Question 1

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Surgical expense insurance would pay for cosmetic surgery [for a face lift | to reduce the size of your nose | only if deemed a medical necessity].

Accepted Answer

Surgical expense insurance typically only covers cosmetic surgery if it is deemed a medical necessity, such as reconstructive surgery after an accident or disease. A face lift or reducing the size of your nose would generally not be considered medical necessities, so option A and B are incorrect. Therefore, the correct answer is C, neither option A nor B is correct.

Question 2

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Most dental insurance is written through [group | individual] policies.

Accepted Answer

Most dental insurance is provided through group policies offered by employers, although some individuals may choose to purchase individual policies on their own.

Question 3

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Medicare [hospital | supplemental medical] insurance requires that those covered pay a monthly premium.

Accepted Answer

Medicare hospital insurance, also known as Part A, does not require a monthly premium for individuals who have paid Medicare taxes for at least 10 years. However, Medicare supplemental medical insurance, also known as Part B, requires a monthly premium for those who choose to enroll.

Question 4

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Your health insurance stipulates that you will pay the first $500 of your health care expenses for the year.This is an example of a [deductible | co-payment].

Accepted Answer

The term "deductible" refers to the amount of money that the policyholder must pay before their insurance benefits take effect. In this case, the policyholder must pay the first $500 of their healthcare expenses before their insurance coverage will begin. The term "co-payment" refers to a fixed amount that the policyholder must pay for each visit or service provided by their healthcare provider, which is typically a smaller amount than a deductible. Therefore, "deductible" is the correct term to complete the statement.

Question 5

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-[Medicare | Workers' compensation] pays for medical expenses that are the result of on-the-job injuries and illnesses.

Accepted Answer

Medicare is a federal health insurance program for people aged 65 and older, as well as people with certain disabilities. Workers' compensation, on the other hand, is an insurance program that provides benefits to employees who are injured or become ill as a result of their job. Therefore, workers' compensation is the correct choice to complete the statement accurately.

Question 6

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Medicare would pay [the entire | part of the] hospital bill for a covered person.

Accepted Answer

The answer of INSTRUCTIONS: Choose the word or phrase in...

Question 7

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Dependent children [regardless of age | up to a stated maximum age] will usually be covered by your health insurance policy.

Accepted Answer

The phrase "up to a stated maximum age" makes more sense in the context of dependent children being covered by health insurance, as most policies have an age limit up until which children can be included. "Regardless of age" would imply that even adult children would be covered, which is not always true.

Question 8

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Premiums for Workers Compensation are paid by the [employees | employers].

Accepted Answer

Premiums for Workers Compensation are typically paid by employers, not employees.

Question 9

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-If you are laid off,your health insurance [can be continued at the employer's option | must be continued if you pay the premiums].

Accepted Answer

If you are laid off, your employer is required to offer you the option to continue your health insurance under COBRA (Consolidated Omnibus Budget Reconciliation Act), but you will have to pay the full premium yourself. Therefore, the correct phrase is "must be continued if you pay the premiums."

Question 10

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-The amount of health insurance reimbursement actually paid may be reduced by [internal limits | co-payment caps].

Accepted Answer

The answer of INSTRUCTIONS: Choose the word or phrase in...

Question 11

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Scheduled surgical benefits tend to be [very close to | way below] what most surgeons will charge.

Accepted Answer

Most surgeons will charge more than the scheduled surgical benefits set by insurance companies. Therefore, the phrase "way below" is not appropriate as it suggests a significant difference in cost between the two. "Very close to" would imply that the scheduled surgical benefits are almost equal to what most surgeons will charge, which is not accurate.

Question 12

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-A coordination of benefits provision in a health care policy would [aid | prohibit] collecting multiple payments for health care.

Accepted Answer

The answer of INSTRUCTIONS: Choose the word or phrase in...

Question 13

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-[Medicare | Medicaid] makes health care payments available for anyone over age 65.

Accepted Answer

Medicare is the federal health insurance program that provides coverage for individuals over the age of 65. Medicaid, on the other hand, is a joint federal-state program that provides health coverage for people with limited income and resources. While Medicaid may also provide coverage for some individuals over the age of 65, it is primarily focused on providing coverage for those with low income.

