Group health insurance will cover you but not your immediate family.
answer
false
question
Group health insurance covers all of your health insurance needs.
answer
false
question
Individual health insurance covers either one person or family.
answer
true
question
Very few group health policy contracts have a coordination of benefits provision.
answer
false
question
The coordination of benefits is a method of integrating the benefits payable under more than one health insurance plan so that the benefits received from all sources are limited to 100 percent of allowable medical expenses.
answer
true
question
Employees of state or local governments are covered by the Consolidated Omnibus Budget Reconciliation Act of 1986.
answer
false
question
People often buy surgical expense insurance in combination with hospital expense insurance.
answer
true
question
Physician expense insurance coverage never includes visits to the doctor's office, x-rays, and lab tests.
answer
false
question
Basic health insurance coverage includes hospital expense insurance, surgical expense insurance, and physician expense insurance.
answer
true
question
The maximum benefits payable under major medical insurance are high--up to $1 million per illness per year.
answer
true
question
A deductible provision requires the policyholder to pay a basic amount before the policy benefits begin.
answer
true
question
Hospital expense insurance pays part or all of hospital bills for room, board, and other charges.
answer
true
question
Surgical expense insurance pays part or all of the surgeon's fees for an operation.
answer
true
question
Physician expense insurance helps pay for physician's care that does not involve surgery.
answer
true
question
Hospital expense insurance, surgical expense insurance, and physician expense insurance are called basic health insurance coverage.
answer
true
question
The maximum benefits payable under major medical insurance are limited to under $50,000 per illness per year.
answer
false
question
A coinsurance provision requires the policyholder to share the expenses beyond the deductible amount.
answer
true
question
A stop-loss provision requires the policyholder to pay up to a certain amount, after which the insurance company pays 100 percent of all remaining covered expenses.
answer
true
question
Comprehensive major medical insurance is a type of major medical insurance that has a very high deductible amount.
answer
false
question
A hospital indemnity policy pays benefits only when you are not hospitalized.
answer
false
question
The hospital indemnity policy is a good substitute for basic or major medical protection.
answer
false
question
Dread disease and cancer policies are usually very good values.
answer
false
question
Long-term care insurance provides day-in, day-out care for long-term illness or disability.
answer
true
question
When you assign benefits, you let your insurer make direct payments to you.
answer
false
question
Internal limits in a health insurance policy set specific levels of repayment for certain services.
answer
true
question
Co-payment and coinsurance are synonymous.
answer
false
question
Exclusions and limitations provision specifies services that the policy does not cover.
answer
true
question
Guaranteed renewable provision means that the insurer can't cancel the policy unless you fail to pay the premiums.
answer
true
question
A reimbursement policy does not pay you back for actual expenses.
answer
false
question
An indemnity policy provides you with specific amounts, regardless of how much the actual expenses may be.
answer
true
question
A policy with internal limits will cover only a fixed amount for an expense.
answer
true
question
The cost of a health insurance is rarely affected by the size of the deductible.
answer
false
question
The cost of health insurance can be affected by the terms of the coinsurance provision.
answer
true
question
Out-of-pocket limits help you lower your financial risk, but they also increase your premiums.
answer
true
question
Your health insurance plan should offer basic coverage for hospital and doctor bills.
answer
true
question
Most health insurance in the United States is provided by government health care programs.
answer
false
question
Most health insurance in the United States is provided by private organizations rather than by the government.
answer
true
question
Blue Cross provides benefits for surgical and medical services performed by physicians.
answer
false
question
Blue Shield, an independent nonprofit corporation, provides hospital care benefits.
answer
false
question
Managed care refers to prepaid health plans that provide comprehensive health care to their members.
answer
true
question
An HMO is a health insurance plan that provides a wide rage of health care services for a fixed, prepaid monthly premium.
answer
true
question
HMOs allow you to choose any physician of your choice.
answer
false
question
A preferred provider organization (PPO) is a variation of an HMO.
answer
true
question
The premiums for PPOs are slightly lower than the premiums for HMOs.
answer
false
question
PPO plan members often pay no deductibles and may make minimal co-payments.
answer
true
question
A point-of-service plan combines features of both HMOs and PPOs.
answer
true
question
Perhaps the best-known government health program is Medicaid.
answer
false
question
Medicare is a state-funded health insurance program available mainly to people over 65 and to people with disability.
answer
false
question
Part A of Medicare pays for all covered services for inpatient hospital care after you pay a single annual deductible.
answer
true
question
Medigap insurance, intended to supplement Medicare, is sold and serviced by the federal government.
answer
false
question
Medicaid is administered by each state within certain broad federal requirements and guidelines.
answer
true
question
Medicare does not cover the expenses of private-duty nursing care.
answer
true
question
Two sources of government health insurance are Medicare and Medicaid.
