HLSA300 2025|Complete Exam Test
|Recently Testing Real Exam
Questions|Verified Solutions (100%
correct)
Save
Terms in this set (199)
, the monthly amount that health
insurers charge for coverage. If a
portion of the premium comes from
an employer and the remainder
comes from the employee, the entire
amount is the premium while the
Premium separate amounts are called the
Employee Contribution respectively
-in individual markets, people have to
pay full premium but may receive tax
credits to help subsidize the cost
-most medicare beneficiaries do not
have to pay medicare premiums
the money that insured users of the
health care system must pay, in
addition to their monthly insurance
Cost sharing
premiums, to actually use services.
Cost sharing includes deductibles,
coinsurance and co-payments
, payments made by the federal
government to health plans selling
insurance in the healthcare.gov or
state exchanges designed to
subsidize lower income individuals
deductibles and other cost sharing
requirements. These Cost Sharing
reductions are available to people
earning between 100% and 250% of
Cost sharing
the federal poverty level and
reductions
effectively upgrade the typical Silver
Plan (70% actuarial value) to a higher
actuarial value plan (with lower
deductibles,
coinsurance/copayments, and out of
pocket maximums). The enhanced
plans have 73%, 87%, and 94%
actuarial values based on the income
group of the enrollee
, the amount of money you must pay
out-of-pocket toward your health
care before an insurance company
will pay any part of your claim. For
deductible example, if you signed up for a plan
with $2,000 deductible, you would
need to pay $2000 out of your own
pocket before the insurer would start
paying for any portion of your care
the percentage of the cost of services
you are responsible for, after meeting
your deductible. This is charged
INSTEAD of a co-payment and is a
percentage-based calculation. For
Coinsurance example, if you have a $2,000
deductible and are required to pay
20% coinsurance, you would have to
pay out-of-pocket until the deductible
was met, then 20% of any costs
remaining
|Recently Testing Real Exam
Questions|Verified Solutions (100%
correct)
Save
Terms in this set (199)
, the monthly amount that health
insurers charge for coverage. If a
portion of the premium comes from
an employer and the remainder
comes from the employee, the entire
amount is the premium while the
Premium separate amounts are called the
Employee Contribution respectively
-in individual markets, people have to
pay full premium but may receive tax
credits to help subsidize the cost
-most medicare beneficiaries do not
have to pay medicare premiums
the money that insured users of the
health care system must pay, in
addition to their monthly insurance
Cost sharing
premiums, to actually use services.
Cost sharing includes deductibles,
coinsurance and co-payments
, payments made by the federal
government to health plans selling
insurance in the healthcare.gov or
state exchanges designed to
subsidize lower income individuals
deductibles and other cost sharing
requirements. These Cost Sharing
reductions are available to people
earning between 100% and 250% of
Cost sharing
the federal poverty level and
reductions
effectively upgrade the typical Silver
Plan (70% actuarial value) to a higher
actuarial value plan (with lower
deductibles,
coinsurance/copayments, and out of
pocket maximums). The enhanced
plans have 73%, 87%, and 94%
actuarial values based on the income
group of the enrollee
, the amount of money you must pay
out-of-pocket toward your health
care before an insurance company
will pay any part of your claim. For
deductible example, if you signed up for a plan
with $2,000 deductible, you would
need to pay $2000 out of your own
pocket before the insurer would start
paying for any portion of your care
the percentage of the cost of services
you are responsible for, after meeting
your deductible. This is charged
INSTEAD of a co-payment and is a
percentage-based calculation. For
Coinsurance example, if you have a $2,000
deductible and are required to pay
20% coinsurance, you would have to
pay out-of-pocket until the deductible
was met, then 20% of any costs
remaining
