PF Ch. 9 Mult. Choice ?'s

Anna contributes pre-tax dollars to an account managed by her employer for her health care expenses. If she does not spend all of her money by the end of the year, she may forfeit it. What kind of plan does she have? A. FSA B. HRA C. HSA D. Medicare E. Self-funded health plan

A. FSA

Xavier's employer offers a health plan that stresses preventative services and covers routine immunizations and checkups, screening programs, and diagnostic tests. What kind of plan does his employer offer? A. Health maintenance organization (HMO) B. Private insurance company C. Hospital and medical service plan D. Medicare E. Preferred provider organization (PPO)

A. Health maintenance organization (HMO)

Sandy went to the doctor three times, each appointment cost $150. Her copayment was $20 per visit. How much was Sandy required to pay for her three visits? A. $20 B. $60 C. $130 D. $150 E. $450

B. $60

Which of the following is most likely to use a health maintenance organization? A. A healthy young adult who travels around the world for his job B. A family with teenagers who need annual check-ups for sports at school C. An neighbor who has seen the same specialists for the last 15 years D. A low-income elderly relative E. All of the above would be likely to use a health maintenance organization

B. A family with teenagers who need annual check-ups for sports at school

Brittany and Brandon are both charged $250 for an office visit to the same specialist. Brittany's reimbursement policy has a deductible of $300. Once she has met the deductible, the policy will cover the full cost of her visits. Brandon's indemnity policy will pay him $150, the maximum amount his plan provides for a visit to any specialist. Which of the following is correct? A. Brittany will pay less because the policy will cover up to $300 for her visit. B. Brittany will pay more because she must pay the entire bill since she has not met her deductible while Brandon will have part of his bill paid by his policy. C. Brandon will pay $150 and his insurance company will pay $100. D. Brandon will pay more because Brittany will have the first $300 paid by her policy. E. None of the above is correct.

B. Brittany will pay more because she must pay the entire bill since she has not met her deductible while Brandon will have part of his bill paid by his policy.

Monica's employer offers a health insurance plan with a very high deductible. In addition, her employer provides a fund for her to spend specifically on health care. What kind of plan does she have? A. FSA B. HRA C. HSA D. Medicare E. Self-funded health plan

B. HRA

Which of the following is NOT correct? A. Health costs have increased because of sophisticated technologies that are available B. Victims of accidents and crimes require less emergency medical services than in the past C. Regulations shift costs instead of reduce cost D. Some tests are repeated for patients, leading to higher health costs E. Work rules in the health care delivery system increase health costs

B. Victims of accidents and crimes require less emergency medical services than in the past

Peter has a health insurance policy that includes a deductible of $1,000, a coinsurance of 20 percent and a stop-loss of $5,000. If his total bill is $25,000, how much will he pay? A. $1,000 B. $4,800 C. $5,000 D. $5,800 E. $20,000

C. $5,000

The average per employee cost for health care in 2008 was more than A. $2,000 B. $4,000 C. $8,000 D. $12,000 E. $20,000

C. $8,000

How much income is usually replaced with a private income insurance program for a disability? A. 0 percent B. 10 - 30 percent C. 40 - 60 percent, with some plans paying up to 75 percent D. 50 - 70 percent, with some plans paying up to 100 percent E. 100 percent

C. 40 - 60 percent, with some plans paying up to 75 percent

Jacob is concerned that his out-of-pocket health care expenses will be quite high, so he is considering adding contributions to a tax-free account that he can use with his high-deductible policy to cover catastrophic expenses. What kind of plan does he have? A. FSA B. HRA C. HSA D. Medicare E. Self-funded health plan

C. HSA

Cameron, age 25, sustained a debilitating hand injury and was unable to perform his job as a viola player in the local orchestra for 45 days. His employer has a disability income insurance policy that pays 70 percent of take-home pay with an elimination period of 60 days and coverage to age 65. Given this information, which of the following is true for Cameron? A. He will receive disability income for 15 days. B. His employer will pay 70 percent of his current income for 40 years. C. He will not be eligible for any disability income because his disability ended before the elimination period ended. D. He will receive disability income for 45 days. E. His employer will estimate his average salary through age 65 to determine his disability income.

