Question 1

____________ is a type of major medical insurance that has a very low deductible amount and is offered without any separate basic plan.

Accepted Answer

A) Comprehensive major medical insurance 
B) Major Medical expense insurance 
C) Physician's expense insurance 
D) Hospital expense insurance 
E) Surgical expense insurance

Question 2

Which one of the following provisions requires that the policyholder pay a basic amount before the policy benefits begin?

Accepted Answer

A) coinsurance 
B) stop loss 
C) deductible 
D) self insurance 
E) incontestable

Question 3

A good health insurance plan should offer basic coverage for hospital and doctor bills.

Accepted Answer

A) True 
 B)False

Question 4

People often buy surgical expense insurance in combination with hospital expense insurance.

Accepted Answer

A) True 
 B)False

Question 5

Each year,Sophie Bennett must pay $500 for doctor's visits before her insurance company will make any payments for doctor's visits.What is this requirement called?

Accepted Answer

A) coordination of benefits 
B) deductible 
C) coinsurance 
D) stop-loss provision 
E) waiver of premium

Question 6

Health insurance includes both medical expense insurance and disability income insurance.

Accepted Answer

A) True 
 B)False

Question 7

Marcia Fuller has an insurance policy that lists that she and her three daughters,ages 6,10,and 12,are covered under this policy.Which provision in her insurance policy is defined by this list?

Accepted Answer

A) eligibility 
B) assigned benefits 
C) benefit limits 
D) guaranteed renewable 
E) exclusions and limitations

Question 8

The number of Americans without basic health insurance has been decreasing since the 1980s.

Accepted Answer

A) True 
 B)False

Question 9

Joe Johnson needs surgery for appendicitis.Which part of his basic insurance coverage should help pay for this surgery?

Accepted Answer

A) hospital expense 
B) surgical expense 
C) physician expense 
D) major medical 
E) Medicare Part B

Question 10

Julie Cumbie is playing softball and gets hurt sliding into second base.She gets an x-ray at her doctor's office to make sure her ankle isn't broken.Which part of her basic insurance coverage should help pay for this x-ray?

Accepted Answer

A) hospital expense 
B) surgical expense 
C) physician expense 
D) major medical 
E) Medicare Part B

Question 11

Nathanial Drummond has three different insurance policies.He has been injured in an accident and has incurred $30,000 in medical bills.There is a clause in all of his insurance contracts that ensures he receives no more than a total of $30,000 in payments from his insurance companies.What is this clause called?

Accepted Answer

A) coordination of benefits 
B) deductible 
C) coinsurance 
D) stop-loss provision 
E) waiver of premium

Question 12

Medicaid is financed by both state and federal funds.

Accepted Answer

A) True 
 B)False

Question 13

Generally,disability income policies with shorter waiting periods have lower premiums.

Accepted Answer

A) True 
 B)False

Question 14

Medicare does not cover the expenses of private-duty nursing care.

Accepted Answer

A) True 
 B)False

Question 15

In 2009,the largest percentage of U.S.health care dollars was spent on:

Accepted Answer

A) hospital care. 
B) dental care. 
C) physician/clinical services. 
D) prescription drugs. 
E) nursing carE.

Question 16

Very few group health policy contracts have a coordination of benefits provision.

Accepted Answer

A) True 
 B)False

Question 17

Which type of health insurance pays part or all of an insured's hospital bills for room,board,and other charges?

Accepted Answer

A) surgical expense 
B) hospital expense 
C) physician's expense 
D) Medicare Part B 
E) major medical

Question 18

What should you do when an HMO denies treatment or coverage?

Accepted Answer

A) Ask for a letter detailing the clinical reasons for the denial. 
B) Refer to the plan document or contact your HMO's member services department to gather information on the appeals process. 
C) Make copies of any correspondence,including payments,and any reimbursements. 
D) Enlist the help of your doctor,employer,and state insurance department to lobby your case before the HMO. 
E) You should do everything included in the other answers.

Question 19

Title XIX of the Social Security Act provides for a program of medical assistance to certain low-income individuals and families.

Accepted Answer

A) True 
 B)False

Question 20

Which of the following is not a key provision of the Patient Protection and Affordable Care Act of 2010?

Accepted Answer

A) Offers tax credits for small businesses to make employee coverage more affordable 
B) Eliminates co-payments for preventive services 
C) Encourages insurance companies to drop people from coverage when they get sick 
D) Restricts the annual limits to ensure access to needed care in all plans 
E) Increases funds for Community Health Centers

Exam 11: Health, Disability, and Long-Term Care Insurance

____________ is a type of major medical insurance that has a very low deductible amount and is offered without any separate basic plan.

Which one of the following provisions requires that the policyholder pay a basic amount before the policy benefits begin?

A good health insurance plan should offer basic coverage for hospital and doctor bills.

People often buy surgical expense insurance in combination with hospital expense insurance.

Each year,Sophie Bennett must pay $500 for doctor's visits before her insurance company will make any payments for doctor's visits.What is this requirement called?

Health insurance includes both medical expense insurance and disability income insurance.

Marcia Fuller has an insurance policy that lists that she and her three daughters,ages 6,10,and 12,are covered under this policy.Which provision in her insurance policy is defined by this list?

The number of Americans without basic health insurance has been decreasing since the 1980s.

Joe Johnson needs surgery for appendicitis.Which part of his basic insurance coverage should help pay for this surgery?

Julie Cumbie is playing softball and gets hurt sliding into second base.She gets an x-ray at her doctor's office to make sure her ankle isn't broken.Which part of her basic insurance coverage should help pay for this x-ray?

Medicaid is financed by both state and federal funds.

Generally,disability income policies with shorter waiting periods have lower premiums.

Medicare does not cover the expenses of private-duty nursing care.

In 2009,the largest percentage of U.S.health care dollars was spent on:

Very few group health policy contracts have a coordination of benefits provision.

Which type of health insurance pays part or all of an insured's hospital bills for room,board,and other charges?

What should you do when an HMO denies treatment or coverage?

Title XIX of the Social Security Act provides for a program of medical assistance to certain low-income individuals and families.

Which of the following is not a key provision of the Patient Protection and Affordable Care Act of 2010?