Question 1

Preferred provider organizations combine the best elements of the fee-for-service and HMO systems.

Accepted Answer

A) True 
 B)False

Question 2

According to your textbook,the average benefit paid under supplemental hospital indemnity plans:

Accepted Answer

A)  are almost always excellent buys.
B)  should be purchased at an early age.
C)  does not justify the premium cost.
D)  should be purchased only by older people.
E)  are meant for couples with two or three children.F) B) and E)
G) C) and D)

Question 3

Which of the following is an innovative way concerned groups are containing health care costs?

Accepted Answer

A)  Incentives to encourage preventive care
B)  Encouragement of prepaid group practices
C)  Establishment of community health education programs
D)  Encouragement by doctors to pay cash for routine medical care
E)  All of theseF) A) and B)
G) A) and C)

Question 4

The best way to avoid the high cost of illness is to stay well.

Accepted Answer

A) True 
 B)False

Question 5

Which one of the following is a source of government health insurance that is administered by each state?

Accepted Answer

A)  Blue Cross
B)  Blue Shield
C)  National Institutes of Health
D)  HMO
E)  MedicaidF) A) and D)
G) A) and C)

Question 6

The hospital insurance portion of Medicare helps pay for:

Accepted Answer

A)  inpatient hospital care.
B)  inpatient care in a skilled nursing facility.
C)  home health care.
D)  hospice care.
E)  All of these types of careF) D) and E)
G) C) and D)

Question 7

Which one of the following is a source of government health insurance?

Accepted Answer

A)  Blue Cross
B)  Blue Shield
C)  Medicare
D)  HMO
E)  PPOF) B) and C)
G) All of the above

Question 8

Good disability plans pay when you are unable to work at your regular job; poor disability plans pay only when you are unable to work at any job.

Accepted Answer

A) True 
 B)False

Question 9

A good health insurance plan should:

Accepted Answer

A)  impose unreasonable exclusions.
B)  provide at least a $2 million lifetime maximum for each family member.
C)  pay 100 percent for out-of-hospital expenses.
D)  provide at least 120 days' hospital room and board in full.
E)  limit your out-of-pocket expenses to no more than $1,000 per year.F) A) and E)
G) A) and D)

Question 10

Sophie Bennett is required to pay 20 percent of her medical costs after the deductible has been paid.What is this requirement called?

Accepted Answer

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

Question 11

A deductible provision requires the policyholder to pay a basic amount before the policy benefits begin.

Accepted Answer

A) True 
 B)False

Question 12

Medicare medical insurance helps pay for:

Accepted Answer

A)  inpatient hospital care.
B)  doctors' services.
C)  home health care.
D)  hospice care.
E)  inpatient care in a skilled nursing facility.F) A) and B)
G) B) and C)

Question 13

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

Accepted Answer

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

Question 14

Most group health insurance plans in the United States are sponsored by:

Accepted Answer

A)  victims of communicable diseases.
B)  individuals with families.
C)  single individuals with no dependents.
D)  elderly individuals.
E)  employers, who in turn offer the benefits to employees.F) B) and C)
G) C) and E)

Question 15

A recent industry survey estimated that _____ percent of employed Americans are enrolled in some form of managed care.

Accepted Answer

A)  85
B)  75
C)  50
D)  40
E)  25F) A) and E)
G) A) and C)

Question 16

A coinsurance provision requires the policyholder to share the expenses beyond the deductible amount.

Accepted Answer

A) True 
 B)False

Question 17

Physician expense insurance coverage excludes which of the following:

Accepted Answer

A)  Visits to the doctor's office
B)  X-rays
C)  Surgery
D)  Lab tests
E)  General physician careF) A) and B)
G) A) and C)

Question 18

Which health insurance policy pays benefits only when you are hospitalized,but pays these benefits in cash which you can use for medical,nonmedical,or supplementary expenses?

Accepted Answer

A)  Hospital indemnity
B)  Interim or short-term
C)  Disability income
D)  Comprehensive major medical
E)  Major medical expenseF) All of the above
G) C) and E)

Question 19

Surgical expense insurance pays part or the full amount of the surgeon's fees for an operation.

Accepted Answer

A) True 
 B)False

Question 20

Medigap insurance,intended to supplement Medicare,is sold and serviced by the federal government.

Accepted Answer

A) True 
 B)False

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

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

Correct AnswerverifiedShow Answer

The best way to avoid the high cost of illness is to stay well.

Correct AnswerverifiedShow Answer

A deductible provision requires the policyholder to pay a basic amount before the policy benefits begin.

Correct AnswerverifiedShow Answer

Which one of the following is a source of government health insurance that is administered by each state?

Correct AnswerverifiedShow Answer

Medigap insurance,intended to supplement Medicare,is sold and serviced by the federal government.

Correct AnswerverifiedShow Answer

Sophie Bennett is required to pay 20 percent of her medical costs after the deductible has been paid.What is this requirement called?

Correct AnswerverifiedShow Answer

Physician expense insurance coverage excludes which of the following:

Correct AnswerverifiedShow Answer

Good disability plans pay when you are unable to work at your regular job; poor disability plans pay only when you are unable to work at any job.

Correct AnswerverifiedShow Answer

Preferred provider organizations combine the best elements of the fee-for-service and HMO systems.

Correct AnswerverifiedShow Answer

The hospital insurance portion of Medicare helps pay for:

Correct AnswerverifiedShow Answer

Which one of the following is a source of government health insurance?

Correct AnswerverifiedShow Answer

Medicare medical insurance helps pay for:

Correct AnswerverifiedShow Answer

Surgical expense insurance pays part or the full amount of the surgeon's fees for an operation.

Correct AnswerverifiedShow Answer

According to your textbook,the average benefit paid under supplemental hospital indemnity plans:

Correct AnswerverifiedShow Answer

A coinsurance provision requires the policyholder to share the expenses beyond the deductible amount.

Correct AnswerverifiedShow Answer

Which of the following is an innovative way concerned groups are containing health care costs?

Correct AnswerverifiedShow Answer

A recent industry survey estimated that _____ percent of employed Americans are enrolled in some form of managed care.

Correct AnswerverifiedShow Answer

A good health insurance plan should:

Correct AnswerverifiedShow Answer

Most group health insurance plans in the United States are sponsored by:

Correct AnswerverifiedShow Answer

Which health insurance policy pays benefits only when you are hospitalized,but pays these benefits in cash which you can use for medical,nonmedical,or supplementary expenses?

Correct AnswerverifiedShow Answer

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