What is the primary purpose of medical expense insurance?:
a. Protect against death expenses
b. Provide payments to make up for some income of a person who cannot work as a result of injury or illness
c. Pay medical costs
for illness and injury
d. Pay a s
c. Pay medical costs
for illness and injury
Which of the following is correct?:
a. A premium reimburses you for hospital stays, doctors' visits and medications
b. A premium is the amount your employer will pay for your health insurance coverage
c. Disability income insurance pays the actual medical
e. Most medical expense plans reimburse an individual for hospital stays, doctors' visits and medications
Most people receive health insurance from:
a. Individual plans
b. Their bank or lending institution
c. A plan offered by their employer
d. COBRA
e. None of the above
c. A plan offered by their employer
The Health Insurance Portability and Accountability Act of 1996:
a. Sets federal standards to ensure that workers would not lose their health insurance if they changed jobs
b. Sets state standards to ensure that workers would not lose their health insuran
a. Sets federal standards to ensure that workers would not lose their health insurance if they changed jobs
Coordination of benefits (COB) applies to:
a. Combining health insurance and disability insurance coverage
b. Combing all group and individual insurance coverages
c. Combining The Health Insurance Portability and Accountability act of 1996 and COBRA
d. Co
e. Combining two insurance policies issued for a married couple
Which of the following about individual health insurance policies are correct?:
a. They are used by employees of large organizations
b. All insurance companies that offer this type of policy are required to charge the same rates
c. They are primarily for
e. They are available for the self-employed or others who are dissatisfied with the coverage that their group plan provides
Which of the following about individual health insurance policies is NOT correct?:
a. They can cover individuals
b. They are used by the self-employed
c. They can provide family coverage
d. All insurance companies that offer this type of policy are requir
d. All insurance companies that offer this type of policy are required to charge the same rates
COBRA stands for:
a. Coverage of Benefits Reduction Act
b. Continuation of Benefits for Retirees Act
c. Consolidated Omnibus Budget Reconciliation Act
d. Coverage of Benefits for the Retired Act
e. Consolidation of Benefit Reapplication Act
c. Consolidated Omnibus Budget Reconciliation Act
The type of health insurance coverage that pays for some or all of the costs of room and board is:
a. Dental expense
b. Surgical expense
c. Hospital expense
d. Physician expense
e. Major medical expense
c. Hospital expense
The type of health insurance coverage that may cover routine doctor visits, X-rays, and lab tests is: a. Dental expense
b. Surgical expense
c. Hospital expense
d. Physician expense
e. Major medical expense
d. Physician expense
The type of health insurance coverage that may cover a specific amount for an operation is:
a. Dental expense
b. Surgical expense
c. Hospital expense
d. Physician expense
e. Major medical expense
b. Surgical expense
The type of health insurance coverage that takes up where basic health insurance coverage leaves off is:
a. Dental expense
b. Surgical expense
c. Hospital expense
d. Physician expense
e. Major medical expense
e. Major medical expense
Fran is interested in purchasing health insurance that limits the total out-of-pocket amount that she will have to pay. She should consider a:
a. Deductible
b. Coinsurance
c. Stop-loss provision
d. Hospital indemnity policy
e. Dread disease policy
c. Stop-loss provision
Jenny wants health insurance that limits the amount that she must pay before the insurance starts paying benefits. She is concerned about a:
a. Deductible
b. Coinsurance
c. Stop-loss provision
d. Hospital indemnity policy
e. Dread disease policy
a. Deductible
Miguel is concerned that the health insurance option he is considering plays upon unrealistic fears. He is most concerned about:
a. Deductible
b. Coinsurance
c. Stop-loss provision
d. Hospital indemnity policy
e. Dread disease policy
e. Dread disease policy
Nancy is studying the health insurance plan options offered by her employer. She wants a policy that will have the insurance pay a percentage of her medical expenses. She should review the:
a. Deductible
b. Coinsurance
c. Stop-loss provision
d. Hospital i
b. Coinsurance
The insurance that helps pay extensive hospital, surgical, medical, and other bills with a low deductible is known as a:
a. Basic health insurance policy
b. Individual policy
c. Comprehensive major medical policy
d. Hospital indemnity policy
e. Dread dise
c. Comprehensive major medical policy
Which of the following is NOT a type of health insurance available to individuals or employees?:
a. Dental expense insurance
b. Hospital indemnity policy
c. Dread disease policy
d. Minor medical indemnity insurance
e. Vision care insurance
d. Minor medical indemnity insurance
This health insurance provision lets your insurer make direct payment to your doctor or hospital:
a. Assigned benefits
b. Benefit limits