C. He will not be eligible for any disability income because his disability ended before the elimination period ended.

Blue Cross and Blue Shield are A. Health maintenance organizations (HMO) B. Private insurance companies C. Hospital and medical service plans D. Types of Medicare E. Preferred provider organizations (PPO)

C. Hospital and medical service plans

Jack needs comprehensive medical coverage, however, his income is quite low. What plan should he investigate? A. Medicare Part A B. Medicare Part B C. Medicaid D. Medigap E. Medicare Part C

C. Medicaid

A Medigap policy fills the gap between medical costs and payments from A. Home health care agencies B. Hospital and medical service plans C. Medicare D. Medicaid E. Private insurance companies

C. Medicare

Georgia has a health insurance policy that includes a deductible of $750 and a coinsurance of 20 percent. If her total bill is $2,750, how much will she be required to pay? A. $400 B. $550 C. $750 D. $1150 E. $1600

D. $1150

Larry has a health insurance policy that includes a deductible of $1,000 and a coinsurance of 20 percent. If his total bill is $4,000, how much will his insurance pay? A. $800 B. $1,000 C. $1,600 D. $2,400 E. $3,000

D. $2,400

Which of the following is INCORRECT? A. Disability income insurance provides regular cash income when you're unable to work because of a disability. B. Disabilities can include pregnancy, a non-work-related accident, or an illness. C. The definition of disability varies from insurer to insurer. D. A bad disability policy pays you if you cannot work at your regular job. E. Disability can cause even greater financial problems than death.

D. A bad disability policy pays you if you cannot work at your regular job.

Disability income insurance plans offer benefits A. For only a few years B. Until age 65 C. For life D. All of the above are possibilities E. None of the above is correct

D. All of the above are possibilities

Who is most likely to use a home health care agency? A. A mother who is looking for a plan to cover immunizations for her children B. A healthy young adult C. A family with teenagers who need annual check-ups for sports at school D. An elderly neighbor E. All of the above would be likely to use a home health care agency

D. An elderly neighbor

Rising health costs are due to all except A. Cost of prescription drugs B. Growing number of uninsured C. Advancements in medical technology D. Baby boomers using fewer health care services E. Overweight population

D. Baby boomers using fewer health care services

If you are concerned that your disability insurer may try to cancel your coverage if your health becomes poor, you should look for a plan that offers A. Duration of benefits to age 65 B. A plan that provides 70 - 80% of your take-home pay C. Accident and sickness coverage D. Guaranteed renewability E. A short elimination period

D. Guaranteed renewability

Medicare covers A. Dental care B. Routine checkups C. Most immunizations D. Inpatient hospital care E. All of the above are covered by Medicare.

D. Inpatient hospital care

A health insurance policy that will cover only a fixed amount of an expense is called A. Reimbursement B. Out-of-pocket limit C. Deductible D. Internal limit E. Indemnity

D. Internal limit

Which of the following is NOT a private health care plan? A. Health maintenance organization (HMO) B. Home health care agency C. Hospital and medical service plan D. Medicare E. Preferred provider organization (PPO)

D. Medicare

Individuals over the age of 65 who are eligible for federal government health plan coverage may also be interested in purchasing A. Medicare Part A B. Medicare Part B C. Medicaid D. Medigap E. State-wide health coverage

D. Medigap

This type of plan combines features of HMOs and PPOs. It uses a network of participating physicians and medical professionals who have contracted to provide services for certain fees. What kind of plan does his employer offer? A. Home health care agency B. Hospital and medical service plan C. Medicare D. Point-of-service plan E. Private insurance company

D. Point-of-service plan

Mark was severely injured and expects to be unable to work for at least 12 months. Because of his injury, he should expect to be eligible for disability income from A. A private income insurance program B. His employer's plan C. Medicare D. Social Security E. Worker's compensation

D. Social Security

Georgia has a health insurance policy that includes a deductible of $750 and a coinsurance of 20 percent. If her total bill is $2,750, how much will her insurance pay? A. $400 B. $550 C. $750 D. $1150 E. $1600

E. $1600

How many people in the United States do not have health insurance? A. 500,000 B. 2 million C. 9 million D. 27 million E. 48 million

E. 48 million

Medicaid covers A. Lab services B. Skilled nursing and home health services C. Prescription drugs D. Eyeglasses E. All of the above

E. All of the above

All of the following are sources of disability income except A. Worker's compensation B. Disability benefits from an employer C. Social security D. Private income insurance programs E. All of the above are sources of disability income.

