Deck 11: Managing Health Expenses
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Deck 11: Managing Health Expenses
1
Open-enrollment periods are common in group health care plans.
True
2
Medicaid is a health care program for low income individuals.
True
3
HMOs generally require that your primary care physician must order all procedures and approve referrals to medical specialists.
True
4
The most obvious health related financial loss is the need for income replacement when one is unable to work.
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5
Less than 50 percent of Americans are covered by some type of private or government health care plan.
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6
Health care plan is a generic name for any program that pays for or provides reimbursement for direct health care expenditures.
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7
Medicare is the only federal health care program currently in place.
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8
The United States spends a higher percentage of its gross domestic product than any other country
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9
A group health care plan is sold collectively to an entire group of persons rather than individuals.
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10
Health maintenance organizations provide health care rather than health insurance.
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11
It is becoming increasingly common for health care plans to offer lower rates to persons with a healthy lifestyle.
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12
Traditional health insurance plans are often referred to as basic indemnity plans.
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13
Medicare (Part A) covers prescription drugs
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14
You can make changes in your group health care plan at any time during the year
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15
Both Medicare Part A and Part B pay 100 percent of covered expenses
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16
The official name of the 2010 health insurance reform law is Obamacare.
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17
Young adults may stay on a parent's health care plans until age 22 or graduating from college whichever comes first.
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18
Choosing your Medicare plan through a private company that combines Medicare Parts A and B into one plan called a Medicare Advantage plan can broaden health care benefits.
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19
Medicare (Part B) requires a monthly premium for coverage.
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20
The hospitalization portion of Medicare (Part A) requires a monthly premium from the insured.
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21
If one is covered by workers' compensation,he or she probably does not need additional health insurance coverage.
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22
An HSA is a tax-deductible savings account into which individuals and/or their employers can deposit tax-sheltered funds for use to pay medical bills including the deductibles and other out-of-pocket costs required by a high-deductible plan.
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23
Long-term care insurance replaces a portion of the income lost when you cannot work because of illness or injury.
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24
HMOs have dollar limits on their coverage
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25
An HRA is a tax-deductible savings account into which individuals and/or their employers can deposit tax-sheltered funds for use to pay medical bills including the deductibles and other out-of-pocket costs required by a high-deductible plan.
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26
The health benefits provided under Medicaid differ from state to state.
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27
Long-term care insurance that provides coverage if a lower number of activities of daily living are unperformable will cost less.
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28
Workers' compensation covers a full range of health care losses for job-related injuries and illnesses.
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29
Married couples who are both covered by a health care plan at work should maintain both plans for even broader coverage.
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30
The claims procedures for nearly all health care plans include patient payment for the health service with the insurance reimbursing the patient after the appropriate forms are filed.
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31
Traditional health insurance provides protection against financial loss resulting from the perils of illness and injury.
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32
Medicaid pays for the costs of custodial nursing home care.
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33
Combining a health savings account with a high deductible health care plan is a way to save money on the cost of a health care plan.
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34
A copayment differs from a deductible in that the copayment typically requires you to pay a specific dollar amount each time you have a specific covered expense item.
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35
By selecting a longer waiting period,the purchaser of long-term care insurance can afford long-term coverage and still keep the premiums affordable.
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36
Long-term care insurance policies can be written to cover in-home care.
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37
A preferred provider organization is a group of health care providers who contract with a health insurance company to provide services at a discount.
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38
Long-term care insurance premiums are lower for younger individuals.
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39
A certificate of insurance,rather than an insurance policy,is received by those with group health care coverage.
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40
A student who has lost group health care coverage under his or her parent's employer group plan due to the parent leaving the job is eligible to continue coverage through COBRA rights.
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41
To make it possible for consumers to comply with the individual mandate to buy health insurance the Affordable Care Act established ______ run by their states or the federal government.
A)health insurance exchanges
B)health maintenance organizations
C)Medicaid
D)Medicare
A)health insurance exchanges
B)health maintenance organizations
C)Medicaid
D)Medicare
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42
Increasing the waiting period on a disability income policy from 30 to 90 days can significantly reduce the premium.
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43
When illness or injuries strike which of these issues may affect your finances?
