Mastering TOEIC Reading: Insurance Terms Practice Test

TOEIC Reading Practice Test: Health Insurance Terms

Part 1: Incomplete Sentences

1. The insurance company offers a comprehensive ____ that covers both inpatient and outpatient care.
   A. policy
   B. premium
   C. deductible
   D. claim

2. You must pay the annual ____ before your insurance coverage begins.
   A. copayment
   B. deductible
   C. premium
   D. benefit

3. The ____ is the amount you pay for your insurance coverage, typically on a monthly basis.
   A. premium
   B. deductible
   C. copayment
   D. coinsurance

4. After meeting your deductible, you may still be responsible for a ____, which is a percentage of the cost for each service.
   A. premium
   B. copayment
   C. coinsurance
   D. claim

5. The ____ is a fixed amount you pay for certain services, such as doctor visits or prescription medications.
   A. deductible
   B. premium
   C. copayment
   D. benefit

6. Your insurance plan has an annual ____ of $5,000, which is the maximum amount you’ll pay out-of-pocket for covered services.
   A. deductible
   B. premium
   C. copayment
   D. out-of-pocket maximum

7. The ____ is the highest amount your insurance will pay for covered services in a policy year.
   A. deductible
   B. premium
   C. annual limit
   D. copayment

8. You must obtain a ____ from your primary care physician before seeing a specialist under this insurance plan.
   A. claim
   B. referral
   C. appeal
   D. authorization

9. If your claim is denied, you have the right to file an ____ to request a review of the decision.
   A. appeal
   B. claim
   C. authorization
   D. referral

10. The insurance company requires ____ for certain expensive procedures to ensure they are medically necessary.
    A. referral
    B. appeal
    C. pre-authorization
    D. claim

11. Your policy includes a ____ period during which you cannot receive benefits for pre-existing conditions.
    A. grace
    B. waiting
    C. exclusion
    D. probation

12. The ____ lists all the medications covered by your insurance plan and their associated costs.
    A. formulary
    B. policy
    C. benefit summary
    D. explanation of benefits

13. Your insurance card contains important information such as your ____, which is a unique identifier for your policy.
    A. group number
    B. policy number
    C. claim number
    D. authorization code

14. The ____ of Benefits (EOB) document explains how your insurance processed a recent claim.
    A. Summary
    B. Explanation
    C. Statement
    D. Declaration

15. Your plan has a ____ provider network, which means you can see doctors outside the network but at a higher cost.
    A. closed
    B. exclusive
    C. preferred
    D. open

16. The ____ is the amount your insurance company agrees to pay for a particular service.
    A. allowed amount
    B. billed amount
    C. copayment
    D. deductible

17. Some plans offer ____ savings accounts, which allow you to set aside pre-tax dollars for medical expenses.
    A. flexible spending
    B. health reimbursement
    C. health savings
    D. medical savings

18. Your policy has a ____ clause, which means it won’t cover injuries resulting from high-risk activities.
    A. exclusion
    B. limitation
    C. restriction
    D. prohibition

19. The ____ period is the time during which you can enroll in or change your health insurance plan.
    A. grace
    B. waiting
    C. open enrollment
    D. qualifying

20. Your plan offers ____ care benefits, which cover services to help maintain your current health status.
    A. preventive
    B. curative
    C. palliative
    D. restorative

21. The insurance company uses a ____ review process to determine if a treatment is medically necessary.
    A. utilization
    B. quality
    C. peer
    D. clinical

22. Your policy includes a ____ clause, allowing you to continue coverage for a limited time after leaving your job.
    A. portability
    B. continuation
    C. COBRA
    D. extension

23. The ____ is the difference between what your provider charges and what your insurance pays.
    A. balance billing
    B. coinsurance
    C. copayment
    D. deductible

24. Your plan has a ____ drug program, which encourages the use of less expensive, equally effective medications.
    A. generic
    B. brand-name
    C. formulary
    D. step therapy

25. The ____ limit is the maximum amount your insurance will pay for a specific service or over your lifetime.
    A. annual
    B. benefit
    C. coverage
    D. payout

26. Your policy includes ____ benefits, which cover services like physical therapy to help you regain function.
    A. rehabilitative
    B. preventive
    C. palliative
    D. custodial

27. The ____ of coverage document provides a summary of your plan’s benefits and costs.
    A. explanation
    B. summary
    C. statement
    D. declaration