E. All of the above are sources of disability income.

Which of the following activities is NOT a step being taken to reduce health care costs? A. Community health education programs motivate people to take better care of themselves B. Physicians encourage patients to pay cash for routine medical care and lab tests C. Programs to review health care fees are available D. Community health planning can help achieve a better balance between health needs and health care resources E. All of the activities can reduce health care costs

E. All of the activities can reduce health care costs

Yvonne's employer offers a health plan that has a group of doctors and hospitals that agree to provide specified medical services to members at prearranged fees. This health plan offers some flexibility since members can either visit a physician from a list or go to their own doctors. What kind of plan does her employer offer? A. Health maintenance organization (HMO) B. Private insurance company C. Hospital and medical service plan D. Medicare E. Preferred provider organization (PPO)

E. Preferred provider organization (PPO)

Which of the following is true about the elimination period? A. Premiums for a plan with an elimination period of 30 days will be less than the premiums for a plan with an elimination period of 45 days. B. Premiums for a plan with an elimination period of 50 days will be the same as the premiums for a plan with an elimination period of 75 days. C. Premiums for a plan with an elimination period of 40 days will be less than the premiums for a plan with an elimination period of 75 days. D. Premiums for a plan with an elimination period of 90 days will be the same as the premiums for a plan with an elimination period of 60 days. E. Premiums for a plan with an elimination period of 90 days will be less than the premiums for a plan with an elimination period of 60 days.

E. Premiums for a plan with an elimination period of 90 days will be less than the premiums for a plan with an elimination period of 60 days.

A quality health insurance plan should do all of the following except A. Offer basic coverage for hospital and doctor bills B. Impose no unreasonable exclusions C. Limit out-of-pocket expenses to more than no $5,000 per year D. Provide at least 120 days' hospital room and board in full E. Provide a lifetime maximum level of coverage of up to $50,000

E. Provide a lifetime maximum level of coverage of up to $50,000

Katrina was injured in an accident at work. The benefits she will receive to cover part of her income will come from A. A private income insurance program B. Her employer plan C. Medicare D. Social Security E. Worker's compensation

E. Worker's compensation

This health insurance provision lets your insurer make direct payment to your doctor or hospital: a. Assigned benefits b. Benefit limits c. Exclusions and limitations d. Internal limits e. Service benefits

a. Assigned benefits

Jenny wants health insurance that limits the amount that she must pay before the insurance starts paying benefits. She is concerned about a: a. Deductible b. Coinsurance c. Stop-loss provision d. Hospital indemnity policy e. Dread disease policy

a. Deductible

The Health Insurance Portability and Accountability Act of 1996: a. Sets federal standards to ensure that workers would not lose their health insurance if they changed jobs b. Sets state standards to ensure that workers would not lose their health insurance if they changed jobs c. Applies to individual health insurance policies d. Prevents employees from moving from one group health plan to another without a lapse in coverage e. Is an update of the Consolidated Omnibus Budget Reconciliation Act of 1986

a. Sets federal standards to ensure that workers would not lose their health insurance if they changed jobs

What is a typical copayment amount for individuals?: a. $0-$5 b. $15-$25 c. $35-50 d. $75-$100 e. $100-$200

b. $15-$25

A policy that pays you back for actual expenses is called: a. A coinsurance plan b. A reimbursement plan c. A deductible plan d. An indemnity plan e. A reasonable and customary plan

b. A reimbursement plan

Nancy is studying the health insurance plan options offered by her employer. She wants a policy that will have the insurance pay a percentage of her medical expenses. She should review the: a. Deductible b. Coinsurance c. Stop-loss provision d. Hospital indemnity policy e. Dread disease policy

b. Coinsurance

Which of the following is INCORRECT about dread disease policies?: a. They are illegal in many states b. Each policy covers a wide rage of conditions c. They play upon unrealistic fears d. These policies are usually sold through the mail, in newspapers, and magazines, or by door-to-door people e. They cover diseases that are already covered if you are insured under a major medical plan

b. Each policy covers a wide rage of conditions

After you have reached a certain limit, the insurance company covers 100 percent of any additional cost. This is called: a. Reimbursement b. Out-of-pocket limit c. Deductible d. Internal limit e. Indemnity

b. Out-of-pocket limit

The type of health insurance coverage that may cover a specific amount for an operation is: a. Dental expense b. Surgical expense c. Hospital expense d. Physician expense e. Major medical expense

b. Surgical expense

Most people receive health insurance from: a. Individual plans b. Their bank or lending institution c. A plan offered by their employer d. COBRA e. None of the above

c. A plan offered by their employer

The insurance that helps pay extensive hospital, surgical, medical, and other bills with a low deductible is known as a: a. Basic health insurance policy b. Individual policy c. Comprehensive major medical policy d. Hospital indemnity policy e. Dread disease policy