answer
true
question
President Franklin D. Roosevelt established Medicare for people who are at least 60 years old.
answer
false
question
Local IRS offices take applications for Medicare and provide information about the program.
answer
false
question
Medicare has two parts: hospital insurance (Part A) and medical insurance (Part B).
answer
true
question
Hospital insurance (Part A) is financed from a portion of the Social Security payroll tax.
answer
true
question
Medicare hospital insurance (Part A) helps pay for doctors' services and a variety of other medical services and supplies not covered by hospital insurance.
answer
false
question
Medicare medical insurance (Part B) helps pay for doctors' services and a variety of other medical services and supplies not covered by hospital insurance.
answer
true
question
To get medical insurance (Part B) you must sign for it and pay a monthly premium.
answer
true
question
Medicare covers all medical costs but only if you are at least 65 years of age.
answer
false
question
Skilled nursing care is approved and covered by Medicare.
answer
false
question
Medicare covers routine checkups, dental care, most immunizations, cosmetic surgery, routine foot care, eyeglasses, and hearing aids.
answer
false
question
Medigap insurance is not sold or serviced by the federal government or state governments.
answer
true
question
Medicaid provides for a program of medical assistance to certain low-income individuals and families.
answer
true
question
Medicaid is financed by both state and federal funds.
answer
true
question
Medicaid differs from Medicare because eligibility for Medicaid depends on having very low income and assets.
answer
true
question
The Department of Health and Human Services maintains one of the richest and most reliable sources of information on the Internet.
answer
true
question
Unfortunately, the federal government does not provide any medical information on the Internet.
answer
false
question
Healthfinder, Medlineplus, and JIH Health Information are just a few sources provided by the American Medical Association.
answer
false
question
Disability income insurance benefits provide regular cash income lost by employees as the result of an accident, illness, or pregnancy.
answer
true
question
Disability income insurance is very common today, and several hundred insurance companies offer it.
answer
true
question
Disability can cause even greater financial problems than death.
answer
true
question
Basically, the word disability has only one definition.
answer
false
question
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.
answer
true
question
Disability benefits begin on the first day you are disabled.
answer
false
question
Generally, disability income policies with shorter waiting periods have lower premiums.
answer
false
question
You should seek a disability policy that pays benefits for life.
answer
true
question
Disability income benefits begin on the 10th day you are disabled.
answer
false
question
You should aim for a disability benefit amount that when added to your other income will equal about 90 percent of your gross pay.
answer
false
question
The premium for non-cancelable and guaranteed renewable coverage is higher, but the coverage is well worth the extra cost.
answer
true
question
Most health insurance policies in the United States are sold to
A) victims of communicable diseases.
B) individuals with families.
C) single individuals with no dependents.
D) Employees and their dependents.
E) Employers, who in turn offer the benefits to employees.
answer
E) Employers, who in turn offer the benefits to employees.
question
Which health insurance coverage requires careful shopping because coverage and cost vary from company to company?
A) group health
B) individual health
C) hospital expense
D) surgical expense
E) physician's expense
answer
B) individual health
question
Which type of insurance provides for the partial replacement of income lost by employees as a result of an accident, illness, etc.?
A) Comprehensive major medical
B) major medical expense
C) physician's expense
D) Disability income
E) surgical expense
answer
D) Disability income
question
Which type of health insurance pays part or all of hospital bills for room, board, and other charges?
A) surgical expense
B) hospital expense
C) physician's expense
D) Basic health
E) major medical
answer
B) hospital expense
question
Which type of health insurance pays part or all of the surgeon's fee for an operation?
A) surgical expense
B) hospital expense
C) physician's expense
D) Basic expense
E) major medical expense
answer
A) surgical expense
question
Which type of health insurance pays for physician's care that does not involve surgery?
A) surgical expense
B) hospital expense
C) physician's expense
D) Basic expense
E) major medical expense
answer
C) physician's expense
question
Which type of insurance is usually bought in combination with hospital and surgical insurance?
A) Disability income
B) Comprehensive major medical
C) major medical expense
D) hospital indemnity
E) physician's expense
answer
E) physician's expense
question
Which type of insurance protects against the large expenses of a serious injury or a long illness?
A) Disability income
B) major medical expense
C) hospital indemnity
D) physician's expense
E) interim medical
answer
B) major medical expense
question
Which one of the following provisions requires that the policyholder pay a basic amount before the policy benefits begin?
A) Coinsurance
B) stop loss
C) Deductible
D) self insurance
E) incontestable
answer
C) Deductible
question
Which health insurance policy pays benefits only when you are hospitalized, but pays these benefits in cash which you can use as you like?
