Basic Health Insurance FAQ | Major Medical Expense Insurance

Basic Health Insurance FAQs

What is Health Insurance?

A health insurance policy covers a wide variety of medical expenses such as hospital room and board, surgery, physician services, nursing care, and prescriptions. Many plans provide an unlimited dollar amount of lifetime benefits which help to cover catastrophic coverage needs. These policies also feature deductibles and coinsurance.

Take Control of Your Learning Experience

Being able to learn outside of the classroom puts the control of your health insurance licensing exam preparation experience into your hands. Go as quickly or slowly as best meets your needs, with easy to review materials that give learners the choice to study concise guides, imitate the classroom experience, and take practice health insurance licensing exams.

During your preparation for the state health insurance licensing exam, you will learn key terms that will be an integral part of the test such as:

Deductible - The amount the insured must pay before the insurer pays any benefits.

Co-insurance - A percentage of costs beyond the deductible that the insured pays up to a certain stated amount, after which the insurer pays 100% up to the policy limits.

Family Deductible - The maximum deductible paid for all covered family members, which is usually two or three times the individual maximum. A family of five with a $500 individual co-insurance maximum would need to pay only $1,000 or $1,500 for all family members combined.

Out of Pocket Limit - This provision places a dollar limit on the insured's yearly out-of-pocket expenses. After the deductible and co-insurance payments reach the out of pocket limit, the insurer pays for covered expenses up to the policy's maximum benefit amount. Premiums for the insured can be lowered by increasing a policy’s deductible and out of pocket limit.

There are other provisions affecting premium costs to insureds, including:

• Size of the provider network
• Co-payment amounts
• Lifetime benefit amount
• Policy coverages and exclusions

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