Deck 9: Insuring Your Health

Question 1

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Advances in medical technology,prescriptions drugs and treatments have substantially reduced the costs health care in recent decades.

Answer 1

False

Question 2

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Some surgical expense insurance pays a specific amount for a list of various types of surgery.

Answer 2

True

Question 3

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Health insurance is considered to be one of the most complex insurance programs.

Answer 3

True

Question 4

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Medicare and Medicaid are hospital and physicians coverage,respectively.

Question 5

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Health Maintenance Organizations (HMOs)provide pre-paid health care to participants.

Question 6

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Typically group health insurance plans provide substantially less comprehensive coverage than the average individually underwritten policy.

Question 7

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Hospital insurance policies will pay for all hospital expenditures most of the time.

Question 8

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Millions of Americans are not covered by health insurance.

Question 9

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
A preferred provider organization has characteristics of both managed care and an indemnity plan.

Question 10

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Supplementary Medical Insurance is a voluntary participatory program,commonly known as Medicare Part B.

Question 11

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
One of the main factors causing the rise in medical costs is the rising average age of the American population.

Question 12

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Large employers are less likely to offer health insurance to their employees than small employers.

Question 13

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Blue Cross provides hospital coverage and Blue Shield provides prescription pharmacy coverage.

Question 14

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
You would have a better chance to choose your own doctor with a PPO rather than an HMO.

Question 15

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Group health insurance premiums are usually lower than individual health insurance premiums.

Question 16

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
When you are hospitalized for surgical care,surgical expense coverage will pay the hospital bill.

Question 17

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Hospital insurance will pay daily room and board charges up to a specified number of days and reimbursement for ancillary charges up to a specified dollar amount.

Question 18

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
If you lose your job,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.

Question 19

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Workers compensation plans are uniform through the 50 states.

Question 20

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
Health insurance costs have been increasing at a rate greater than the CPI.

Question 21

Specified accident or sickness policies are suitable substitutes for disability income protection.

Question 22

Hospital expense coverage is adequate for long-term or catastrophic medical needs of most people.

Question 23

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

Question 24

Your health insurance has an 80% co-insurance clause.Once the deductible is satisfied,your insurance company will pay 80% of your covered losses up to the stated limits.

Question 25

Most group insurance policies require a second opinion for non-surgical procedures.

Question 26

The major emphasis of dental insurance is to cover only extractions and x-rays.

Question 27

Terms of payment and terms of coverage are two sets of provisions that should be carefully scrutinized when evaluating an insurance program.

Question 28

Internal limits are constraints placed on insurance agents stipulating the level of risk for which they can write a policy.

Question 29

INSTRUCTIONS: Choose the word or phrase in [ ] which will correctly complete the statement.Select A for the first item,B for the second item,and C if neither item will correctly complete the statement.
A comprehensive health insurance usually covers the cost of anesthetics and their administration.

Question 30

College graduates who become ineligible for group health insurance through their parent's employer group policies can generally get COBRA coverage for up to 36 months.

Question 31

Increasing the deductible is likely to lower the premium on a comprehensive major medical policy.

Question 32

Comprehensive major medical simply increases the policy limits of major medical insurance without changing the coverage.

Question 33

Your bill for consultation with a specialist would ordinarily be paid by physician's expense insurance.

Question 34

In insurance terminology,"participation" and "coinsurance" mean the same thing.

Question 35

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

Question 36

Increasing the stop loss provision is likely to lower the premium on a comprehensive major medical policy.

Question 37

As soon as one graduates from college,he will generally become ineligible to be covered by your parents' health insurance.

Question 38

Buying cancer insurance would be considered a requirement since cancer is prevalent.

Question 39

Mental illness is normally not covered in health insurance policies.

Question 40

Health insurance policies automatically cover all family members.

Question 41

An elimination period is the number of days that must pass before disability policies pay proceeds.

Question 42

The definition of "disability" is standardized in disability income policies.

Question 43

Disability income benefits under social security are automatically adjusted periodically for cost of living increases.

Question 44

Higher income people are more likely than middle income families to need long-term care insurance.

Question 45

The protection need that most people do not adequately address is most often replacement of lost income.

Question 46

An "any occ" definition of disability is more liberal that an "own occ" definition.

Question 47

Workers compensation may trigger coverage in a disability income policy.

Question 48

Long-term care insurance can cover both nursing home and home health care.

Question 49

A policy with an "own occupation" definition is generally more expensive than a policy with an "any occupation for which reasonable suited" definition of disability.

Question 50

Disability occurs only when someone is completely incapable of returning to work.

