FINN 3003 (CH 12)
7) Medicare basic coverage (Part A) covers
A) hospital expenses, including surgeries.
15) Indemnity health care plans have
A) more flexibility and choices than managed care plans.
18) Which of the following is an advantage of a PPO compared to an HMO?
B) There are more choices of specialized health care providers.
10) The part of Medicare that provides coverage for prescription drugs is
D) Part D.
17) Which of the following statements about an HMO is not true?
D) The health care providers are compensated on the basis of each visit by a patient.
1) Basic health insurance policies and Medicare will not cover stays in nursing homes or assisted living centers for very long.
T
1) Certain federal regulations ensure that individuals can maintain continuous health care coverage.
T
1) Health insurance protects net worth by minimizing the chance that you will have to reduce savings or incur debt when you require medical attention.
T
1) Private health insurance plans contain hospital insurance, physician insurance, and surgical insurance.
T
2) Having money taken out of your paycheck and put in a flexible spending account is one of the ways you can avoid paying taxes on the amount you spend for health care expenses.
T
2) Most people obtain health insurance through group plans offered by employers.
T
3) In order remain eligible for protection under HIPAA, a person must maintain continuous enrollment in a health care plan.
T
3) Medicaid is health insurance for the poor and is administered by each state within certain broad federal requirements and guidelines.
T
3) Usually plans such as dental insurance and vision insurance are good deals if they are offered through employers.
T
5) Beginning in 2014, health insurers will not be able to deny applicants based on pre-existing conditions.
T
5) Compared to indemnity plans, managed health care plans impose more restrictions on the specific health care providers.
T
5) You must have Parts A and B of Medicare in order to qualify for Part D.
T
6) In most HMOs, if a person sees a specialist without being referred by the primary care physician, the HMO will not pay for the treatment.
T
7) Health care providers who are part of an HMO are paid a predetermined amount of compensation per month for each patient who participates in the plan.
T
8) A PPO health insurance plan allows individuals a better selection of health care providers, but is more expensive than an HMO.
T
12) Which of the following is usually not offered as part of a benefits package to employees?
A) Auto insurance
10) Which of the following is not true regarding employer disability insurance?
A) Disability benefits are provided for very long periods, usually up to 30 years.
6) Which statement regarding COBRA is true?
A) The act applies to private firms and agencies of state government but not to federal government agencies.
5) Which of the following statements is not true of disability insurance?
A) You should have it even if you are retired and living on a pension.
16) Compared to indemnity plans, what is an advantage of managed health care plans?
A) You will have lower insurance premiums.
5) Long-term care policies
A) commonly have an elimination period (waiting period) of between 60 and 90 days before the policies will begin to pay.
8) Sources of disability income do not include
A) federal disability insurance.
11) What would be the out-of-pocket cost to an individual whose health care policy includes a 20% co-pay for all long-term illnesses. The policy has a stop loss provision of $40,000. A current long-term illness has resulted in total expenses of $250,000.
B) $40,000
4) The federal law that allows you to continue health insurance coverage through your former employer's plan for 18 months after you stop work is
B) COBRA.
11) Which one of the following benefits is most often available through an employer?
B) Health insurance
6) ________ is the government program that provides health insurance to individuals who are 65 years of age or older.
B) Medicare
3) Which of the following is not a true statement?
B) Medicare covers most of the expenses associated with long-term care.
10) Comparing auto insurance and health insurance,
B) both types of policies have deductibles.
9) Before you decide to take out an individual disability policy, you should consider all of the following except
B) cost of gasoline commuting to and from work.
7) Regarding the definition of disability,
B) it varies from one disability policy to another.
9) Private health insurance plans contain all of the following coverage except
B) nursing home insurance.
21) An arrangement in whish the preferred provider organization (PPO) pays the provider a specific sum for each day a patient is hospitalized is called a
B) per diem rate arrangement.
12) In purchasing disability insurance, you should consider all of the following except the
B) probationary period.
14) Indemnity health plans
B) require you to pay the doctor and then get reimbursed.
24) How much would be owed by the patient on a $3,000 bill if a PPO uses a discount on charge arrangement wherein the percentage paid to the provider is 70% and the patient's co-pay, as specified by the PPO, is 20 percent?
C) $420
5) Which of the following is not true as it relates to the cost of health care?
C) Better claim handling and processing has helped reduce the cost of health care.
