Health
Health & Disability Basics for the Texas Exam
Deductibles, coinsurance, HMO/PPO, disability definitions, Medicare pieces, and LTC ADL triggers for exam prep.
Cost sharing vocabulary is non-negotiable: deductible, coinsurance, copay, out-of-pocket maximum. Major medical designs blend those pieces; indemnity hospital cash pays fixed amounts instead.
Managed care: HMOs emphasize networks and gatekeepers; PPOs trade higher out-of-network cost for flexibility. Utilization review (prospective, concurrent, retrospective) polices medical necessity.
Disability income hinges on definitions: own-occupation vs any-occupation, elimination periods, residual/partial benefits, and presumptive disability lists.
Know Medicare Parts A/B/C/D at a purpose level, plus Medigap’s role. LTC turns on ADLs and custodial care — not acute hospital surgery trivia.