Question 51

Bathing is an example of an "activity of daily living" as the term is used in a long term care policy.

Question 52

Disability income benefits under social security will be paid as long as you cannot perform the duties of the job you were holding when the disability began.

Question 53

Eating healthy and exercising is an acceptable substitute for comprehensive health care coverage.

Question 54

Long-term care insurance provides protection against the cost of extended hospital stays.

Question 55

Males are more likely to become disabled than women.

Question 56

Payments under workers compensation are more readily available than are social security disability benefits.

Question 57

Most disabilities are permanent.

Question 58

If you are trying to keep your disability income premiums reasonably priced but still appropriate for insuring your financial needs,select a short elimination period and a short duration of benefits.

Question 59

An elimination period is a term that applies to disability insurance and does not have any meaning in long-term care insurance.

Question 60

Major medical plans will usually cover the cost of nursing home care.

Question 61

Most employees select ____ for their health insurance needs.

A) indemnity plans
B) preferred provider organizations
C) health maintenance organizations
D) individual practice associations
E) point of service plans

Question 62

The "O" in COBRA stands for which of the following words?

A) optical
B) opportunity
C) ordinary
D) omnibus
E) occupational

Question 63

The majority of employers pay

A) the entire health care insurance premium for workers.
B) the entire health care insurance premium for dependents.
C) the entire health care premium for workers and dependents.
D) part of the premium for workers and dependents.
E) none of the premium for workers and dependents.

Question 64

A group HMO employs a group of doctors to provide healthcare services to members in a central facility.

Question 65

The fastest growing segment of the health care industry is

A) fee for service plans.
B) Medicaid.
C) managed care plans.
D) All of these are growing at the same rate.
E) none of these.

Question 66

If your employment is terminated,COBRA provides for

A) cancellation of all group insurance benefits.
B) continuation of group insurance benefits until you are reemployed.
C) permanent continuation of group health insurance.
D) temporary continuation of group insurance benefits;you pay premiums.
E) temporary continuation of group insurance benefits;employer pays premiums.

Question 67

OASDHI,sometimes called social security,actually refers to the following:

A) Old-Age,Survivor's,Disability,and Hospital Insurance.
B) Old-Age,Survivors,Disaster,and Hospital Insurance.
C) Old-Age,Survivor's,Disability,and Health Insurance.
D) Old-Age,Singles,Disability,and Hospital Insurance.
E) none of the above.

Question 68

An Individual Practice Association differs from a HMO in that

A) you have no choice of the physician.
B) they are located in a central facility.
C) associated doctors operate from their own offices.
D) they are less likely to be found in small communities.
E) none of these.

Question 69

Social security provides health care coverage to persons age ____ and those who are ____.

A) 55 and over;collecting disability under Social Security
B) 60 and over;collecting disability under Social Security
C) 65 and over;collecting disability under Social Security
D) 60 and over;low income
E) 60 and over;low income

Question 70

Health insurance coverage can include

A) group plans.
B) workers' compensation.
C) social security.
D) veteran's benefits.
E) all of the above.

Question 71

A managed care plan is a healthcare plan that emphasizes cost control and preventative treatment.

Question 72

____ is not a factor in rising health care costs.

A) Demand generated by Medicare
B) Technological improvements
C) New drug therapies
D) Increasing availability of health care protection
E) Lengthening hospital stays

Question 73

Generally,insurance is more reasonably priced through group plans than as individual policies.

Question 74

Blue Cross / Blue Shield plans are really hybrid HMOs that allow members to go outside of network.

Question 75

Jackie pays $20 every time she visits her doctor.She is covered by a(n)

A) HMO
B) IPA
C) PPO
D) Indemnity plan
E) Could be any of these except the indemnity plan.

Question 76

Medicare is a government-sponsored health care plan composed of Part A and Part B.Part A covers

A) hospital expenses.
B) doctor's bills.
C) custodial nursing home expenses.
D) prescription drugs.
E) all of the above.

Question 77

The usual,customary,and reasonable (UCR)charges are important to insured persons that are covered by

A) traditional indemnity plans.
B) health maintenance organizations.
C) individual practice associations.
D) preferred provider organizations.
E) All of the above

Question 78

The largest portion of health care costs pay for

A) hospital expenses.
B) prescription drugs..
C) physicians' services.
D) nursing home costs.
E) medical equipment.

Question 79

Living a healthy lifestyle is an example of loss prevention and control.

Question 80

Which of the following types of plans pay for some medical costs even when the insured decides to go out of the provider network (without a referral)for services?

A) HMO
B) IPA
C) PPO
D) POS
E) c and d