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Health Insurance Exam-Illinois Questions and Answers 100% Pass

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Health Insurance Exam-Illinois Questions and Answers 100% Pass What is a health insurance policy? A health insurance policy is a contract between an insurer and the insured that outlines the terms of coverage, including benefits, costs, and exclusions. What does the term "network" refer t...

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  • September 29, 2024
  • 27
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Health Insurance Exm-Illinois
  • Health Insurance Exm-Illinois
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Health Insurance Exam-Illinois
Questions and Answers 100% Pass
What is a health insurance policy?


✔✔ A health insurance policy is a contract between an insurer and the insured that outlines the

terms of coverage, including benefits, costs, and exclusions.




What does the term "network" refer to in health insurance?


✔✔ A network refers to a group of healthcare providers that have agreed to provide services at

negotiated rates for an insurance plan's members.




What are essential health benefits under the ACA?


✔✔ Essential health benefits are a set of healthcare service categories that must be covered by

certain plans under the Affordable Care Act, including emergency services, hospitalization, and

preventive services.




How does a high-deductible health plan (HDHP) work?


✔✔ An HDHP has higher deductibles and lower premiums, making it a cost-effective option for

individuals who want to save on monthly costs and are able to pay higher out-of-pocket expenses

when accessing care.

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,What is the role of an insurance broker?


✔✔ An insurance broker assists individuals and businesses in finding the right insurance

coverage by comparing different policies and providers.




What does it mean to "waive" coverage?


✔✔ To waive coverage means that an individual chooses not to accept health insurance benefits,

often signing a document to formalize their decision.




What is a formulary in health insurance?


✔✔ A formulary is a list of prescription drugs covered by a health insurance plan, often

categorized by tiers that determine cost-sharing levels.




How do preventive services benefit policyholders?


✔✔ Preventive services, such as vaccinations and screenings, help detect health issues early,

often at no additional cost to the policyholder, thereby promoting overall health and reducing

long-term costs.




What is a lifetime limit in health insurance?


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, ✔✔ A lifetime limit is a cap on the total benefits an insurer will pay for a covered individual

during their lifetime, which was prohibited under the ACA.




What are Health Savings Accounts (HSAs)?


✔✔ HSAs are tax-advantaged savings accounts that allow individuals to set aside money for

qualified medical expenses, typically associated with high-deductible health plans.




What is the purpose of coordination of benefits (COB)?


✔✔ COB is a process used to determine the order in which multiple health insurance plans will

pay benefits, ensuring that the total reimbursement does not exceed the actual medical expenses.




What are the differences between Medicare and Medicaid?


✔✔ Medicare is a federal health insurance program primarily for individuals aged 65 and older,

while Medicaid is a state and federal program providing health coverage to low-income

individuals and families.




What does "underwriting" refer to in health insurance?


✔✔ Underwriting is the process by which an insurance company assesses risk and determines

the eligibility and premium rates for potential policyholders based on their health and lifestyle.


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