Question 1

You would have a better chance to choose your own doctor with a PPO rather than an HMO.

Accepted Answer

PPO plans typically allow for greater flexibility in choosing a primary care physician and specialists, while HMO plans often require you to choose a physician or specialist from within their network.

Question 2

Group health insurance premiums are usually lower than individual health insurance premiums.

Accepted Answer

This is because group plans spread the risk among a larger pool of people, which can result in lower costs for individuals. Additionally, employers may also subsidize a portion of the premium cost for their employees.

Question 3

Advances in medical technology,drugs prescriptions,and treatments have substantially reduced the costs of health care in recent decades.

Accepted Answer

Advances in medical technology, drug prescriptions, and treatments have actually led to an increase in healthcare costs in recent decades. While these advances have certainly improved patient outcomes and quality of life, they have also resulted in more expensive procedures, medications, and equipment. Additionally, increased access to healthcare services through insurance coverage or government programs has also contributed to rising healthcare costs.

Question 4

Blue Cross provides hospital coverage and Blue Shield provides prescription pharmacy coverage.

Accepted Answer

The statement is false. Blue Cross typically provides hospital and medical coverage, while Blue Shield typically provides prescription pharmacy coverage. However, there may be variations in coverage based on the specific plans offered in each state.

Question 5

Your bill for consultation with a specialist would ordinarily be paid by physicians expense insurance.

Accepted Answer

Physicians expense insurance typically covers the cost of consultation with a specialist.

Question 6

Large employers are less likely to offer health insurance to their employees than small employers.

Accepted Answer

This statement is false. According to a 2019 survey by the Kaiser Family Foundation, large employers (those with 1,000 or more workers) are more likely to offer health insurance to their employees than small employers. 99% of large employers and 73% of small employers offered health benefits to their employees.

Question 7

Hospitalization insurance policies will pay for all hospital expenditures most of the time.

Accepted Answer

Hospitalization insurance policies may have limitations, exclusions, or deductible amounts that policyholders must pay out of pocket. In some cases, the policy may also have a maximum limit on how much it will pay per hospital stay or over the lifetime of the policy. It is important to carefully review the terms and conditions of any insurance policy before purchasing it.

Question 8

Millions of Americans are not covered by health insurance.

Accepted Answer

According to recent data from the US Census Bureau, approximately 28 million Americans do not have health insurance coverage.

Question 9

A preferred provider organization has characteristics of both Individual practice association (IPA)and an indemnity plan.

Accepted Answer

A preferred provider organization (PPO) allows members to choose from a network of preferred healthcare providers who have contracted with the PPO at a discounted rate. This is similar to an Individual Practice Association (IPA). However, unlike an IPA, PPO members have the option to seek care outside of the network, but may incur higher out-of-pocket costs. This flexibility is more like an indemnity plan. Therefore, a PPO has characteristics of both an IPA and an indemnity plan.

Question 10

Health Maintenance Organizations (HMOs)provide prepaid health care to participants.

Accepted Answer

HMOs require members to pay a fixed monthly fee to receive healthcare services from a network of providers. This is considered prepaid healthcare.

Question 11

Some surgical expense insurance pays a specific amount for a list of various types of surgery.

Accepted Answer

Some surgical expense insurance policies do indeed pay a specific amount for a list of various types of surgery. This is known as a scheduled benefit. However, not all surgical expense insurance plans work this way and some may cover a broader range of surgical procedures with varying levels of coverage.

Question 12

If you lose your job,Consolidated Omnibus Budget Reconciliation Act (COBRA)permits you to continue your group health insurance coverage permanently as long as you pay the premium within 36 months of the termination of employment.

Accepted Answer

COBRA allows you to continue your group health insurance coverage for a limited time (usually 18 to 36 months) after you lose your job, but it is not permanent. You must pay the premium yourself, which can often be expensive.

Question 13

Major medical insurance often supplements the basic coverage of hospital,surgical,and physician's expense insurance.

Accepted Answer

Major medical insurance is designed to provide additional coverage beyond basic insurance policies such as hospital, surgical, and physician's expense insurance. It helps cover the costs of catastrophic illnesses and injuries that require extensive medical care, hospitalization, and/or long-term treatment. Major medical insurance typically has higher policy limits, deductible, and co-insurance than basic insurance plans.

Question 14

Medicare and Medicaid are hospital and physicians coverage,respectively.

Accepted Answer

Medicare is a federal health insurance program that primarily covers individuals aged 65 and older, as well as those with certain disabilities or medical conditions. It covers both hospital and physician services. Medicaid, on the other hand, is a joint federal and state program that provides health coverage to low-income individuals, pregnant women, children, and people with disabilities. It primarily covers physician services, but also covers some hospital and long-term care services.

Question 15

Hospitalization insurance pays daily room and board charges up to a specified number of days and reimburses for ancillary charges up to a specified dollar amount.

Accepted Answer

Hospitalization insurance typically covers daily room and board charges for a specified number of days and may also cover ancillary charges like diagnostic tests and medications up to a specified dollar limit.

Question 16

A comprehensive major medical insurance covers the cost of anesthetics and their administration.

Accepted Answer

A comprehensive major medical insurance typically covers the cost of anesthetics and their administration, along with other medical expenses such as hospitalization, surgery, and prescription drugs. However, it is important to check the specific policy details and any exclusions or limitations before assuming coverage.

Question 17

Supplementary Medical Insurance is a voluntary participatory program,commonly known as Medicare Part B.

Accepted Answer

Supplementary Medical Insurance is indeed a voluntary program, commonly referred to as Medicare Part B.

Question 18

When you are hospitalized for surgical care,surgical expense insurance will pay the hospital bill.

Accepted Answer

Surgical expense insurance covers the costs of surgery, not hospital bills.

Question 19

A deductible clause in major medical insurance plans is most often on a per year basis.

Accepted Answer

A deductible clause in major medical insurance plans is usually on a per year basis, meaning that the insured person is responsible for paying a certain amount of money before the insurance policy begins to cover the costs of medical care for the rest of the year.

Question 20

Typically group health insurance plans provide substantially less comprehensive coverage than the average individually underwritten policy.

Accepted Answer

Typically, group health insurance plans provide more comprehensive coverage than the average individually underwritten policy, as they are designed to provide coverage for a group of people and are negotiated by the employer or organization on behalf of their employees or members.

Quiz 9: Insuring Your Health