9) Regarding Medicaid, which of the following is true?
C) It is a federal program administered by each state.
11) Which of the following statements about the Medicare Prescription Drug Improvement and Modernization Act of 2003 is not true?
C) Low-income seniors are subject to a $250 deductible.
19) ________ insurance serves as a backup for expenses not covered by basic health insurance.
C) Major medical insurance
20) When considering an HMO or PPO, which of the following would you not consider regarding the cost of the plan?
C) Number of doctors accepting new patients
8) Which of the following is true regarding Medicare?
C) Part of the program is optional and has a charge.
6) Which of the following statements regarding health insurance is not true?
C) There are many more options available for homeowner's insurance than for health insurance.
11) Disability insurance would probably cost the most for which of the following people?
C) a construction worker
13) Disability insurance policies usually cover
C) a percentage of your income before you were disabled.
7) An account that allows employees to use pre-tax income to pay for medical expenses is a
C) flexible spending account.
10) One disadvantage of a flexible spending account is
C) funds are available to pay for out-of-pocket expenses.
22) Under a discount on charge arrangement, the provider receives
C) less than what it would normally charge for a particular service.
9) If a person is diabetic and is applying for a new health care insurance policy, s/he might be most concerned with which of the following?
C) pre-existing conditions
4) The cost of health care has risen dramatically in recent years due to all except
C) reduced litigation costs.
13) Since health insurance is expensive
C) the employer and employee typically share the cost of the health insurance.
6) All of the following will lower the premium of long-term care insurance except
C) waiting until you are retired to obtain the insurance.
6) The definition of disability can be defined as all of the following except
C) you are unable to perform the duties of your job due to a work-related injury.
25) How much of a $2,000 medical bill would you pay if your policy contains a $400 deductible and a 10% coinsurance clause?
D) $560
7) Which act established provisions that require U.S. citizens to obtain health insurance?
D) Affordable Care Act
5) Which of the following is not true regarding government regulations to allow individuals who change jobs to maintain health insurance coverage?
D) When changing jobs, you are allowed to stop and start health care plans whenever you need to and still be guaranteed insurance coverage by a new provider.
8) Regarding a flexible spending account, which of the following is not true?
D) Your employer will match your funds dollar-for-dollar.
23) Patients receive a(n) ________ from the PPO that lists the total charges, the total amount owed to the provider, and the total amount billed to the patient.
D) explanation of benefits
1) Generally, disability income policies with shorter waiting periods have lower premiums.
F
1) Medicare is a government health insurance program for those over 65 years of age who can show need for financial assistance.
F
1) One of the problems with changing jobs is that you will immediately lose your health insurance and may not be able to get new insurance right away.
F
2) Because of COBRA, you can continue to remain covered by your employer's health insurance plan for one year after you stop working for your employer.
F
2) Hospitals, doctors, and patients have enough incentive to make the most economical use of health care services.
F
2) Medigap insurance, intended to supplement Medicare, is sold and serviced by the federal government.`
F
2) Policy premiums for long-term care insurance are relatively low, even for those over 60 years old.
F
2) The best disability plans pay you if you are not able to work at any job, not just your regular job.
F
3) Buying health insurance through employer-sponsored plans is somewhat more expensive than buying your own policy individually.
F
3) Since most workers have employer-sponsored disability coverage and are also eligible for Social Security and worker's compensation, there is very little demand or need for individual disability insurance.
F
3) Technological advances are one of the things helping to keep the cost of health care from escalating further.
F
4) Although indemnity plans are less flexible than managed care plans, they charge lower rates.
F
4) Part D of Medicare represents a combination of Part A and Part B provided through private insurance companies.
F
4) Social Security is the easiest disability coverage to qualify for benefits.
F
4) The Affordable Care Act allows young adults to continue on a parent's health insurance plan until age 19.
F
27) The managed health care plan with the lowest premiums and also the least choice of health care providers is the ________.
HMO
12) ________ insurance is provided by private insurance companies to cover medical expenses that are not covered by Medicare.
Medigap
28) The managed health care plan with higher costs, but a greater choice of health care providers is the ________.
PPO
26) A(n) ________ plan requires that individuals pay health care providers and then put in a claim for reimbursement.
indemnity
7) One of the newest types of health care insurance is ________ insurance, which provides coverage to those in a nursing home, assisted living facility, or at home.
long-term care
14) Disability income is
tax-free