A)direct health care expenses
B)recuperative care costs
C)rehabilitation costs
D)All of these
A)direct health care expenses
B)recuperative care costs
C)rehabilitation costs
D)All of these
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44
Social Security disability income payments are available to covered workers who are either partially or totally disabled.
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45
A residual clause will allow a reduced level of disability income benefits when partial,rather than full,disability strikes.
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46
Disability income insurance plans may cover long-term but not short-term disability.
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47
A health care proxy is a legal document in which an individual designates another person to make health care decisions if the individual is rendered incapable of making his or her wishes known.
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48
A living will addresses financial issues should one become mentally incapacitated.
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49
You might want to seek out disability income policies with a cost-of-living clause,which will increase your benefit amount to keep up with inflation.
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50
A special power of attorney gives the designated person virtually absolute power to manage your financial affairs.
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51
The benefit period in a disability income policy is the minimum period of time for which benefits will be paid
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52
A living will is a written statement indicating that its signer does not wish extraordinary medical measures to be taken if he or she has no reasonable expectation of recovery from a desperate medical problem.
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53
An any-occupation policy will cost more than an own-occupation policy,everything else being equal.
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54
Employers are more likely to offer short-term rather than long-term disability income insurance as a free employee benefit.
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55
Most companies will not write disability income insurance policies for more than 60 to 80 percent of the insured's after-tax earnings.
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56
Many employers provide income protection during a period of disability,but most are for only short periods of time.
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57
Long-term disability income insurance is probably the type of insurance most often overlooked by individuals and families
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58
The greater your age when a disability income policy is purchased,the more you might need inflation protection.
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59
As a result of the health care reform Patient Protection and Affordable Health Care Act which of the following aspects of health care plans will no longer be allowed?
A)charging men and women different rates
B)payout maximums
C)denial of coverage for preexisting conditions
D)All of these.
A)charging men and women different rates
B)payout maximums
C)denial of coverage for preexisting conditions
D)All of these.
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60
Under the Affordable Care Act,a health policy that cost 8 percent of your income for premiums or 9.5 percent of family income if obtained through an employer is referred to as
A)Medicare.
B)benchmark premium.
C)individual shared responsibility fee.
D)affordable health insurance.
A)Medicare.
B)benchmark premium.
C)individual shared responsibility fee.
D)affordable health insurance.
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61
Under the Affordable Care Act,all health care plans must include
A)ten specified essential health benefits
B)up to ten family members
C)disability income insurance
D)no out-of-pocket spending requirements
A)ten specified essential health benefits
B)up to ten family members
C)disability income insurance
D)no out-of-pocket spending requirements
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62
Medicare Part A
A)is a hospitalization program for persons over 65.
B)requires no premiums.
C)provides custodial care in a nursing home.
D)is a hospitalization program for persons over 65 and requires no premiums.
A)is a hospitalization program for persons over 65.
B)requires no premiums.
C)provides custodial care in a nursing home.
D)is a hospitalization program for persons over 65 and requires no premiums.
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63
Which of the following government programs is jointly funded by federal and state governments?
A)Social Security disability income
B)Medicare
C)Medicaid
D)Veterans Administration hospitals
A)Social Security disability income
B)Medicare
C)Medicaid
D)Veterans Administration hospitals
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64
Under the Affordable Care Act,your level of income used to calculate the maximum tax penalty if you do not have a health care plan is your
A)adjusted gross income
B)modified adjusted gross income
C)gross income
D)taxable income.
A)adjusted gross income
B)modified adjusted gross income
C)gross income
D)taxable income.
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65
Drawbacks of an HMO include
A)limited choice of physicians
B)no coverage for preventive treatments
C)limited availability through group plans.
D)higher deductibles and copayments compared to other plans
A)limited choice of physicians
B)no coverage for preventive treatments
C)limited availability through group plans.
D)higher deductibles and copayments compared to other plans
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66
The period of time each year when you can make changes in your selection of health care plans available from your employer is called a(n)
A)benefit period.
B)waiting period
C)open-enrollment period.
D)eligibility window
A)benefit period.
B)waiting period
C)open-enrollment period.
D)eligibility window
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67
Medicare Part B covers all of the following except
A)outpatient care.
B)doctor office visits
C)chiropractic services.
D)hospitalization
A)outpatient care.
B)doctor office visits
C)chiropractic services.