A) hospital indemnity
B) interim or short-term
C) Disability income
D) Comprehensive major medical
E) major medical expense
answer
A) hospital indemnity
question
Dental expense insurance provides reimbursement for
A) oral examinations.
B) fillings.
C) Extractions.
D) oral surgery.
E) All of the above provide reimbursement.
answer
E) All of the above provide reimbursement.
question
According to your textbook, dread disease policies
A) are almost always excellent buys.
B) should never be purchased.
C) play upon unrealistic fears.
D) should be purchased only by older people.
E) are meant for couples with two or three children.
answer
C) play upon unrealistic fears.
question
Which type of health insurance is illegal in many states?
A) Individual health insurance
B) Group health insurance
C) Dread disease policy
D) Dental insurance
E) Vision insurance
answer
C) Dread disease policy
question
In choosing health insurance, ideally, you should
A) get a basic plan and a major supplementary plan.
B) get dental and vision plans.
C) buy dread disease and cancer insurance plans.
D) purchase nursing home insurance.
E) purchase accident insurance.
answer
A) get a basic plan and a major supplementary plan.
question
Which plan provides benefits for surgical and medical services performed by physicians?
A) Blue Cross
B) Blue Shield
C) Medicare
D) Medicaid
E) HMO
answer
B) Blue Shield
question
Health insurance is available from
A) private insurance companies.
B) Blue Cross and Blue Shield.
C) HMOs.
D) PPOs.
E) All of the above offer health insurance.
answer
E) All of the above offer health insurance.
question
Most private insurance companies sell health insurance policies to
A) individuals.
B) families.
C) Employers.
D) Employees.
answer
C) Employers.
question
Which statewide health plan provides hospital care benefits to millions of Americans?
A) Blue Cross
B) Blue Shield
C) managed care
D) Medicare
E) Medicaid
answer
A) Blue Cross
question
Which statewide health plan provides benefits for surgical and medical services performed by physicians?
A) Blue Cross
B) Blue Shield
C) home health agencies
D) home health associations
answer
B) Blue Shield
question
Which health care institution directly employs or contracts with selected medical care specialists to give you health care services in exchange for a fixed, prepaid monthly premium?
A) Blue Cross
B) Blue Shield
C) Medicare
D) Medicaid
E) HMO
answer
E) HMO
question
Which health care program is perhaps the best-known government health program?
A) Blue Cross
B) Blue Shield
C) Medicare
D) Medicaid
E) HMO
answer
C) Medicare
question
Hospital insurance Part A and medical insurance Part B is characteristics of
A) Blue Cross.
B) Blue Shield.
C) Medicare.
D) Medicaid.
E) HMO.
answer
C) Medicare.
question
What is covered by Medicare?
A) intermediate and custodial nursing care
B) out-of-hospital prescription drugs
C) private-duty nursing
D) physician charges above Medicare's approved amount
E) None of the above is covered.
answer
E) None of the above is covered.
question
Which health care plan is administered by each state within certain broad federal requirements and guidelines?
A) Blue Cross
B) Blue Shield
C) Medicare
D) Medicaid
E) HMO
answer
D) Medicaid
question
Hospital insurance Part A. of Medicare is financed from part of the ____________ taxes.
A) state income
B) federal excise
C) individual income
D) Corporate income
E) Social Security payroll
answer
E) Social Security payroll
question
Medigap is sold or serviced by
A) Medicare.
B) Medicaid.
C) private insurance companies.
D) Health Care Financing Administration.
E) National Institutes of Health.
answer
C) private insurance companies.
question
Which one of the following is a source of government health insurance?
A) Blue Cross
B) Blue Shield
C) Medicare
D) HMO
E) PPO
answer
C) Medicare
question
Which one of the following is a source of government health insurance?
A) Blue Cross
B) Blue Shield
C) National Institutes of Health
D) HMO
E) Medicaid
answer
E) Medicaid
question
Hospital insurance is which part of Medicare?
A) Part A
B) Part B
C) Part C
D) Part D
E) None of the above
answer
A) Part A
question
Medical insurance is which part of Medicare?
A) Part A
B) Part B
C) Part C
D) Part D
E) None of the above
answer
B) Part B
question
Which one of the following is not covered by Medicare?
A) Care in a skilled nursing facility
B) Intermediate and custodial nursing care as would be needed in a nursing home.
C) Private duty nursing
D) Out-of-hospital prescription drugs
E) All of the above would not be covered by Medicare.
answer
E) All of the above would not be covered by Medicare.
question
Hospital insurance (Part A) of Medicare helps pay for
A) inpatient hospital care
B) inpatient care in a skilled nursing facility.
C) home health care.
D) hospice care.
E) all of the above.
answer
E) all of the above.
question
Medicare medical insurance (Part B) helps pay for
A) inpatient hospital care
B) doctors' services and other medical services and supplies not covered by hospital insurance.
