Question 1

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 has a notoriously poor value so she politely declines. What type of insurance policy did this salesperson likely try to sell her?

Accepted Answer

The salesperson tried to scare Joan about her high risk of death from a specific disease, which implies that they were attempting to sell her a cancer insurance policy. Additionally, the statement that this type of insurance policy has a "notoriously poor value" further supports this as cancer insurance policies often have high premiums and limited coverage.

Question 2

Which type of insurance protects against the large expenses of a serious injury or a long illness?

Accepted Answer

Major medical expense insurance typically provides coverage for large medical expenses related to serious injury or long-term illness, including hospitalization, surgery, and other treatments. It may also cover expenses related to ongoing care and therapy, as well as prescription drugs.

Question 3

Which type of insurance is usually bought in combination with hospital and surgical insurance?

Accepted Answer

The answer of Which type of insurance is usually bought...

Question 4

Which one of the following provisions requires that the policyholder pay a basic amount before the policy benefits begin?

Accepted Answer

The provision that requires the policyholder to pay a basic amount before the policy benefits begin is called a deductible. The deductible is an important aspect of an insurance policy because it helps to keep insurance premiums lower by reducing the number of small claims that an insurer has to pay out. Once the deductible is met, the policy will start providing coverage for the remaining costs of the claim.

Question 5

Chris Jones has an insurance policy that pays benefits in cash when he is hospitalized. What type of insurance would this be?

Accepted Answer

A hospital indemnity insurance policy provides cash benefits directly to the policyholder when they are hospitalized, regardless of the specific medical procedure or treatment they receive. This is different from comprehensive major medical insurance, which typically reimburses medical expenses rather than providing cash benefits, and from long-term care, cancer, and disability income insurance policies, which are designed to address specific medical conditions or events.

Question 6

Which of the following should you ask about when considering a long-term care insurance policy?

Accepted Answer

All of these are important factors to consider when choosing a long-term care insurance policy. The daily benefit determines how much the policy will pay per day for care, the benefit period is the length of time the policy will pay benefits, the policy limit is the maximum amount the policy will pay over its lifetime, and the elimination period is the amount of time that must pass before the policy will begin to pay benefits. It is important to carefully consider each of these factors in order to choose a policy that best meets your needs.

Question 7

Each year, Sophie Bennett must pay $500 for doctor's visits before her insurance company will make any payments for doctor's visits. What is this requirement called?

Accepted Answer

The requirement for Sophie Bennett to pay $500 for doctor's visits before her insurance company will make any payments for doctor's visits is called a deductible.

Question 8

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

Accepted Answer

Exclusions and limitations are provisions in an insurance policy that specify what is not covered. In this case, cosmetic surgery is not covered under Benjamin's insurance policy, which would be specified in the exclusions and limitations section.

Question 9

____________ is a type of major medical insurance that has a very low deductible amount and is offered without any separate basic plan.

Accepted Answer

Comprehensive major medical insurance typically has a low deductible and covers a broad range of medical expenses, often including hospital stays, surgeries, and other major medical procedures. It is often offered as a stand-alone plan without the need for a separate basic plan.

Question 10

Sophie Bennett is required to pay 20 percent of her medical costs up to a stated dollar limit. What is this requirement called?

Accepted Answer

The requirement for Sophie Bennett to pay 20 percent of her medical costs up to a stated dollar limit is called coinsurance. Coinsurance is a cost-sharing provision in health insurance plans in which an individual pays a percentage of the cost of medical treatment after the deductible has been met. In this case, Sophie must pay 20 percent of her medical costs, and the insurance company will pay the remaining 80 percent, up to a certain limit.

Question 11

Sophie Bennett has personally paid a total of $5,000 in medical costs this year. At this point, there is a clause in her insurance contract that requires her insurance company to pay 100% of her medical costs for the remainder of the year. What clause is this likely to be?

Accepted Answer

The stop-loss provision is a clause in health insurance policies that limits the amount a policyholder has to pay out-of-pocket for medical expenses. Once the policyholder reaches this limit, the insurance company covers 100% of the remaining costs for the year.

Question 12

Which type of health insurance pays part or all of the surgeon's fee for an operation?

Accepted Answer

Surgical expense insurance typically covers the surgeon's fee for an operation, along with other expenses directly related to the surgery, such as anesthesia and operating room charges. Hospital expense insurance may cover the cost of the hospital stay, but not necessarily the surgeon's fee. Physician's expense insurance may cover visits to a doctor's office or outpatient procedures, but may not cover a surgical procedure. Long-term care insurance is designed to cover the costs of long-term care services, such as nursing home care or in-home care, and would not typically cover a surgical procedure. Medicare Part B may cover some surgical procedures, but there may be limitations and out-of-pocket costs for the patient.

