Question 1

The Wilson family has health insurance coverage that pays 50 percent of out-of-hospital expenses after a $1,000 deductible per person.Mrs.Wilson incurred doctor and prescription medication expenses of $3,650.What amount would the insurance company pay and what amount will the Wilson family pay?

Accepted Answer

Total expenses $3,650 - deductible $1,00...

Question 2

According to the Government Accountability Office,fraud and abuse account for nearly _____ percent of all dollars spent on health care.

Accepted Answer

A)  10%
B)  11%
C)  15%
D)  20%
E)  25%F) A) and E)
G) All of the above

Question 3

Joan Wilder receives a phone call from a salesperson who tries to sell her an insurance policy by scaring her about her high risk of death from this disease.She knows that this type of insurance policy is notoriously a poor value,so she politely declines.What type of insurance policy did this salesperson likely try to sell her?

Accepted Answer

A)  Comprehensive major medical
B)  Hospital indemnity
C)  Long-term care
D)  Cancer
E)  Disability incomeF) A) and B)
G) A) and C)

Question 4

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.F) C) and D)
G) None of the above

Question 5

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

Accepted Answer

A) True 
 B)False

Question 6

The definition of disability:

Accepted Answer

A)  is universally accepted.
B)  has several variations.
C)  is standardized by the American Council of Life Insurance.
D)  has been formalized by the National Disability Council.
E)  is provided by the Insurance Information Institute.F) A) and C)
G) A) and B)

Question 7

Blue Cross plans provide for surgical and medical services performed by physicians.

Accepted Answer

A) True 
 B)False

Question 8

In most employer-sponsored disability income insurance plans:

Accepted Answer

A)  your employer pays part or all of the cost.
B)  you pay all the cost.
C)  your union pays all the cost.
D)  the Social Security Administration pays most of the premium.
E)  the Veterans Administration foots the bill.F) B) and E)
G) A) and E)

Question 9

Hospital insurance is which part of Medicare?

Accepted Answer

A)  Part A
B)  Part B
C)  Part C
D)  Part D
E)  Part EF) A) and B)
G) B) and C)

Question 10

A sign that your group health coverage needs supplementing would be:

Accepted Answer

A)  it covers a minor portion of your dental bills.
B)  it covers a major portion of your hospital charges.
C)  it covers a major portion of your doctor bills.
D)  it covers over 50% of the going rate for surgical procedures.
E)  it covers a minor portion of your hospital, doctor, and surgical charges.F) A) and B)
G) A) and C)

Question 11

Which of the following factors has not contributed to rising health costs?

Accepted Answer

A)  An aging population
B)  An overweight population
C)  The cost of prescription drugs
D)  The growing number of insured
E)  Advancements in medical technologyF) A) and E)
G) A) and D)

Question 12

Individual health insurance covers either one person or a family.

Accepted Answer

A) True 
 B)False

Question 13

Medicare hospital insurance is financed from a portion of the Social Security tax.

Accepted Answer

A) True 
 B)False

Question 14

Which country has the highest per capita medical expenditures of any industrialized country in the world?

Accepted Answer

A)  Australia
B)  Britain
C)  Canada
D)  Denmark
E)  United StatesF) None of the above
G) All of the above

Question 15

Benjamin Northcutt has an insurance policy that does not cover cosmetic surgery like the nose job he would like to have.Which provision in his insurance policy would specify this?

Accepted Answer

A)  Eligibility
B)  Assigned benefits
C)  Benefit limits
D)  Guaranteed renewable
E)  Exclusions and limitationsF) A) and B)
G) All of the above

Question 16

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 provision in all of his insurance contracts that ensures the total benefits he receives from all sources is limited to 100% of allowable medical expenses.What is this provision called?

Accepted Answer

A)  Coordination of benefits
B)  Deductible
C)  Coinsurance
D)  Stop-loss provision
E)  Waiver of premiumF) All of the above
G) C) and D)

Question 17

Medicaid differs from Medicare because eligibility for Medicaid depends on having very low income and assets.

Accepted Answer

A) True 
 B)False

Question 18

As a national average,a year in a nursing home can cost over:

Accepted Answer

A)  $32,000.
B)  $49,000.
C)  $63,000.
D)  $88,000.
E)  $96,000.F) B) and E)
G) A) and D)

Question 19

Once a person is eligible,Medicaid provides more benefits than does Medicare.

