Exam 9: Insuring Your Health

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Payments under social security disability benefits are available to those who are unable to work for atleast a year.

(True/False)
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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].

(Short Answer)
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Your health insurance has an 80% co-insurance clause.Once the deductible is satisfied,your insurance company will pay 80% of your covered losses up to the stated limits.

(True/False)
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Internal limits are constraints placed on insurance agents stipulating the level of risk for which they can write a policy.

(True/False)
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All of the following except a _____ are highly recommended for a long-term disability income policy.

(Multiple Choice)
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A preferred provider organization has characteristics of both Individual practice association (IPA)and an indemnity plan.

(True/False)
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Surgical expenses now generally are reimbursed on the basis of:

(Multiple Choice)
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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 | Workers' compensation] pays for medical expenses that are the result of on-the-job injuries and illnesses.

(Short Answer)
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A characteristic of dental insurance is:

(Multiple Choice)
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Medicare Advantage policies require payment from the policyholder in the form of a deductible.

(True/False)
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An elimination period in disability income insurance is most closely analogous to which of the following cost sharing provisions in health insurance?

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

(True/False)
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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. -Loss prevention tactics can be [only marginally | very] successful in reducing accidents and illnesses.

(Short Answer)
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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% co-insurance clause.The following losses occur: On January 1,2013,Sheila was treated for an infection at a cost of $200,on July 1,2013,Wally was treated for an injury suffered while waterskiing at a cost of $10,000,on December 5,2013,Nick underwent eye surgery at a cost of $1,500,and on January 5,2014,Brent was treated for a broken leg at a cost of $2,000. How much will the insurer pay for each of these losses?

(Essay)
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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.

(Short Answer)
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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. -About [one in two | one in seven] people between the ages of 35 and 65 will become disabled for five years or more.

(Short Answer)
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Blue Cross provides hospital coverage and Blue Shield provides prescription pharmacy coverage.

(True/False)
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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 ["own occupation" | "any occupation"] definition of disability is more restrictive.

(Short Answer)
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A group HMO employs a group of doctors to provide healthcare services to members in a central facility.

(True/False)
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Disability income insurance will provide income to a disabled or ill person:

(Multiple Choice)
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