how to navigate your health insurance successfully.

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1. Which of the following is the best definition of the term “health insurance premium?” *

1 point

The best type of health insurance you can buy

The amount health insurance companies charge each month for coverage

A bonus you get at the end of the year if you remain enrolled

The amount you owe after your health insurance plan processes your claim

An additional amount you owe if you are unhealthy

2. Which of the following is the best definition of the term “annual health insurance deductible?”
*

1 point

The amount that is deducted from your paycheck each year to pay for your policy

The amount of health expenses you can subtract from income on your yearly tax return

The amount of covered health care expenses you must pay yourself each year before your insurance will pay

The value of healthcare services that you can deduct from your Federal Income Tax return

3. Which of the following best describes the “annual out-of-pocket limit” under a health insurance policy?
*

1 point

The most you will have to pay in deductibles and coinsurance for the year

The most your insurance policy will pay for covered services in a calendar year

The most you will have to pay in premiums in a given year

The maximum benefit amount paid by your insurance company

4. Suppose that under your health insurance policy, hospital expenses are subject to a $1,000 deductible and a $250 per day copay. You get sick and are hospitalized for 4 days, and the bill (after insurance discounts are applied) comes to $6,000. How much of the hospital bill will you have to pay yourself?

1 point

0.00

$1,000

$2,000

$4,000

$6,000

5. Which of the following best describes a health plan “provider network?”

1 point

The computer system doctors and hospitals use to submit bills to insurance companies

The hospitals and doctors that contract with your health plan to provide services for an agreed-upon rate or fee schedule

A website where consumers can find information about the best doctors

Group of medical providers affiliated with a hospital

6. Which of the following best describes a “health insurance formulary?

1 point

The form you send to your insurance company when you need to have a medical bill paid

The type of permission you must get from your insurance company before surgery will be covered

The list of prescription drugs your health plan will cover

The process insurance companies undertake to determine the maximum amount of reimbursement for medical treatment by their plan

7. What is a Summary of Benefits and Coverage?

1 point

The claims statement a health insurance creates after a claim is paid

An easy-to-read summary that lets you make apples-to-apples comparisons of costs and coverage between health plans

Summary of your HIPAA Rights provided by your doctor at the time of a visit

A written document provided by your doctor detailing the course of treatment and how much you owe

8. True or false: If you receive inpatient care at a hospital that participates in your health plan’s provider network, all the doctors who care for you while you’re in the hospital will also be in-network.

1 point

True

False

9. Suppose your health plan covers lab tests in full if use an in-network lab, but will only pay 60% of allowed charges if you go out-of-network. You forget to check and go get your blood test at a lab that turns out to be out-of-network. The lab bills you $100 for the blood test. Your health insurance allows only a $20 charge for that test. How much would you have to pay out-of-pocket for that lab test assuming you've already met your deductible?

1 point

$0.00

$40.00

$60.00

$80.00

$88.00

10. True or false? If your health insurance or health plan refuses to pay for a service that you think is covered and your doctor says you need, you can appeal the denial and possibly get the insurance company to pay the claim.

1 point

True

False

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