Health Insurance Quiz
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Questions and Answers

Which type of major medical policy deductible is not considered a common type?

  • Flat (correct)
  • Corridor
  • Integrated
  • Franchise
  • What kind of medical expense policy offers payments based on the length of hospital stay?

  • Hospital expense policy
  • Hospital Fixed-rate policy (correct)
  • Daily room and board expense policy
  • Surgical expense policy
  • Which type of insurance specifically addresses high costs related to certain illnesses?

  • Limited risk (correct)
  • Major medical
  • Comprehensive medical
  • Surgical expense
  • In the event of an accident, which aspect is most likely to be covered by William's disability income policy?

    <p>His lost income</p> Signup and view all the answers

    What type of insurance should Cathy purchase to protect a substantial part of her income if she becomes disabled?

    <p>Disability income insurance</p> Signup and view all the answers

    What is the total amount the insurer paid for Ed's accidents?

    <p>$4,800</p> Signup and view all the answers

    Which statement regarding total disability defined as 'own occupation' is inaccurate?

    <p>More advantageous to the insurer</p> Signup and view all the answers

    What does the term 'Schedule of Benefits' refer to?

    <p>Schedule of Benefits</p> Signup and view all the answers

    Which term is related to payments made for partial disabilities?

    <p>Residual disability</p> Signup and view all the answers

    How does Scheduled Coverage in a Major Medical Plan compare to a Basic Medical Expense Plan?

    <p>There are no schedules in a Major Medical Policy.</p> Signup and view all the answers

    What type of policy primarily provides benefits for surgical procedures?

    <p>Surgical expense policy</p> Signup and view all the answers

    What type of payment did Hank receive for his hospitalization?

    <p>A benefit payment from a Hospital Income Policy.</p> Signup and view all the answers

    In Claim #1, what amount does the insurer cover after the deductible?

    <p>$1,400</p> Signup and view all the answers

    What is the role of a Common Accident Provision in Ed's policy?

    <p>Only one deductible applies per claim despite multiple injuries.</p> Signup and view all the answers

    What would lead to Hank receiving a refund from his doctor?

    <p>He was overcharged for services rendered.</p> Signup and view all the answers

    What is the amount covered by the insurer in Claim #2 after the deductible?

    <p>$3,400</p> Signup and view all the answers

    What is the main purpose of Medicaid in California?

    <p>To offer increased assistance for medical needs to those unable to pay</p> Signup and view all the answers

    Which service is NOT typically included in LTC policies providing homecare benefits?

    <p>Acute care</p> Signup and view all the answers

    What is Part A of Medicare commonly referred to as?

    <p>Hospital Insurance</p> Signup and view all the answers

    What must an insurer do if they offer any Medicare Supplement plans?

    <p>Offer Plan A if they sell any of the other plans</p> Signup and view all the answers

    Which of the following describes Long-Term Care?

    <p>Covers various care services provided outside of hospital acute care units</p> Signup and view all the answers

    Which of the following would NOT be considered an approved Long-Term Care facility?

    <p>A sanitarium for weight loss</p> Signup and view all the answers

    Which condition is NOT an exclusion in most insurance policies?

    <p>Nonoccupational injuries</p> Signup and view all the answers

    What type of coverage is specifically designed to relieve the burden on the caregiver in an LTC situation?

    <p>Respite Care</p> Signup and view all the answers

    Which definition of Long-Term Care is incorrect?

    <p>Custodial Care Facility - care given without the supervision of an R.N.</p> Signup and view all the answers

    How is a preexisting condition defined in relation to an LTC policy?

    <p>A condition for which advice or treatment was received within 6 months of coverage</p> Signup and view all the answers

    Which of the following is true regarding Medicare Supplement insurance?

    <p>It limits coverage to only skilled nursing care for a certain number of days</p> Signup and view all the answers

    What is the focus of Respite Care in Long-Term Care?

    <p>Allowing for caregiver relief</p> Signup and view all the answers

    Which of the following services is primarily aimed at providing care during the day while caregivers are at work?

    <p>Adult Day Care</p> Signup and view all the answers

    Which program offers supplemental income to individuals who are aged, blind, or disabled?

    <p>Supplemental Security Income</p> Signup and view all the answers

    An LTC policy may NOT terminate coverage based on which of the following reasons?

    <p>Age of the insured</p> Signup and view all the answers

    What is the primary focus of hospice services in an LTC context?

    <p>Providing comfort for terminal illnesses</p> Signup and view all the answers

    Which of the following statements about Medicare Supplement policies is false?

    <p>They must cover pre-existing conditions from the start date of the policy.</p> Signup and view all the answers

    Which action is NOT required from an agent when soliciting Medicare supplements?

    <p>Send a signed form to the company explaining why coverage could not be placed.</p> Signup and view all the answers

    Which of the following is NOT considered a category level of long-term care?

    <p>Hospitalization care</p> Signup and view all the answers

    What term describes the short rest period provided for a family caregiver in long-term care insurance?

    <p>Respite care</p> Signup and view all the answers

    Which type of care in a long-term care policy focuses on helping with daily living activities such as bathing and dressing?

    <p>Custodial care</p> Signup and view all the answers

    At what age can an individual apply for Medicare Supplement policies without providing evidence of insurability?

    <p>59 1/2 years</p> Signup and view all the answers

    Who is eligible to receive Medicare Supplement policies?

    <p>Anyone qualifying for Medicaid benefits</p> Signup and view all the answers

    What must Medicare Supplement policies do regarding benefits relative to Medicare?

    <p>Automatically reflect changes in Medicare policies.</p> Signup and view all the answers

    What is the time limit for proving a loss according to the Proof of Loss Provision?

    <p>90 days</p> Signup and view all the answers

    What happens if an insured changes to a more hazardous occupation and files a claim?

    <p>Benefits will be reduced to reflect premiums that would have been charged.</p> Signup and view all the answers

    Which of the following statements about notifying the insurer of a change of occupation is true?

    <p>The policy may be cancelled if not notified.</p> Signup and view all the answers

    Under which provision can an insurer deny liability if the insured is intoxicated at the time of loss?

    <p>Intoxicants and Narcotics</p> Signup and view all the answers

    What is the role of Optional Uniform Provisions in an insurance policy?

    <p>They are included at the insurer's option and must comply with state regulations.</p> Signup and view all the answers

    If Albert was injured while committing an illegal act, what is the likely outcome of his insurance claim?

    <p>The claim will be denied due to the illegal act.</p> Signup and view all the answers

    What must an insured do if they change to a less hazardous occupation?

    <p>They may apply for a rate reduction.</p> Signup and view all the answers

    What can happen if an insured does not notify their insurer about working in two occupations?

    <p>It could result in the policy being cancelled.</p> Signup and view all the answers

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    Description

    Test your knowledge on various health insurance policies and related terms. This quiz covers deductibles, disability income policies, and benefits associated with hospitalization. See how well you understand the intricacies of medical expense policies.

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