Question 1

Match each type of health plan to its description.

-A contract that insures a person against on-the-job injury or illness.

Accepted Answer

Workers' compensation insurance is specifically designed to insure against on-the-job injury or illness.

Answer: C
 State disability or Unemployment Compensation Disability (UCD) provides benefits to workers who are unable to work due to a non-work-related illness or injury.

Answer: D
 TRICARE is a health plan that provides coverage to military members, retirees, and their families.

Answer: I
 Medicare is a federal health insurance program that provides coverage to people who are 65 years or older, or who have certain disabilities.

Answer: F
 CHAMPVA is a health plan that provides coverage to eligible military family members and veterans who are not eligible for TRICARE.

The following health plan types were not included in the descriptions: Independent practice association (IPA), Health maintenance organization (HMO), and Disability income insurance.

Question 2

Match each type of health plan to its description.

-A program sponsored jointly by federal and state governments for medically indigent persons, aged individuals who meet certain financial requirements, and the disabled.

Accepted Answer

Medicaid is a program jointly sponsored by federal and state governments that provides medical assistance for medically indigent persons, individuals who meet certain financial requirements, and the disabled.

Answer: C 
 State disability or Unemployment Compensation Disability (UCD) provides temporary disability insurance for individuals who are unable to work due to injury or illness.

Answer: D 
 TRICARE is a health plan for military personnel and their families.

Answer: F 
 CHAMPVA provides healthcare benefits for eligible spouses and children of certain disabled or deceased veterans.

Answer: I 
 Medicare is a federal health insurance program for individuals aged 65 and older, and individuals with certain disabilities or medical conditions.

The other options are not health plans.

Therefore, the answer is:
Answer: B, C, D, F, I
 These options are all health plans that match their respective descriptions.

Question 3

Match each type of health plan to its description.

-Provides coverage for spouses and children of veterans with total, permanent, service-connected disabilities or for the surviving spouses and children of veterans who died as a result of service-connected disabilities.

Accepted Answer

CHAMPVA provides coverage for spouses and children of veterans with total, permanent, service-connected disabilities or for the surviving spouses and children of veterans who died as a result of service-connected disabilities.

Answer: D
 TRICARE provides health care to active duty service members, retirees, and their families, including coverage for spouses and children of veterans with total, permanent, service-connected disabilities.

Question 4

Parents of a college student who is living away from home are liable for the medical expenses incurred by their financially dependent child.

Accepted Answer

Once a child reaches the age of 18, the parents are no longer responsible for their medical expenses, even if the child is financially dependent. However, some insurance plans may offer coverage for dependent children up to a certain age or under certain circumstances.

Question 5

If Mary Smith goes to Dr. Baker's office and Dr. Baker gives Mary Smith professional services that she accepts, this is an expressed contract.

Accepted Answer

An expressed contract is one where the terms are clearly stated, either orally or in writing. In this scenario, there is no indication that the terms of the agreement were explicitly communicated, so it may be considered an implied contract instead.

Question 6

Basic health insurance coverage includes benefits for skilled nursing facilities.

Accepted Answer

The answer of Basic health insurance coverage includes benefits for...

Question 7

The Supreme Court deemed the Affordable Care Act's requirement to require individuals to have health insurance coverage or face a penalty as unconstitutional.

Accepted Answer

This statement is incorrect. In fact, the Supreme Court upheld the constitutionality of the Affordable Care Act's individual mandate in a landmark decision in 2012. However, in 2017, Congress passed a tax law that effectively eliminated the penalty for not having health insurance, rendering the mandate toothless.

Question 8

An insurance policy becomes effective after the person accepts the policy and signs the contract.

Accepted Answer

An insurance policy typically becomes effective after the insurer approves the application, the first premium is paid, and the policy is issued, not merely when the person accepts and signs the contract.

Question 9

Match each type of health plan to its description.

-Insurance that covers off-the-job injury or sickness and is paid by deductions from a person's paycheck.

Accepted Answer

The answer of Match each type of health plan to...

Question 10

Under the health care reform legislation of 2010, health plans must allow employees to keep their children on their plans until the child is 26 years old.

Accepted Answer

This is a provision of the Affordable Care Act, also known as the health care reform legislation of 2010. It allows children to remain on their parent's health insurance plan until age 26, regardless of whether they are married, living with their parents, financially dependent on their parents, or eligible for other health insurance coverage.

Question 11

Match each type of health plan to its description.

-An organization that provides a wide range of comprehensive health care services for a specified group at a fixed periodic payment.

Accepted Answer

A health maintenance organization (HMO) provides a wide range of comprehensive health care services for a specified group at a fixed periodic payment.

Answer: B
 Medicaid is a type of health plan that provides health coverage to individuals and families with low incomes, and is typically administered by the state government.

Answer: D
 TRICARE is a type of health plan that provides health coverage to active duty military personnel, retirees, and their families.

Answer: F
 CHAMPVA is a type of health plan that provides health coverage to eligible dependents of veterans who have been rated permanently and totally disabled due to a service-connected disability, or who died while on active duty.

Note: the other options listed are not health plans, but rather types of insurance or government programs that may provide coverage for certain types of medical expenses.