D)hospitalization
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68
Under the Affordable Care Act,all health care plans must cover ten essential benefits of adequate coverage and be labeled as a
A)comprehensive health care plan
B)quality healthcare plan
C)health maintenance plan
D)full-coverage health plan
A)comprehensive health care plan
B)quality healthcare plan
C)health maintenance plan
D)full-coverage health plan
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69
Traditional health insurance plans typically have ____ and ____ requirements that result in out-of-pocket costs for the insured.
A)deductibles; coinsurance
B)Medicare; Medicaid
C)HMOs; PPOs
D)POS; PSN
A)deductibles; coinsurance
B)Medicare; Medicaid
C)HMOs; PPOs
D)POS; PSN
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70
As a result of the health care reform Patient Protection and Affordable Health Care Act a child may stay on a parent's health care plan until age
A)18.
B)21 or graduating from college whichever comes sooner.
C)21 or graduating from college whichever comes later.
D)26.
A)18.
B)21 or graduating from college whichever comes sooner.
C)21 or graduating from college whichever comes later.
D)26.
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71
A group of physicians and hospitals who have banded together to offer a health insurance contract in areas where there is no available HMO is called a
A)preferred-provider network
B)individual practice organization
C)cooperative health care group
D)provider-sponsored network
A)preferred-provider network
B)individual practice organization
C)cooperative health care group
D)provider-sponsored network
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72
Which of the following is not true of Medicare Part B?
A)Is supplementary health care coverage
B)Does not cover outpatient care
C)Requires the payment of monthly premiums
D)Covers doctor office visits
A)Is supplementary health care coverage
B)Does not cover outpatient care
C)Requires the payment of monthly premiums
D)Covers doctor office visits
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73
Which of the following is a general term used to describe an HMO,health insurance or another plan that pays for or provides reimbursement for direct health care expenditures? A legal document that directs life support measures,such as a respirator,to be removed is called
A)hospitalization
B)Medicare
C)health insurance
D)a health care plan
A)hospitalization
B)Medicare
C)health insurance
D)a health care plan
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74
Which of the following best describes a preexisting condition?
A)An exclusion
B)Cancer, heart condition, or other serious disease
C)An injury that results from an accident
D)A previously diagnosed medical condition
A)An exclusion
B)Cancer, heart condition, or other serious disease
C)An injury that results from an accident
D)A previously diagnosed medical condition
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75
The cost of a health maintenance organization is generally a(n)
A)monthly fee and coinsurance.
B)annual premium and a deductible
C)monthly premium, deductible, and coinsurance
D)monthly fee, a deductible, and copayments
A)monthly fee and coinsurance.
B)annual premium and a deductible
C)monthly premium, deductible, and coinsurance
D)monthly fee, a deductible, and copayments
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76
Preventive health care and catching medical problems early is encouraged by
A)government health care plans.
B)health maintenance organizations (HMOs).
C)preferred provider organizations (PPOs).
D)private health insurance.
A)government health care plans.
B)health maintenance organizations (HMOs).
C)preferred provider organizations (PPOs).
D)private health insurance.
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77
Health care plans for Medicare eligible people that are purchased through a private company and provide both Medicare Parts A and B coverage are called.
A)Medicare Advantage Plans
B)Medicaid Plans
C)S-CHIP Plans
D)Medicare Part D Plans
A)Medicare Advantage Plans
B)Medicaid Plans
C)S-CHIP Plans
D)Medicare Part D Plans
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78
______ provide(s) preventative care as well as other types of care for a set monthly fee which is considered to be advance payment for the care received
A)Traditional health insurance
B)Consumer-driven health insurance
C)Health maintenance organization (HMO)
D)Preferred provider organization (PPO)
A)Traditional health insurance
B)Consumer-driven health insurance
C)Health maintenance organization (HMO)
D)Preferred provider organization (PPO)
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79
Which of the following is not a characteristic of Medicare Part A?
A)Available to eligible persons 65 or older
B)Requires monthly premium payments
C)Available to individuals with kidney disorders
D)Provides benefits for hospitalization
A)Available to eligible persons 65 or older
B)Requires monthly premium payments
C)Available to individuals with kidney disorders
D)Provides benefits for hospitalization
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80
Open enrollment period requirements are generally waived for such family changes as
A)births
B)adoptions
C)marriages
D)All of these
A)births
B)adoptions
C)marriages
D)All of these
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