Chapter 11 Personal Finance

Most insurers limit disability benefits from all sources to ________ of your take-home pay

70% - 80%

A "good" health insurance plan pays at least _________ percent of out-of-hospital expenses once a yearly deductible for the individual and family have been met.

80

What are some of the factors that have led to increasing health care costs?

An increased number of crimes and accidents The use of expensive technologies

Name an independent membership corporation that provides protection against the cost of hospital care:

Blue Cross

True or false: Administration costs for health care in the United States are less than in nations such as Canada and Mexico.

False

True or false: Most private insurance companies do not provide group policies.

False

_____________ compiles websites from nonprofits, federal and local websites, and many other sources to present a complete health resources website.

Healthfinder

What program was designed to provide medical assistance to low-income individuals and families?

Medicaid

_____________ was designed to provide medical assistance to groups or categories of persons who are eligible to receive payments under one of the cash assistance programs.

Medicaid

_____________ insurance makes up the difference between Medicare payments and medical costs not covered by providing supplemental insurance that can be purchased

Medigap

Which insurance supplements Medicare by filling the difference between Medicare payments and medical costs not covered by Medicare?

Medigap insurance

A group of doctors and hospitals that agree to provide health care to members at prearranged fees is called _________

PPO

____________ work like HMOs, except the networks are managed by doctors and hospitals.

PPOs

Identify ways in which you can personally reduce your health care costs.

Rest. Eat a balanced diet to keep weight under control. Avoid smoking.

Copayment is the provision under which the insured pays a flat dollar amount each time a covered medical service is received.

True

Health insurance is one way people protect themselves against economic losses due to illness, accident, or disability.

True

True or false: Healthfinder includes links to more than 1,600 websites operated by government and nonprofit organizations.

True

True or false: Insurers limit benefits from all sources to 70%-80% of your take-home pay because you no longer incur work-related expenses and your taxes are much lower, if not zero.

True

Physician expense insurance provides benefits for which of the following?

X-rays lab tests doctors' fees for nonsurgical care

What might a person who is uninsured experience during times of illness and injury?

a financial burden

A good health insurance provides which of the following?

at least $1 million lifetime maximum for each family member a provision so the policyholder will pay no more than $6,000 out of pocket a year

Key provisions in the Patient Protection and Affordable Care Act of 2010 include _________

banning companies from dropping people when they get sick providing tax credits for small businesses to make employee coverage affordable prohibiting lifetime caps on coverage

A combination of hospital expense insurance, physician expense insurance, and surgical expense insurance is called _____________

basic health insurance

A good disability plan would pay you when you ________

can only work part-time at your regular job are unable to work your regular job

In order to contain health care costs, physicians are encouraging consumers to pay with __________ for routine medical care and lab services

cash

The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986 requires employers to offer employees and dependents, who would otherwise lose group health insurance, the option to continue their group health coverage for:

certain amount of time

A provision under which the insured pays a flat dollar amount each time a covered medical service is received is called:

copayment

__________ __________ insurance provides regular cash income lost by employees as a result of an accident or illness.

disability income

Which insurance provides payments to replace income when an insured person is unable to work for a long period of time?

disability income insurance

The Patient Protection and Affordable Care Act bans insurance companies from ______ coverage when they get sick.

dropping people from

Age, marital status, and dependency requirements are usually specified in the ______ provision of an insurance policy.

eligibility

The federal Consolidated Omnibus Budget Reconciliation Act of 1986 requires many employers to offer group health benefits to:

employees and dependents who would normally lose group health insurance.

Most private insurance companies are providers of ___________ health insurance policies through employers.

group

Most private insurance companies are providers of _______________ health insurance policies through employers.

group

By exercising, not smoking, getting rest, and driving carefully, individuals can greatly reduce their ____________

health care costs

The added use of technology, use of prescription drugs, life expectancy of the elderly, and accidents and crimes all lead to _____________ health care costs

high

For surgical expense insurance, larger maximum fees allowed for each surgery will cause the premiums to be ____________

higher

Rising hospital care costs, new medical technology, and the increasing number of elderly people have helped make ______ one of the fastest-growing areas of the health care industry.

home health providers

Blue Cross is an independent, nonprofit membership corporation that provides protection against the cost of ____________ care

hospital

Which type of insurance pays part or all of hospital bills for room, board, and other charges?

hospital expense insurance

Health insurance is one way people protect themselves against economic losses due to __________

illness accident disability

A(n) ________ policy provides specified benefits regardless of whether the actual expenses are greater or less than the benefits. A(n) __________ policy provides benefits based on the actual expense.

indemnity ; reimbursement

Which of the following activities have been undertaken by health care professionals and consumers to keep the overall cost of health care down?

initiating community health education programs getting involved in community health planning offering incentives to encourage preventive care

The eligibility provision defines who:

is entitled to benefits under the policy.

____________-term care insurance provides day-in day-out care for extended illness or disability.

long

Match the waiting periods and premiums for disability plans.

long waiting period <-----> lower premiums short waiting period <----> higher premiums

Which type of insurance is the fastest growing type of insurance today?

long-term care

With disability plans, the longer the waiting period, the ________ the premiums

lower

_____________ medical expense insurance pays most of the costs exceeding those covered by the hospital, surgical, and physician expense policies.

major

Which type of insurance pays the larger expenses of a serious injury or long illness, including those covered by the hospital, surgical, and physician expense policies?

major medical expense insurance

Prepaid health plans that provide comprehensive health care to members are called ___________

managed care

Surgical expense insurance pays part or all of surgeons' fees for a(n) ___________

operation

Administrative costs in the United States are much higher than those in other nations due to activities such as:

paying health insurance premiums. checking eligibility. enrolling beneficiaries in a health plan. filing reimbursement claims.

Self-insurance is an arrangement in which a company collects premiums from employees and __________

pays medical benefits if needed

Which type of insurance provides benefits for doctors' fees for nonsurgical care, X-rays, and lab tests?

physician expense insurance

Managed care refers to ___________ health plans that provide comprehensive health care to members.

prepaid

Flexible spending accounts allow you to contribute ______ dollars to an account managed by your employer.

pretax

Health insurance provides ____________ to alleviate the financial burden individuals suffer from illness or injury.

protection

Which policy provides benefits based on the actual expense incurred?

reimbursement

The reasons for the increased need for home health care include __________

rising hospital costs older U.S. population new medical technology

Hospital expense insurance pays part or all of hospital bills for _____________, board, and other charges.

room

The main risk involved with a ______ health plan is the financial burden if the medical bills are greater than the amount covered by premium income.

self-funded

A poor disability plan pays you only when you are ______ to work at any job

unable

What are the sources of disability income coverage?

worker's compensation employer plans Social Security

The money in a flexible spending account must be used for health care and used by the end of the ___________

year