HLTH 3050 Final Exam Questions and
Answers
beneficiary - Answer-individual who buys health insurance
premium - Answer-annual fee paid by the beneficiary to the health plan and are paid in
monthly installments
benefits - Answer-the list of services covered by the health insurance plan (ex. well
visits, blood work, specific procedures, X-rays, MRI)
deductible - Answer-the amount of money you pay first, before your health insurance
starts to pay
cost-sharing - Answer-costs shared between the insurance company and the individual
seeking health care
the two ways of cost-sharing - Answer-1. co-payments
2. co-insurance
co-payment - Answer-a set dollar amount the beneficiary must pay at time services are
rendered
co-insurance - Answer-the amount of the bill that the individual must pay AFTER the
deductible is met (usually expressed as a percentage)
out of pocket maximums - Answer-the most money you have to pay out of pocket per
year (co-pays are not included)
what role does uncertainty play in health insurance to the individual? - Answer-there is
an uncertainty whether an expensive and unforeseen event that impacts their health
status will occur
what role does risk play in health insurance to the individual? - Answer-there is risk of
financial exposure due to the unexpected event
what role does uncertainty and risk play in health insurance companies? - Answer-
insurance companies are concerned about uncertainty and risk because they are
businesses that need to cover the cost of their expenditures
medical underwriting - Answer-when insurance companies use an applicant's medical
history or other personal information to assess their risk for healthcare needs
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