Exam 9: Insuring Your Health

Nick and Sheila Preston are married and have purchased a comprehensive major medical policy which covers them and their two sons,Wally and Brent.The policy has a $500 calendar-year family deductible,a $2,500 stop-loss provision,and an 80% coinsurance clause.The following losses occur: On January 1,Sheila was treated for an infection at a cost of $200; on July 1,Wally was treated for an injury suffered while waterskiing at a cost of $10,000; on December 5,Nick underwent eye surgery at a cost of $1,500; and on January 5 of the following year,Brent was treated for a broken leg at a cost of $2,000. ​ How much will the insurer pay for each of these losses?

Under the ACA,all Americans are required to have or buy health insurance or pay a penalty.

Choose the word or phrase in [ ] which will correctly complete the statement. Select A for the first item, B for the second item, and C if neither item will correctly complete the statement. -If you are laid off,your health insurance [can be continued at the employer's option | may be continued if you pay the premiums].

A characteristic of dental insurance is

Your health insurance has an 80% co-insurance clause.Once the deductible is satisfied,your insurance company will pay 80% of your covered losses up to the stated limits.

When you are hospitalized for surgical care,surgical expense coverage will pay the hospital bill.

Internal limits are constraints placed on insurance agents stipulating the level of risk for which they can write a policy.

Major medical plans are characterized by deductibles,internal limits,and

Medicare provides health care coverage to persons age ____ and those who are ____.

Most surgical expense plans fully reimburse the cost of second opinions.

Choose the word or phrase in [ ] which will correctly complete the statement. Select A for the first item, B for the second item, and C if neither item will correctly complete the statement. -Your health insurance stipulates that you will pay the first $500 of your health care expenses for the year.This is an example of a [deductible | co-payment].

Health insurance policies automatically cover all family members.

Disability benefits are almost always taxable,so you typically need to purchase coverage that will replace gross pay.

The Affordable Care Act requires insurance companies to set premiums based on all of the following except

Hospital insurance policies will pay for all hospital expenditures most of the time.

Disability occurs only when someone is completely incapable of doing any type of work.

Hospital indemnity policies would make payment for

Medicare Advantage supplemental benefits include all of the following except

In insurance terminology,"participation" and "co-insurance" mean the same thing.

Suppose a person has a health insurance policy with a $500 calendar-year deductible,a $2,000 out-of-pocket cap,and an 80% coinsurance provision.If this person suffers a $600 covered loss,how much will the insurance company pay? (Assume no previous losses have occurred.)