Question 13

Raymond Carter has a type of medical insurance that has a very low deductible and pays for hospital, surgical, medical, and other bills under one plan. What type of insurance does he have?

Accepted Answer

Comprehensive major medical insurance typically has a low deductible and covers a wide range of medical expenses, including hospital stays, surgeries, and other medical bills.

Question 14

Karen Blumenthall was seriously injured in a car accident and is paralyzed from the waist down. Luckily, she has an insurance policy that will pay for someone to come in and help with her day-to-day activities such as bathing, dressing, and household chores. What type of insurance policy is this likely to be?

Accepted Answer

Long-term care insurance is designed to cover services that assist with day-to-day activities for individuals who are unable to perform them due to chronic illness, disability, or injury.

Question 15

A good health insurance plan should:

Accepted Answer

A good health insurance plan should offer basic coverage for hospital and doctor bills. This means that the plan should cover at least the essential health benefits as outlined by the Affordable Care Act, such as outpatient care, emergency services, hospitalization, prescription drugs, lab tests, and preventive care. Other options listed may not be feasible for all individuals or families and may not be necessary for basic coverage.

Question 16

Darren Chase has an insurance policy that will only pay for a maximum of 60 days of hospitalization during a year. What provision in his insurance policy would specify this?

Accepted Answer

Benefit limits specify the maximum amount of coverage that an insurance policy will pay for a particular benefit, such as hospitalization. In this case, Darren's policy has a benefit limit of 60 days of hospitalization per year.

Question 17

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

Accepted Answer

The provision of the policy that is defined by listing the insured individuals is eligibility. It specifies who is covered under the policy and who is eligible to receive the benefits.

Question 18

Dean Thomas has an insurance policy that cannot be cancelled unless he fails to pay his premium. What provision in his insurance policy would specify this?

Accepted Answer

The provision that would specify that Dean Thomas' insurance policy cannot be cancelled unless he fails to pay his premium is the guaranteed renewable provision. This provision guarantees that the policy will be renewable at the end of each term without any changes to the coverage, except for a possible increase in premium.

Question 19

Which type of health insurance pays for physician's care that does not involve surgery?

Accepted Answer

Physician's expense insurance covers the cost of doctor visits and other medical services that do not involve surgery. Surgical expense insurance covers the cost of surgical procedures, hospital expense insurance covers the cost of inpatient hospital stays, and long-term care insurance covers the cost of extended care in a nursing home or other facility. Medicare Part B is a type of insurance provided by the government that covers certain medical services and supplies, including physician visits.

Question 20

A good health insurance plan should:

Accepted Answer

A good health insurance plan should offer all of the listed provisions, including paying at least 80% for out-of-hospital expenses after the yearly deductible, providing at least 120 days' hospital room and board in full, offering a high lifetime maximum for each family member, and imposing no unreasonable exclusions. Choosing a plan that offers all of these provisions ensures comprehensive coverage and financial protection in case of a medical emergency or illness.

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

Which type of insurance protects against the large expenses of a serious injury or a long illness?

Which type of insurance is usually bought in combination with hospital and surgical insurance?

Which one of the following provisions requires that the policyholder pay a basic amount before the policy benefits begin?

Chris Jones has an insurance policy that pays benefits in cash when he is hospitalized. What type of insurance would this be?

Which of the following should you ask about when considering a long-term care insurance policy?

Each year, Sophie Bennett must pay $500 for doctor's visits before her insurance company will make any payments for doctor's visits. What is this requirement called?

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

____________ is a type of major medical insurance that has a very low deductible amount and is offered without any separate basic plan.

Sophie Bennett is required to pay 20 percent of her medical costs up to a stated dollar limit. What is this requirement called?

Sophie Bennett has personally paid a total of $5,000 in medical costs this year. At this point, there is a clause in her insurance contract that requires her insurance company to pay 100% of her medical costs for the remainder of the year. What clause is this likely to be?

Which type of health insurance pays part or all of the surgeon's fee for an operation?

Raymond Carter has a type of medical insurance that has a very low deductible and pays for hospital, surgical, medical, and other bills under one plan. What type of insurance does he have?

A good health insurance plan should:

Darren Chase has an insurance policy that will only pay for a maximum of 60 days of hospitalization during a year. What provision in his insurance policy would specify this?

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

Dean Thomas has an insurance policy that cannot be cancelled unless he fails to pay his premium. What provision in his insurance policy would specify this?

Which type of health insurance pays for physician's care that does not involve surgery?

A good health insurance plan should: