Health Insurance Exam Practice Questions
1. What is the primary purpose of health insurance?
A) To provide financial protection in the event of a car accident
B) To protect your home from natural disasters
C) To cover medical expenses and provide healthcare benefits
D) To insure against theft and vandalism
2. What is a premium in the context of health insurance?
A) The amount of money paid to the insurance company for coverage
B) A medical examination required for insurance approval
C) The maximum amount an insurer will pay for a single claim
D) A policyholder’s medical history
3. Which type of health insurance plan typically allows you to choose any doctor or specialist without a referral?
A) HMO (Health Maintenance Organization)
B) PPO (Preferred Provider Organization)
C) EPO (Exclusive Provider Organization)
D) POS (Point of Service)
4. What does the term “deductible” refer to in health insurance?
A) The amount you pay out of pocket before your insurance coverage kicks in
B) A discount on your premium for being a safe driver
C) The coinsurance percentage you pay after meeting your out-of-pocket maximum
D) The cost of prescription drugs
5. Which of the following healthcare services is typically covered by health insurance?
A) Cosmetic surgery for aesthetic purposes
B) Routine check-ups and preventive care
C) Alternative medicine treatments not supported by medical evidence
D) Over-the-counter medications
6. What is the purpose of “co-insurance” in health insurance?
A) To determine the maximum coverage limit of the policy
B) To calculate the cost-sharing between the insured and the insurer
C) To pay the monthly premium for the policy
D) To cover pre-existing medical conditions
7. What is a Health Savings Account (HSA) commonly used for?
A) Paying for health insurance premiums
B) Saving for retirement
C) Covering medical expenses with pre-tax dollars
D) Purchasing life insurance policies
8. In a typical health insurance policy, what is a “pre-existing condition”?
A) A medical condition that has been treated and resolved
B) A condition that is not covered under any circumstances
C) A medical condition that existed before the policy’s effective date
D) A condition that only affects young people
9. What does the term “network” refer to in the context of health insurance?
A) A group of healthcare providers and facilities that have a contract with the insurance company
B) The policyholder’s immediate family members who are covered by the policy
C) The maximum number of claims allowed per year
D) The deductible amount
10. Which government program provides health insurance to individuals over the age of 65 in the United States?
A) Medicaid
B) CHIP (Children’s Health Insurance Program)
C) Social Security
D) Medicare
11. What is a “grace period” in health insurance?
A) The time frame in which you must file a claim after a medical procedure
B) A period of extended coverage after missing a premium payment
C) The time allowed for pre-authorization of a medical procedure
D) The period when the policy is not in effect
12. When does an individual typically enroll in a health insurance plan during the open enrollment period?
A) At any time during the year
B) When they experience a medical emergency
C) During a specific time frame designated by the insurer
D) On their birthday
13. What is the purpose of the Affordable Care Act (ACA) in the United States?
A) To regulate automobile insurance rates
B) To provide subsidies for farmers
C) To make health insurance more affordable and accessible
D) To establish national parks
14. In health insurance, what is the “out-of-pocket maximum”?
A) The most you can be charged for a medical procedure
B) The minimum amount you must pay for a prescription
C) The highest premium rate available
D) The most you will pay for covered medical expenses in a policy year
15. What is a “policyholder” in the context of health insurance?
A) An insurance company executive
B) The person or entity that owns and maintains the insurance policy
C) A healthcare provider
D) A government agency responsible for regulating insurance
16. Which government program provides health insurance to low-income individuals and families in the United States?
A) Social Security
B) Medicaid
C) Medicare
D) CHIP
17. What is “catastrophic health insurance”?
A) A type of insurance that covers routine check-ups and preventive care
B) Coverage that only kicks in after a significant health event or high medical costs
C) A policy that provides unlimited coverage for all medical expenses
D) Insurance for natural disasters
18. What is the primary difference between group health insurance and individual health insurance?
A) Group insurance is typically more expensive
B) Group insurance is only available to senior citizens
C) Group insurance is provided by the government
D) Group insurance is purchased by an organization or employer for its members
19. What does “COBRA” stand for in health insurance?
A) A venomous snake found in North America
B) Consolidated Omnibus Budget Reconciliation Act
C) A popular health insurance company
D) A medical condition
20. What is the purpose of the “waiting period” in health insurance?
A) To delay the start of coverage for a specified period
B) To expedite the claims process
C) To determine the annual deductible
D) To establish network provider preferences
These practice questions cover a range of topics related to health insurance. For a comprehensive preparation, you can find additional study materials and resources specific to your health insurance exam. Good luck with your exam preparation!