Chapter 4: Medical Expense Insurance

D. a disease

A fee for service health insurance plan will normally cover: A. vitamins and natural remedies B. cosmetic procedures C. gym membership D. a disease

C. indicates a preexisting condition

A proposed insured for a health insurance policy was treated for heart disease within the past year. When applying for health insurance, the heart disease treatment: A. does not count as a preexisting condition B. is not required to be reported on the application C. indicates a preexisting condtion D. is irrelevant to underwriting

C. enrolled in a health plan with a prescription drug benefit

All of the following are qualifications for establishing a health saving account (HSA0 EXCEPT: A. enrolled in a high deductible health plan B. be under the age of 65 (not enrolled in Medicare) C. enrolled in a health plan with a prescription drug benefit D. enrolled in a health plan that limits out of pocket expenses

B. $900

Amy has a group medical policy through her employer with a $500 deductible and a 90% coinsurance provision. She incurs $1,500 in covered health care services. How much will her group insurance carrier pay? A. $500 B. $900 C. $1,000 D. $1,350

B. removing excess fat from an insured's waistline

An example of elective cosmetic surgery would be: A. reconstructive breast surgery after a mastectomy B. removing excess fat from an insured's waistline C. surgery to correct a birth defest D. reconstructive surgery after suffering injuries from an automobile accident

B. deductible

Jennifer is required to pay a specific sun out of pocket before any benefits are paid in a year. Her health policy most likely contains a(n): A. stop-loss provision B. deductible C. copayment D. out of pocket provision

A. an injury occurring at the insured's residence

Medical Expense Insurance would cover A. an injury occurring at the insured's residence B. an injury occurring at work C. an injury occurring by war D. elective surgeries

A. calendar-year deductible

Ted has a health insurance plan that requires him to pay a specific sum out of pocket before any benefits are paid in a calendar year. Which of these does his health plan have? A. calendar-year deductible B. coinsurance provision C. stop-loss feature D. integrated deductible

D. the specified number of days an insured must wait before becoming eligible to receive benefits for each hospitalization

The elimination period under a hospital indemnity plan is: A. the period in which pre-existing conditions are not taken into consideration B. the period in which all deductibles are eliminated C. the specified number of days after an insurance policy's issue date during which coverage is not afforded for sickness D. the specified number of days an insured must wait before becoming eligible to receive benefits for each hospitalization

C. medical and hospitalization expenses

The focus of major medical insurance is providing coverage for: A. critical illnesses only B. preventative care C. medical and hospitalization expenses D. doctor's visits

C. no tax payment is needed

What is the tax liability for employer contributions in Health Savings Accounts (HSA's)? A. taxable as regular income to the employee B. tax-deductible expense to the employee C. no tax payment is needed D. taxable to the employee when they exceed 7 1/2% AGI

C. dread disease insurance

What type of policy would only provide coverage for specific types of illnesses (cancer, stroke, etc.)? A. MEWA B. blanket insurance C. dread disease insurance D. disability insurance

A. no deductible payment is required

When an insured has a major medical plan with first dollar coverage, how does this impact the benefits paid? A. no deductible payments are required B. deductible specified in the contract is payable by the insurance C. insured must pay a percentage of covered losses D. an initial deductible plus a percentage of the remaining covered loss is owed by the insured

C. integrated deductible

Which of the following types of deductibles would apply a single deductible to both medical and dental insurance coverage? A. standard deductible B. combined deductible C. integrated deductible D. blended deductible

A. upper limit of the total lifetime benefits the insurance company will pay

"Maximum benefits" refers to the: A. upper limit of the total lifetime benefits the insurance company will pay B. upper limit percentage of what the insurance company will pay for coinsurance C. upper limits of what the insured will pay in out-of-pocket expenses D. upper limits of what an insurance company will pay for any particular claim