Accepted Answer

A) True 
 B)False

Question 20

People are more likely to lose their incomes due to _____ than death.

Accepted Answer

A)  retirement
B)  unemployment
C)  a layoff
D)  disability
E)  warF) A) and D)
G) A) and E)

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

Correct Answer
verified

Medicaid differs from Medicare because eligibility for Medicaid depends on having very low income and assets.

Correct Answer
verified

A sign that your group health coverage needs supplementing would be:

Correct Answer
verified

People are more likely to lose their incomes due to _____ than death.

Correct Answer
verified

Which country has the highest per capita medical expenditures of any industrialized country in the world?

Correct Answer
verified

Individual health insurance covers either one person or a family.

Correct Answer
verified

Once a person is eligible,Medicaid provides more benefits than does Medicare.

Correct Answer
verified

In most employer-sponsored disability income insurance plans:

Correct Answer
verified

Medicare hospital insurance is financed from a portion of the Social Security tax.

Correct Answer
verified

Hospital insurance is which part of Medicare?

Correct Answer
verified

As a national average,a year in a nursing home can cost over:

Correct Answer
verified

The Wilson family has health insurance coverage that pays 50 percent of out-of-hospital expenses after a $1,000 deductible per person.Mrs.Wilson incurred doctor and prescription medication expenses of $3,650.What amount would the insurance company pay and what amount will the Wilson family pay?

Correct Answer
verified
Total expenses $3,650 - deductible $1,00...
View Answer

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

Correct Answer
verified

Benjamin Northcutt has an insurance policy that does not cover cosmetic surgery like the nose job he would like to have.Which provision in his insurance policy would specify this?

Correct Answer
verified

Correct Answer
verified

Which of the following factors has not contributed to rising health costs?

Correct Answer
verified

The definition of disability:

Correct Answer
verified

Blue Cross plans provide for surgical and medical services performed by physicians.

Correct Answer
verified

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

Correct Answer
verified

According to the Government Accountability Office,fraud and abuse account for nearly _____ percent of all dollars spent on health care.

Correct Answer
verified

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

Correct AnswerverifiedShow Answer

Medicaid differs from Medicare because eligibility for Medicaid depends on having very low income and assets.

Correct AnswerverifiedShow Answer

A sign that your group health coverage needs supplementing would be:

Correct AnswerverifiedShow Answer

People are more likely to lose their incomes due to _____ than death.

Correct AnswerverifiedShow Answer

Which country has the highest per capita medical expenditures of any industrialized country in the world?

Correct AnswerverifiedShow Answer

Individual health insurance covers either one person or a family.

Correct AnswerverifiedShow Answer

Once a person is eligible,Medicaid provides more benefits than does Medicare.

Correct AnswerverifiedShow Answer

In most employer-sponsored disability income insurance plans:

Correct AnswerverifiedShow Answer

Medicare hospital insurance is financed from a portion of the Social Security tax.

Correct AnswerverifiedShow Answer

Hospital insurance is which part of Medicare?

Correct AnswerverifiedShow Answer

As a national average,a year in a nursing home can cost over:

Correct AnswerverifiedShow Answer

The Wilson family has health insurance coverage that pays 50 percent of out-of-hospital expenses after a $1,000 deductible per person.Mrs.Wilson incurred doctor and prescription medication expenses of $3,650.What amount would the insurance company pay and what amount will the Wilson family pay?

Correct AnswerverifiedTotal expenses $3,650 - deductible $1,00...View AnswerShow Answer

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

Correct AnswerverifiedShow Answer

Benjamin Northcutt has an insurance policy that does not cover cosmetic surgery like the nose job he would like to have.Which provision in his insurance policy would specify this?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

Which of the following factors has not contributed to rising health costs?

Correct AnswerverifiedShow Answer

The definition of disability:

Correct AnswerverifiedShow Answer

Blue Cross plans provide for surgical and medical services performed by physicians.

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

According to the Government Accountability Office,fraud and abuse account for nearly _____ percent of all dollars spent on health care.

Correct AnswerverifiedShow Answer

Correct Answer
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Correct Answer
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Correct Answer
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Total expenses $3,650 - deductible $1,00...
View Answer

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
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Correct Answer
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Correct Answer
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