The Health Insurance Portability and Accountability Act of 1996
A) Sets federal standards to ensure that workers do not lose their health insurance if they change jobs.
B) Prevents employees from moving from one group health plan to another without a laps
A
Coordination of benefits (COB) provision applies to
A) Combining the Health Insurance Portability and Accountability Act of 1996 and COBRA.
B) Combining three or more disability policies issued for an individual.
C) Combining the benefits of two insurance
C
The type of health insurance coverage that pays for some or all of the daily costs of room and board during a hospital stay is
A) Hospital expense.
B) Physician expense.
C) Dental expense.
D) Major medical expense.
E) Surgical Expense
A
The type of health insurance coverage that may cover routine doctor visits, X-rays, and lab tests is
A) Physician expense.
B) Hospital expense.
C) Major medical expense.
D) Surgical expense.
E) Dental expense.
A
Fran is interested in purchasing a major medical policy that limits the total out-of-pocket amount that she will have to pay. She should consider a
A) Stop-loss provision.
B) Coinsurance.
C) Hospital indemnity policy.
D) Copay.
E) Dread disease policy.
A
The insurance that helps pay hospital, surgical, medical, and other bills with a low deductible is known as a(n)
A) Individual policy.
B) Dread disease policy.
C) Hospital indemnity policy.
D) Comprehensive major medical policy.
E) Basic health insurance
D
This health insurance provision lets your insurer make direct payments to your doctor or hospital.
A) Internal limits
B) Assigned benefits
C) Benefit limits
D) Service benefits
E) Exclusions and limitations
B
Which of the following is TRUE about long-term care insurance?
A) It covers help at home but not in a nursing home.
B) Insurance plans are sold primarily to individuals in the 20-40 age group.
C) It covers a stay in a nursing home but not help at home.
D)
D
A health insurance policy with this provision lists coverage in terms of services, not dollar amounts.
A) Service benefits
B) Assigned benefits
C) Benefit limits
D) Exclusions and limitations
E) Internal limits
A
A policy that pays you back for actual expenses is called
A) A reasonable and customary plan.
B) An indemnity plan.
C) A reimbursement plan.
D) A deductible plan.
E) A coinsurance plan.
C
After you have reached a certain limit that you must pay for the deductible and coinsurance, the insurance company covers 100% of any additional cost. This is called
A) Indemnity.
B) Internal limit.
C) Deductible.
D) Reimbursement.
E) Out-of-pocket limit.
E
A provision in a health insurance policy that sets specific levels of repayment for certain services is called
A) Indemnity.
B) Deductible.
C) Internal limit.
D) Reimbursement.
E) Out-of-pocket limit.
c
A health insurance plan should include all of the following "must-haves" except
A) Provide at least 120 days' hospital room and board in full.
B) Limit out-of-pocket expenses to no more than $3,000 to $5,000 per year.
C) Offer basic coverage for hospital
D
Steve's employer offers a health plan that stresses preventive services and covers routine immunizations and checkups, screening programs, and diagnostic tests. What kind of plan does his employer offer?
A) Public insurance company
B) Medicaid
C) Hospital
D
Yvonne's employer offers a health plan that has a group of doctors and hospitals that agree to provide specified medical services to members at prearranged fees. This health plan offers some flexibility since members can either visit a physician from a li
E
This type of plan combines features of Health maintenance organizations and PPOs. It uses a network of participating physicians and medical professionals who have contracted to provide services for certain fees.
A) Point-of-service (POS) plan
B) Hospital
A
Who is most likely to use a home health care agency?
A) An elderly neighbor.
B) A healthy young adult.
C) A mother who is looking for a plan to cover immunizations for her children.
D) A family with teenagers who need annual check-ups for sports at school
A
Anna contributes pretax dollars to an account managed by her employer for her health care expenses. If she does not spend all of her money by the end of the year, she may forfeit it. What kind of plan does she have?
A) Medicaid
B) HRA
C) FSA
D) Self-funde
C
Monica's employer offers a health insurance plan with a very high deductible. In addition, her employer provides a fund for her to spend specifically on health care. What kind of plan does she have?
Correct Answer
A) HRA
B) Self-funded health plan
C) Medi
A
Jacob is concerned that his out-of-pocket health care expenses will be quite high, so he is considering adding contributions to a tax-free account that he can use with his high-deductible policy to cover catastrophic expenses. What kind of plan does he ha
B
Individuals over the age of 65 who are eligible for medicare may also be interested in purchasing more coverage called
A) Medicare Part A.
B) Statewide health coverage.
C) Medicaid.
D) Medicare Part B.
E) Medigap.
E
Jack needs comprehensive medical coverage. However, his income is very low. What plan should he investigate?
A) Medicaid
B) Medigap
C) Medicare Part C
D) Medicare Part A
E) Medicare Part B
A
Which of the following is incorrect?
A) A bad disability policy pays you if you cannot work at your regular job.
B) Disability can cause even greater financial problems than death.
C) Disabilities can include pregnancy, a non-work-related accident, or an
A
How much does a private income insurance program pay for loss of normal income from a disability?
A) 10-30%
B) 50-70%, with some plans paying up to 100%
C) 0%
D) 40-60%, with some plans paying up to 75%
E) 100%
D
Katrina was injured in an accident at work. The benefits she will receive to cover part of her income will come from
A) Worker's compensation.
B) A public income insurance program.
C) Social Security.
D) Medicare.
E) Her health insurance plan.
A
Mark was severely injured while on vacation and expects to be unable to work for at least 12 months. Because of his injury, he should expect to be eligible for disability income from
A) Worker's compensation.
B) A public income insurance program.
C) Medic
D
Cameron, age 25, sustained a debilitating hand injury and was unable to perform his job as a viola player in the local orchestra for 45 days. His employer has a disability income insurance policy that pays 70% of take-home pay with an elimination period o
D
If you are concerned that your disability insurer may try to cancel your coverage if your health becomes poor, you should look for a plan that offers
A) A short elimination period.
B) A plan that provides 70-80% of your take-home pay.
C) Accident and sick
E
Under the Patient Protection and Affordable Care Act of 2010, which of the following is NOT correct?
A) Employers must offer continuing coverage through COBRA for up to 24 months after you leave your job.
B) Expands the Medicaid program for the nation's p
A
Georgia is considering between two health insurance policies. One includes a deductible of $600 and the other includes a coinsurance of 20%. If a bill is $4,000, how much will she be required to pay under the policy with the coinsurance?
A) $4,000
B) $120
D
Georgia has a health insurance policy that includes a deductible of $500. If her total bill is $3,000, how much will her insurance pay?
A) $2,500
B) $3,000
C) $0
D) $5,000
E) $3,500
A
Sandy went to the doctor three times, and each appointment cost $200. Her copayment was $25 per visit. How much was Sandy required to pay in total for her three visits?
Correct Answer
A) $75
B) $25
C) $175
D) $200
E) $525
A
Cynthia was charged $300 for a specialist office visit. Her indemnity policy will pay $125. What amount will she have to pay?
A) $425
B) $125
C) $175
D) $300
E) None of the choices
C