c. Exclusions and limitations
d. Internal limits
e. Service benefits
a. Assigned benefits
Which of the following is TRUE about long-term care insurance?:
a. It covers help at home, but not in a nursing home
b. It covers a stay in a nursing home, but not help at home
c. The older you are when you enroll, the higher the annual premium
d. Insuran
c. The older you are when you enroll, the higher the annual premium
This health insurance provision sets limits on the amount of repayment for certain services:
a. Assigned benefits
b. Copayment
c. Exclusions and limitations
d. Internal limits
e. Service benefits
d. Internal limits
A health insurance policy with this provision lists coverage in terms of services, not dollar amounts:
a. Assigned benefits
b. Benefit limits
c. Exclusions and limitations
d. Internal limits
e. Service benefits
e. Service benefits
Which of the following is INCORRECT about dread disease policies?:
a. They are illegal in many states
b. Each policy covers a wide rage of conditions
c. They play upon unrealistic fears
d. These policies are usually sold through the mail, in newspapers, a
b. Each policy covers a wide rage of conditions
What is a typical copayment amount for individuals?:
a. $0-$5
b. $15-$25
c. $35-50
d. $75-$100
e. $100-$200
b. $15-$25
A policy that pays you back for actual expenses is called:
a. A coinsurance plan
b. A reimbursement plan
c. A deductible plan
d. An indemnity plan
e. A reasonable and customary plan
b. A reimbursement plan
After you have reached a certain limit, the insurance company covers 100 percent of any additional cost. This is called:
a. Reimbursement
b. Out-of-pocket limit
c. Deductible
d. Internal limit
e. Indemnity
b. Out-of-pocket limit
The set amount that you must pay toward medical expenses before the insurance company pays benefits is called:
a. Reimbursement
b. Out-of-pocket limit
c. Deductible
d. Internal limit
e. Indemnity
c. Deductible
A health insurance policy that will cover only a fixed amount of an expense is called
A. Reimbursement
B. Out-of-pocket limit
C. Deductible
D. Internal limit
E. Indemnity
D. Internal limit
Brittany and Brandon are both charged $250 for an office visit to the same specialist. Brittany's reimbursement policy has a deductible of $300. Once she has met the deductible, the policy will cover the full cost of her visits. Brandon's indemnity policy
B. Brittany will pay more because she must pay the entire bill since she has not met her deductible while Brandon will have part of his bill paid by his policy.
A quality health insurance plan should do all of the following except
A. Offer basic coverage for hospital and doctor bills
B. Impose no unreasonable exclusions
C. Limit out-of-pocket expenses to more than no $5,000 per year
D. Provide at least 120 days'
E. Provide a lifetime maximum level of coverage of up to $50,000
Which of the following is NOT a private health care plan?
A. Health maintenance organization (HMO)
B. Home health care agency
C. Hospital and medical service plan
D. Medicare
E. Preferred provider organization (PPO)
D. Medicare
Blue Cross and Blue Shield are
A. Health maintenance organizations (HMO)
B. Private insurance companies
C. Hospital and medical service plans
D. Types of Medicare
E. Preferred provider organizations (PPO)
C. Hospital and medical service plans
Xavier's employer offers a health plan that stresses preventative services and covers routine immunizations and checkups, screening programs, and diagnostic tests. What kind of plan does his employer offer?
A. Health maintenance organization (HMO)
B. Priv
A. Health maintenance organization (HMO)
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. Preferred provider organization (PPO)
This type of plan combines features of HMOs and PPOs. It uses a network of participating physicians and medical professionals who have contracted to provide services for certain fees. What kind of plan does his employer offer?
A. Home health care agency
B
D. Point-of-service plan
Which of the following is most likely to use a health maintenance organization?
A. A healthy young adult who travels around the world for his job
B. A family with teenagers who need annual check-ups for sports at school
C. An neighbor who has seen the sam
B. A family with teenagers who need annual check-ups for sports at school
Who is most likely to use a home health care agency?
A. A mother who is looking for a plan to cover immunizations for her children
B. A healthy young adult
C. A family with teenagers who need annual check-ups for sports at school
D. An elderly neighbor
E.
D. An elderly neighbor
Anna contributes pre-tax 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. FSA
B. HRA
C. HSA
D. Medicare
E. Se
A. FSA
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?
A. FSA
B. HRA
C. HSA
D. Medicare
E. Self-funded health p
B. HRA
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
C. HSA
Individuals over the age of 65 who are eligible for federal government health plan coverage may also be interested in purchasing
A. Medicare Part A
B. Medicare Part B
C. Medicaid
D. Medigap
E. State-wide health coverage
D. Medigap
Jack needs comprehensive medical coverage, however, his income is quite low. What plan should he investigate?