Question 12

Match each type of health plan to its description.

-A medical capitation plan in which the treatment is delivered via a clinic or independent physician that provides a number of basic medical services for a fixed capitation payment per month.

Accepted Answer

An Independent Practice Association (IPA) is a type of health plan where physicians are paid a fixed amount per patient (capitation) to provide a range of medical services.

Question 13

Health Benefit Exchanges will make the process of researching, comparing, and purchasing health insurance policies more difficult.

Accepted Answer

Health Benefit Exchanges are designed to make the process of researching, comparing, and purchasing health insurance policies easier for individuals and small businesses. Exchanges provide a one-stop shop where consumers can compare plans side-by-side, receive information on eligibility for subsidies and tax credits, and enroll in coverage online. Therefore, they will not make the process more difficult but rather simplify it.

Question 14

Match each type of health plan to its description.

-The hospital insurance system and supplementary medical insurance for those older than 65 years of age, created by the 1965 Amendments to the Social Security Act.

Accepted Answer

Medicare is specifically described as the hospital insurance system and supplementary medical insurance for those older than 65 years of age, created by the 1965 Amendments to the Social Security Act.

Question 15

An insurance billing specialist can escape liability by pleading ignorance.

Accepted Answer

Ignorance is not a valid defense in insurance billing. As a specialist, it is their responsibility to have the knowledge and understanding necessary to accurately bill insurance claims. Ignorance can lead to errors and even insurance fraud, which can result in legal consequences.

Question 16

The insured may not necessarily be the patient seen for the medical service.

Accepted Answer

This is because insurance policies can cover dependents, such as a spouse or child, and their medical services as well.

Question 17

The Patient Protection and Affordable Care Act (PPACA) will make health care available and affordable to Americans who are currently without insurance coverage.

Accepted Answer

This statement is true according to the goals and intentions of the PPACA. However, the effectiveness and success of the law in achieving this goal are a matter of debate and ongoing evaluation.

Question 18

Match each type of health plan to its description.

-A form of health insurance that provides periodic payments to replace income when the insured is unable to work as a result of illness, injury, or disease.

Accepted Answer

Disability income insurance provides periodic payments to replace income when the insured is unable to work as a result of illness, injury, or disease.

Answer: C
 State disability or Unemployment Compensation Disability (UCD) provides periodic payments to replace income when the insured is unable to work as a result of illness, injury, or disease.

Answer: E
 Workers' compensation insurance provides periodic payments to replace income when the insured is unable to work as a result of an injury or illness sustained on the job.

Question 19

The concept of managed care began in the 1930s when Montgomery Ward and Company offered it to their employees.

Accepted Answer

The answer of The concept of managed care began in...

Question 20

A subscriber of an insurance policy may also be known as a policyholder.

Accepted Answer

This statement is true. A subscriber of an insurance policy is also called a policyholder as they hold the insurance policy and are responsible for paying the premium and managing the policy details.

Quiz 3: Basics of Health Insurance

Match each type of health plan to its description. -A contract that insures a person against on-the-job injury or illness.

Match each type of health plan to its description. -A program sponsored jointly by federal and state governments for medically indigent persons, aged individuals who meet certain financial requirements, and the disabled.

Match each type of health plan to its description. -Provides coverage for spouses and children of veterans with total, permanent, service-connected disabilities or for the surviving spouses and children of veterans who died as a result of service-connected disabilities.

Parents of a college student who is living away from home are liable for the medical expenses incurred by their financially dependent child.

If Mary Smith goes to Dr. Baker's office and Dr. Baker gives Mary Smith professional services that she accepts, this is an expressed contract.

Basic health insurance coverage includes benefits for skilled nursing facilities.

The Supreme Court deemed the Affordable Care Act's requirement to require individuals to have health insurance coverage or face a penalty as unconstitutional.

An insurance policy becomes effective after the person accepts the policy and signs the contract.

Match each type of health plan to its description. -Insurance that covers off-the-job injury or sickness and is paid by deductions from a person's paycheck.

Under the health care reform legislation of 2010, health plans must allow employees to keep their children on their plans until the child is 26 years old.

Match each type of health plan to its description. -An organization that provides a wide range of comprehensive health care services for a specified group at a fixed periodic payment.

Match each type of health plan to its description. -A medical capitation plan in which the treatment is delivered via a clinic or independent physician that provides a number of basic medical services for a fixed capitation payment per month.

Health Benefit Exchanges will make the process of researching, comparing, and purchasing health insurance policies more difficult.

Match each type of health plan to its description. -The hospital insurance system and supplementary medical insurance for those older than 65 years of age, created by the 1965 Amendments to the Social Security Act.

An insurance billing specialist can escape liability by pleading ignorance.

The insured may not necessarily be the patient seen for the medical service.

The Patient Protection and Affordable Care Act (PPACA) will make health care available and affordable to Americans who are currently without insurance coverage.

Match each type of health plan to its description. -A form of health insurance that provides periodic payments to replace income when the insured is unable to work as a result of illness, injury, or disease.

The concept of managed care began in the 1930s when Montgomery Ward and Company offered it to their employees.

A subscriber of an insurance policy may also be known as a policyholder.