Exam 9: Insuring Your Health

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. -Surgical expense insurance would pay for cosmetic surgery [for a face lift | to reduce the size of your nose | only if deemed a medical necessity].

Nick and Sheila Preston are married and have purchased a comprehensive major medical policy which covers them and their two sons,Wally and Brent.The policy has a $500 calendar year family deductible,a $2,500 stop-loss provision,and an 80% coinsurance clause.The following losses occur: On January 1,2004 Sheila was treated for an infection at a cost of $200,on July 1,2004 Wally was treated for an injury suffered while waterskiing at a cost of $10,000,on December 5,2004 Nick underwent eye surgery at a cost of $1,500,and on January 5,2005 Brent was treated for a broken leg at a cost of $2,000. How much will the insurer pay for each of these losses?

Which of the following programs is a public assistance program that provides health insurance benefits only to those who are unable to pay for healthcare?

Suppose a person has a health insurance policy with a $500 calendar year deductible,a $2,000 out-of-pocket cap,and an 80% coinsurance provision.If this person suffers a $600 covered loss,how much will the insurance company pay? (Assume no previous losses have occurred.)

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

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. -During the past few decades,the percent of our income that we as a nation spend on health care has [increased | decreased].

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

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

Medicare Advantage policies require payment from the policyholder in the form of a deductible.

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

When you are hospitalized for surgical care,surgical expense coverage will pay the hospital bill.

Supplementary Medical Insurance (SMI)provides health care protection beyond basic hospital coverage for

Which of the following is(are)characteristic of Social Security disability income benefits? A) 1-year waiting period B) "own occ" definition of disability C) disability expected to last 1 year, or be fatal D) a and b E) a, b, and d

Joe has a disability income policy that pays a monthly benefit of $1,200.Joe has been disabled for 30 days,but he only received a check in the amount of $600 from his disability insurance.What is probably the reason that he only received $600?

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 cover [more | less] than half of the total cost of long-term care.

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 are laid off,your health insurance [can be continued at the employer's option | must be continued if you pay the premiums].

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. -Your health insurance stipulates that you will pay the first $500 of your health care expenses for the year.This is an example of a [deductible | co-payment].

HMOs require members to pick one primary care physician.

Suppose Janet,a skilled neuro-surgeon,became unable to perform surgery because of severe arthritis.Which of the following is NOT true?

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. -The medicare coinsurance payment is usually [10% | 20%].