A. Medicare Part A
B. Medicare Part B
C. Medicaid
D. Medigap
E. Medicare Part C
C. Medicaid
Medicare covers
A. Dental care
B. Routine checkups
C. Most immunizations
D. Inpatient hospital care
E. All of the above are covered by Medicare.
D. Inpatient hospital care
A Medigap policy fills the gap between medical costs and payments from
A. Home health care agencies
B. Hospital and medical service plans
C. Medicare
D. Medicaid
E. Private insurance companies
C. Medicare
Medicaid covers
A. Lab services
B. Skilled nursing and home health services
C. Prescription drugs
D. Eyeglasses
E. All of the above
E. All of the above
Which of the following is INCORRECT?
A. Disability income insurance provides regular cash income when you're unable to work because of a disability.
B. Disabilities can include pregnancy, a non-work-related accident, or an illness.
C. The definition of di
D. A bad disability policy pays you if you cannot work at your regular job.
All of the following are sources of disability income except
A. Worker's compensation
B. Disability benefits from an employer
C. Social security
D. Private income insurance programs
E. All of the above are sources of disability income.
E. All of the above are sources of disability income.
How much income is usually replaced with a private income insurance program for a disability?
A. 0 percent
B. 10 - 30 percent
C. 40 - 60 percent, with some plans paying up to 75 percent
D. 50 - 70 percent, with some plans paying up to 100 percent
E. 100 p
C. 40 - 60 percent, with some plans paying up to 75 percent
Katrina was injured in an accident at work. The benefits she will receive to cover part of her income will come from
A. A private income insurance program
B. Her employer plan
C. Medicare
D. Social Security
E. Worker's compensation
E. Worker's compensation
Mark was severely injured 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. A private income insurance program
B. His employer's plan
C. Medicare
D. Social Securit
D. Social Security
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 percent of take-home pay with an elimination p
C. He will not be eligible for any disability income because his disability ended before the elimination period ended.
Which of the following is true about the elimination period?
A. Premiums for a plan with an elimination period of 30 days will be less than the premiums for a plan with an elimination period of 45 days.
B. Premiums for a plan with an elimination period of
E. Premiums for a plan with an elimination period of 90 days will be less than the premiums for a plan with an elimination period of 60 days.
Disability income insurance plans offer benefits
A. For only a few years
B. Until age 65
C. For life
D. All of the above are possibilities
E. None of the above is correct
D. All of the above are possibilities
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. Duration of benefits to age 65
B. A plan that provides 70 - 80% of your take-home pay
C. Accident and
D. Guaranteed renewability
Rising health costs are due to all except
A. Cost of prescription drugs
B. Growing number of uninsured
C. Advancements in medical technology
D. Baby boomers using fewer health care services
E. Overweight population
D. Baby boomers using fewer health care services
The average per employee cost for health care in 2008 was more than
A. $2,000
B. $4,000
C. $8,000
D. $12,000
E. $20,000
C. $8,000
How many people in the United States do not have health insurance?
A. 500,000
B. 2 million
C. 9 million
D. 27 million
E. 48 million
E. 48 million
Which of the following is NOT correct?
A. Health costs have increased because of sophisticated technologies that are available
B. Victims of accidents and crimes require less emergency medical services than in the past
C. Regulations shift costs instead o
B. Victims of accidents and crimes require less emergency medical services than in the past
Georgia has a health insurance policy that includes a deductible of $750 and a coinsurance of 20 percent. If her total bill is $2,750, how much will she be required to pay?
A. $400
B. $550
C. $750
D. $1150
E. $1600
D. $1150
Which of the following activities is NOT a step being taken to reduce health care costs?
A. Community health education programs motivate people to take better care of themselves
B. Physicians encourage patients to pay cash for routine medical care and lab
E. All of the activities can reduce health care costs
Georgia has a health insurance policy that includes a deductible of $750 and a coinsurance of 20 percent. If her total bill is $2,750, how much will her insurance pay?
A. $400
B. $550
C. $750
D. $1150
E. $1600
E. $1600
Larry has a health insurance policy that includes a deductible of $1,000 and a coinsurance of 20 percent. If his total bill is $4,000, how much will his insurance pay?
A. $800
B. $1,000
C. $1,600
D. $2,400
E. $3,000
D. $2,400
Peter has a health insurance policy that includes a deductible of $1,000, a coinsurance of 20 percent and a stop-loss of $5,000. If his total bill is $25,000, how much will he pay?
A. $1,000
B. $4,800
C. $5,000
D. $5,800
E. $20,000
C. $5,000
Sandy went to the doctor three times, each appointment cost $150. Her copayment was $20 per visit. How much was Sandy required to pay for her three visits?
A. $20
B. $60
C. $130
D. $150
E. $450
B. $60