28. Your plan has a ____ payment structure, meaning you pay a set amount regardless of the services received.
    A. fee-for-service
    B. capitation
    C. bundled
    D. global

29. The insurance company may conduct a ____ review to ensure the appropriateness of ongoing treatment.
    A. concurrent
    B. retrospective
    C. prospective
    D. utilization

30. Your policy has a ____ rider, which provides additional coverage for specific conditions or treatments.
    A. supplemental
    B. exclusionary
    C. waiver
    D. endorsement

Part 2: Text Completion

Questions 31-34 refer to the following text:

Health insurance policies can be complex, but understanding key terms is essential for making informed decisions. The ____ is the amount you pay for your coverage, typically on a monthly basis. Before your insurance starts paying for services, you usually need to meet a ____, which is a set amount you pay out-of-pocket. Once you’ve met this, you may still be responsible for a ____, a fixed amount for certain services, or ____, which is a percentage of the cost for covered services.

31. A. premium
    B. deductible
    C. copayment
    D. coinsurance

32. A. premium
    B. deductible
    C. copayment
    D. coinsurance

33. A. premium
    B. deductible
    C. copayment
    D. coinsurance

34. A. premium
    B. deductible
    C. copayment
    D. coinsurance

Questions 35-38 refer to the following text:

When selecting a health insurance plan, it’s important to consider the provider network. A ____ network limits coverage to a specific group of providers, while a ____ network offers more flexibility but may have higher out-of-pocket costs for out-of-network care. Some plans require a ____ from a primary care physician before seeing a specialist. For certain procedures, you may need to obtain ____ from the insurance company to ensure coverage.

35. A. closed
    B. open
    C. preferred
    D. exclusive

36. A. closed
    B. open
    C. preferred
    D. exclusive

37. A. referral
    B. authorization
    C. claim
    D. appeal

38. A. referral
    B. pre-authorization
    C. claim
    D. appeal

Questions 39-42 refer to the following text:

Understanding your policy’s ____ is crucial for managing healthcare costs. This document outlines covered services, exclusions, and cost-sharing requirements. Pay attention to the ____, which is the maximum amount you’ll pay out-of-pocket for covered services in a year. Some plans offer ____ accounts, allowing you to set aside pre-tax dollars for medical expenses. If a claim is denied, you have the right to file an ____ to request a review of the decision.

39. A. explanation of benefits
    B. summary of benefits
    C. policy rider
    D. formulary

40. A. deductible
    B. premium
    C. out-of-pocket maximum
    D. annual limit

41. A. flexible spending
    B. health savings
    C. retirement
    D. investment

42. A. authorization
    B. referral
    C. claim
    D. appeal

Questions 43-46 refer to the following text:

Prescription drug coverage is an important aspect of health insurance. Many plans use a ____, which categorizes medications into tiers with different cost-sharing requirements. Some policies implement a ____ program, encouraging the use of less expensive, equally effective medications before trying more costly options. Be aware of any ____ periods for pre-existing conditions, during which you may not receive benefits for certain health issues. Lastly, understand your rights under ____ legislation, which allows for temporary continuation of group health coverage after leaving a job.

43. A. formulary
    B. premium
    C. deductible
    D. copayment

44. A. generic
    B. brand-name
    C. step therapy
    D. utilization review

45. A. grace
    B. waiting
    C. exclusion
    D. probation

46. A. HIPAA
    B. COBRA
    C. ACA
    D. ERISA

Answer Key

Part 1: Incomplete Sentences

1. A
2. B
3. A
4. C
5. C
6. D
7. C
8. B
9. A
10. C
11. B
12. A
13. B
14. B
15. C
16. A
17. C
18. A
19. C
20. A
21. A
22. C
23. A
24. D
25. B
26. A
27. B
28. B
29. A
30. A

Part 2: Text Completion

31. A
32. B
33. C
34. D
35. D
36. C
37. A
38. B
39. B
40. C
41. B
42. D
43. A
44. C
45. B
46. B

TOEIC Reading Practice: Health Insurance Terminology

This TOEIC Reading practice test focuses on health insurance terminology, providing a comprehensive review of key concepts and vocabulary commonly encountered in insurance documents. By completing this exercise, test-takers can improve their understanding of complex insurance terms and enhance their ability to navigate health insurance-related texts in the TOEIC exam.