Question 14

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-An individual receiving health care [could | could not] receive multiple payments from more than one insurance company for this care.

Accepted Answer

An individual receiving health care could receive multiple payments from more than one insurance company for this care. This is known as coordination of benefits, where different insurance companies determine how to split the cost of the health care received by the individual.

Question 15

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Workers Compensation would make payments to an injured worker [if he had been hurt on the job | only if he could prove negligence on the part of his employer].

Accepted Answer

Workers Compensation is a no-fault insurance system that provides benefits to employees who are injured or become ill as a direct result of their job. The injured worker would be eligible for benefits as long as they were hurt on the job, regardless of who was at fault.

Question 16

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Physician's expense insurance [would | would not] pay for the cost of a routine office call.

Accepted Answer

"Would not" is the correct choice because physician's expense insurance typically covers the cost of unexpected or major medical expenses, but not routine office visits.

Question 17

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Hospital insurance would pay the costs for room and board and [the use of an operating room | the fee charged by the surgeon].

Accepted Answer

Hospital insurance would typically cover the costs for room and board as well as any use of an operating room. However, the fee charged by the surgeon would likely be covered by medical insurance, not hospital insurance.

Question 18

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Having your "reasonable and customary" surgical expenses paid is an example of [service | scheduled] benefits.

Accepted Answer

Service benefits are those that cover the costs of medical services, such as doctor visits, hospital stays, and surgery. Scheduled benefits are those that are paid out on a regular basis, such as monthly payments for disability or retirement.

Question 19

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-Most commonly,the deductible in a health insurance policy is on [an annual | a per incident] basis.

Accepted Answer

The deductible in a health insurance policy most commonly applies on an annual basis, meaning that the policyholder is responsible for paying a certain amount of expenses out of pocket each year before the insurance coverage kicks in.

Question 20

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. 
-When there is a co-insurance or participation clause in a health insurance policy,the amount the insurance will pay is computed [before | after] the deductible is paid.

Accepted Answer

The answer of INSTRUCTIONS: Choose the word or phrase in...

Quiz 9: Insuring Your Health

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Surgical expense insurance would pay for cosmetic surgery [for a face lift | to reduce the size of your nose | only if deemed a medical necessity].

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Most dental insurance is written through [group | individual] policies.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Medicare [hospital | supplemental medical] insurance requires that those covered pay a monthly premium.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Your health insurance stipulates that you will pay the first $500 of your health care expenses for the year.This is an example of a [deductible | co-payment].

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -[Medicare | Workers' compensation] pays for medical expenses that are the result of on-the-job injuries and illnesses.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Medicare would pay [the entire | part of the] hospital bill for a covered person.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Dependent children [regardless of age | up to a stated maximum age] will usually be covered by your health insurance policy.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Premiums for Workers Compensation are paid by the [employees | employers].

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -If you are laid off,your health insurance [can be continued at the employer's option | must be continued if you pay the premiums].

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -The amount of health insurance reimbursement actually paid may be reduced by [internal limits | co-payment caps].

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Scheduled surgical benefits tend to be [very close to | way below] what most surgeons will charge.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -A coordination of benefits provision in a health care policy would [aid | prohibit] collecting multiple payments for health care.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -[Medicare | Medicaid] makes health care payments available for anyone over age 65.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -An individual receiving health care [could | could not] receive multiple payments from more than one insurance company for this care.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Workers Compensation would make payments to an injured worker [if he had been hurt on the job | only if he could prove negligence on the part of his employer].

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Physician's expense insurance [would | would not] pay for the cost of a routine office call.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Hospital insurance would pay the costs for room and board and [the use of an operating room | the fee charged by the surgeon].

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Having your "reasonable and customary" surgical expenses paid is an example of [service | scheduled] benefits.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -Most commonly,the deductible in a health insurance policy is on [an annual | a per incident] basis.

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement. -When there is a co-insurance or participation clause in a health insurance policy,the amount the insurance will pay is computed [before | after] the deductible is paid.