C) home health care.
D) hospice care.
E) none of the above.
answer
B) doctors' services and other medical services and supplies not covered by hospital insurance.
question
Medicare medical insurance (Part B) for people 65 or over is
A) mandatory
B) financed by corporations.
C) voluntary, and individuals must pay for it.
D) state supported and partially funded by the National Institutes of Health.
E) None of the above.
answer
C) voluntary, and individuals must pay for it.
question
Which of the following is correct about Medigap or MedSup insurance?
A) It is sold and serviced by the federal government.
B) It is sold and serviced by the state government.
C) It is sold and serviced by both the federal and state governments.
D) Private insurance companies sell Medicap Insurance policies.
E) None of the above.
Which of the following statement is correct about Medicaid
A) Medicaid coverage is very comprehensive.
B) Medicaid is a program of medical assistance to certain low-income individuals and families.
C) Medicaid is administered by each state within certain federal guidelines.
D) Medicaid if financed by both state and federal funds.
E) All of the statements are correct.
answer
E) All of the statements are correct.
question
Which of the following statements is correct about Medicaid?
A) Many members of the Medicaid population are also covered by Medicare.
B) Once eligible, Medicaid provides more benefits than does Medicare.
C) Medicaid coverage is so comprehensive, people using it do not need to purchase supplemental insurance.
D) Medicaid is financed by both state and federal funds.
E) All of the above.
answer
E) All of the above.
question
Which type of insurance is probably the most ignored form of available insurance protection?
A) life
B) liability
C) Disability
D) Car
E) home and property
answer
C) Disability
question
Definition of disability
A) is universally accepted.
B) varies.
C) is standardized by American Council of Life Insurance.
D) is provided by the Insurance Information Institute.
answer
B) varies.
question
Good disability plans pay when you are
A) unable to work at your regular job.
B) unable to work at any job.
C) on an extended vacation.
D) ill even for a short period.
E) fired from your regular job.
answer
A) unable to work at your regular job.
question
With disability income insurance, benefits usually begin
A) on the first day of disability.
B) Between 30 and 90 days after the disability occurs.
C) on the 10th day of disability.
D) one year after the start of the disability.
answer
B) Between 30 and 90 days after the disability occurs.
question
The waiting period in disability income insurance is called ____________ period.
A) Exclusion
B) no benefit
C) Coverage
D) trade-off
E) Elimination
answer
E) Elimination
question
Generally, disability income policies with longer waiting periods
A) have higher premiums.
B) have lower premiums.
C) have about the same premium.
D) Are issued by smaller insurance companies.
E) Are issued by larger insurance companies.
answer
B) have lower premiums.
question
The premium for non-cancelable and guaranteed renewable disability income insurance is higher,
A) therefore, younger people should skip these coverage.
B) hence, the insurance companies enjoy better profit margins.
C) therefore, very few older workers should carry these coverage.
D) But the coverage is well worth the extra cost.
answer
D) But the coverage is well worth the extra cost.
question
In most employer-sponsored disability income insurance plans,
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.
answer
A) your employer pays part or all of the cost.
question
What is the importance of health insurance and disability insurance in personal financial planning?
answer
Both protections should be a part of your overall insurance program to safeguard your family's economic security.
question
What are the four basic types of health insurance? What are their benefits and limitations?
answer
Four basic types of health insurance are available under group and individual policies: hospital expense insurance, surgical expense insurance, physician's expense insurance, and major medical expense insurance. The benefits and limitations of each policy differ. Ideally, you should get a basic plan and a major medical policy that combines the values of both of these plans in a single policy.
question
What factors should you consider as you decide which health insurance plan to buy?
answer
Consider the following trade-offs: a. Reimbursement versus indemnity; b. Internal limits versus aggregate limits; c. Deductibles and coinsurance; d. Out-of-pocket limits; e. Benefits based on reasonable and customary charges.
question
What are private sources of health care insurance?
answer
Health insurance and health care are available from private insurance companies, hospital and medical service plans such as Blue Cross/Blue Shield, health maintenance organizations (HMOs), preferred provider organizations (PPOs), health associations, home health agencies, and employer self-funded health plans
question
What are government sources of health care insurance?
answer
The federal government and state governments offer health coverage in accordance with laws that define the premiums and benefits. Two well-known government health programs are Medicare and Medicaid
question
What is disability income insurance? What are the major sources of disability income insurance?
answer
Disability income insurance benefits provide regular cash income lost by employees as the result of an accident, illness, or pregnancy. Sources of disability income insurance include your employer, social security, workers' compensation, the Veterans Administration, the federal government, state governments, unions, and private insurance.
Haven't found what you need?
Search for quizzes and test answers now
Quizzes.studymoose.com uses cookies. By continuing you agree to our cookie policy