c. Comprehensive major medical policy

COBRA stands for: a. Coverage of Benefits Reduction Act b. Continuation of Benefits for Retirees Act c. Consolidated Omnibus Budget Reconciliation Act d. Coverage of Benefits for the Retired Act e. Consolidation of Benefit Reapplication Act

c. Consolidated Omnibus Budget Reconciliation Act

The set amount that you must pay toward medical expenses before the insurance company pays benefits is called: a. Reimbursement b. Out-of-pocket limit c. Deductible d. Internal limit e. Indemnity

c. Deductible

The type of health insurance coverage that pays for some or all of the costs of room and board is: a. Dental expense b. Surgical expense c. Hospital expense d. Physician expense e. Major medical expense

c. Hospital expense

What is the primary purpose of medical expense insurance?: a. Protect against death expenses b. Provide payments to make up for some income of a person who cannot work as a result of injury or illness c. Pay medical costs for illness and injury d. Pay a salary if an employee is disabled e. Repay loans if an employee cannot work because of an illness or injury

c. Pay medical costs for illness and injury

Fran is interested in purchasing health insurance that limits the total out-of-pocket amount that she will have to pay. She should consider a: a. Deductible b. Coinsurance c. Stop-loss provision d. Hospital indemnity policy e. Dread disease policy

c. Stop-loss provision

Which of the following is TRUE about long-term care insurance?: a. It covers help at home, but not in a nursing home b. It covers a stay in a nursing home, but not help at home c. The older you are when you enroll, the higher the annual premium d. Insurance plans are primarily sold to individuals in the 20-40 age group e. These plans typically pay for all costs

c. The older you are when you enroll, the higher the annual premium

Which of the following about individual health insurance policies is NOT correct?: a. They can cover individuals b. They are used by the self-employed c. They can provide family coverage d. All insurance companies that offer this type of policy are required to charge the same rates e. They can be purchased directly from the company of your choice

d. All insurance companies that offer this type of policy are required to charge the same rates

This health insurance provision sets limits on the amount of repayment for certain services: a. Assigned benefits b. Copayment c. Exclusions and limitations d. Internal limits e. Service benefits

d. Internal limits

Which of the following is NOT a type of health insurance available to individuals or employees?: a. Dental expense insurance b. Hospital indemnity policy c. Dread disease policy d. Minor medical indemnity insurance e. Vision care insurance

d. Minor medical indemnity insurance

The type of health insurance coverage that may cover routine doctor visits, X-rays, and lab tests is: a. Dental expense b. Surgical expense c. Hospital expense d. Physician expense e. Major medical expense

d. Physician expense

Coordination of benefits (COB) applies to: a. Combining health insurance and disability insurance coverage b. Combing all group and individual insurance coverages c. Combining The Health Insurance Portability and Accountability act of 1996 and COBRA d. Combining three or more disability policies issued for an individual e. Combining two insurance policies issued for a married couple

e. Combining two insurance policies issued for a married couple

Miguel is concerned that the health insurance option he is considering plays upon unrealistic fears. He is most concerned about: a. Deductible b. Coinsurance c. Stop-loss provision d. Hospital indemnity policy e. Dread disease policy

e. Dread disease policy

The type of health insurance coverage that takes up where basic health insurance coverage leaves off is: a. Dental expense b. Surgical expense c. Hospital expense d. Physician expense e. Major medical expense

e. Major medical expense

Which of the following is correct?: a. A premium reimburses you for hospital stays, doctors' visits and medications b. A premium is the amount your employer will pay for your health insurance coverage c. Disability income insurance pays the actual medical costs d. Medical expense insurance provides payments to make up for income of a person who cannot work as a result of injury or illness e. Most medical expense plans reimburse an individual for hospital stays, doctors' visits and medications

e. Most medical expense plans reimburse an individual for hospital stays, doctors' visits and medications

A health insurance policy with this provision lists coverage in terms of services, not dollar amounts: a. Assigned benefits b. Benefit limits c. Exclusions and limitations d. Internal limits e. Service benefits

e. Service benefits

Which of the following about individual health insurance policies are correct?: a. They are used by employees of large organizations b. All insurance companies that offer this type of policy are required to charge the same rates c. They are primarily for employees of small companies d. They are permitted for individuals only, not for families e. They are available for the self-employed or others who are dissatisfied with the coverage that their group plan provides

e. They are available for the self-employed or others who are dissatisfied with the coverage that their group plan provides