U.S. Health Insurance Vocabulary - Statistics

General Stats
  • This quiz has been taken 39 times
  • The average score is 12 of 25
Answer Stats
Hint First
Letter
Answer % Correct
The amount you owe for health care services your health insurance or plan covers before your health insurance or plan begins to pay. D Deductible
84%
A fixed amount you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service. C Co-payment
81%
The amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly or yearly. P Premium
81%
Services to provide comfort and support for persons in the last stages of a terminal illness and their families. H {Hospice} services
75%
The maximum you pay during a policy period (usually a year) before your health insurance or plan begins to pay 100% of the allowed amount. This limit never includes your premium, balance-billed charges or health care your health insurance or plan doesn't cover. O {Out-of-pocket} limit
69%
A physician who focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions; or a non-physician provider who has more training in a specific area of health care. S Specialist
66%
Care for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe as to require emergency care. U {Urgent} care
66%
Evaluation of an emergency medical condition and treatment to keep the condition from getting worse. E {Emergency} services
59%
A formal complaint you communicate to your health insurer or plan. G Grievance
59%
Health care services that help a person keep, get back or improve skills and functioning for daily living that have been lost or impaired because a person was sick, hurt or disabled. R {Rehabilitation} services
59%
The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services. N Network
56%
A request for your health insurer or plan to review a decision or a grievance again. A Appeal
53%
A provider who has a contract with your health insurer or plan to provide services to you at a discount. P {Preferred} provider
53%
Your share of the costs of a covered health care service, calculated as a percent of the allowed amount for the service. C Co-insurance
50%
A physician, health care professional or health care facility licensed, certified or accredited as required by state law. P Provider
44%
The maximum amount on which payment is based for covered health care services. If your provider charges more, you may have to pay the difference. A {Allowed} amount
41%
Billing from the provider for the difference between their charge and the amount allowed by your health plan. B {Balance} billing
41%
A physician, nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state law, who provides, coordinates or helps a patient access a range of health care services. P {Primary care} provider
34%
Equipment and supplies (e.g., crutches, blood glucose testing strips, oxygen) ordered by a health care provider for a patient’s everyday or extended use. D {Durable medical} equipment
31%
Health care services that your health insurance or plan does not pay for or cover. E {Excluded} services
31%
Services from licensed nurses in your own home or in a nursing home. S {Skilled nursing} care
25%
A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. This decision does not guarantee payment. P Preauthorization
19%
Health care services or supplies needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine. M Medically necessary
16%
A provider who has contracted with your health insurer or plan, but whose discount may not be as deep as other preferred providers. P {Participating} provider
16%
The amount paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service. Sometimes used to determine the allowed amount. U {Usual}, {customary} and {reasonable}
13%
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