Health Insurance Chapter 5
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Questions and Answers

All of the following conditions are typically covered in a long-term insurance policy EXCEPT:

  • Heart disease
  • Alcohol dependency (correct)
  • Acute illnesses such as pneumonia
  • Chronic conditions such as Parkinson's
  • Under Medicare Part B, the participant must pay all of the following EXCEPT:

  • Premiums
  • A per benefit deductible (correct)
  • Deductibles
  • Co-insurance
  • Which term refers to doctor-ordered health care performed by skilled medical practitioners and required intermittently, rather than on a daily basis?

    Intermediate care

    Which situation would qualify an individual for receiving benefits from a qualified long-term care policy?

    <p>Becoming cognitively impaired</p> Signup and view all the answers

    Which type of long-term care benefit would be most appropriate for a stroke victim who requires speech therapy administered at her home?

    <p>Home health care</p> Signup and view all the answers

    Which of the following does Medicare Part D cover?

    <p>Prescription drugs</p> Signup and view all the answers

    Which of these factors is NOT taken into consideration when determining the cost of a long-term care policy?

    <p>Personal income</p> Signup and view all the answers

    Continuous 24-hour care provided by licensed medical professionals under the direct supervision of a physician is called:

    <p>Skilled nursing care</p> Signup and view all the answers

    Someone needing custodial care at home would require which type of coverage?

    <p>Long-term care</p> Signup and view all the answers

    Which type of plan would be most appropriate for an individual on Medicare and concerned that Medicare will NOT pay for charges exceeding the approved amount?

    <p>Medicare supplement Plan F</p> Signup and view all the answers

    Benefits provided by a Medicare Supplement policy must NOT:

    <p>Duplicate Medicare benefits</p> Signup and view all the answers

    Which of these gaps in Medicare coverage is addressed with Medicare Supplemental Insurance?

    <p>Medicare in-hospital deductible</p> Signup and view all the answers

    Which of these nursing home options would best serve an individual who requires some nursing care and supervision but NOT full-time care?

    <p>Assisted living</p> Signup and view all the answers

    Shirley has a Medigap policy, which is designed to pay costs associated with:

    <p>Medicare Parts A and B</p> Signup and view all the answers

    Which of these statements about Medicaid is CORRECT?

    <p>It's funded by federal, state, and local taxes</p> Signup and view all the answers

    Study Notes

    Long-Term Care

    • Long-term care insurance includes coverage for both acute illnesses and chronic conditions like Parkinson's and heart disease.
    • Commonly covered conditions in long-term care insurance may not include specific acute illnesses.

    Medicare Part B

    • Medicare Part B covers physician services, medical expenses, and non-hospital supplies.
    • Participants must typically pay deductibles and co-pays, but some costs may be exempt.

    Intermediate Care

    • Refers to health care ordered by a doctor, performed intermittently by skilled medical practitioners rather than daily.

    Cognitive Impairment

    • An individual is qualified for benefits under a long-term care policy if mentally impaired as determined by health professionals.

    Home Health Care

    • Home health care is suitable for individuals recovering at home, like stroke victims needing specialized therapy such as speech rehabilitation.

    Medicare Part D

    • Covers prescription drugs and is essential for beneficiaries needing medication.

    Cost of Long-Term Care Policies

    • Cost assessments for long-term care policies consider various factors, but personal income is not included in calculations.

    Skilled Nursing Care

    • Continuous 24-hour care provided by licensed medical professionals under physician supervision is defined as skilled nursing care.

    Custodial Care

    • Individuals needing custodial care at home should seek a long-term care coverage option to support their needs.

    Medicare Supplement Plan F

    • Recommended for individuals on Medicare who want to cover charges beyond the approved Medicare amounts.

    Medicare Supplement Benefits

    • Medicare Supplement policies should not provide duplicate benefits that are already covered by Medicare.

    Gaps in Medicare Coverage

    • Medicare Supplement Insurance addresses gaps such as in-hospital deductibles incurred under Medicare.

    Assisted Living

    • Assisted living facilities provide care for individuals needing some nursing supervision without the requirement for full-time care.

    Medigap Policy

    • Medigap policies are intended to cover costs related to Medicare Parts A and B, providing additional financial protection.

    Medicaid

    • Medicaid funding comes from federal, state, and local taxes, supporting individuals with low income and limited resources.

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    Test your knowledge of Health Insurance concepts with our flashcards focusing on Chapter 5. Cover key definitions, conditions, and Medicare information to enhance your understanding. Perfect for students preparing for exams on health insurance topics.

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