Health-care Reform; Individual Health Insurance Coverages

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Question 1
Free
Multiple Choice

Problems with the health care system in the United States that led to implementation of the Affordable Care Act included
I) Rising healthcare expenditures
II)Considerable waste and inefficiency in the healthcare system

Choose correct answer/s
A

I only

B

II only

C

both I and II

D

neither I nor II

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Question 2
Free
Multiple Choice

All of the following are historical reasons for the increase in health care expenditures in the U.S. EXCEPT

Choose correct answer/s
A

cost insulation because of third-party payers.

B

employer-sponsored health insurance.

C

universal health insurance coverage.

D

technological advances in health care.

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Question 3
Free
Multiple Choice

The Affordable Care Act requires that most U.S. citizens and legal residents have qualifying health insurance or pay a financial penalty. This provision of the Affordable Care Act is known as the

Choose correct answer/s
A

Health Insurance Marketplace option.

B

public option.

C

individual mandate.

D

premium subsidy option.

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Question 4
Free
Multiple Choice

Under the Affordable Care Act, which of the following statements are true?
I)Health insurers cannot use pre-existing conditions exclusions.
II)Health insurers cannot impose annual benefit limits and lifetime benefit limits.

Choose correct answer/s
A

I only

B

II only

C

both I and II

D

neither I nor II

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Question 5
Free
Multiple Choice

One provision of the Affordable Care Act is designed to benefit young adults up to age 26. This provision allows these young adults to

Choose correct answer/s
A

remain covered under their parents' health insurance policies.

B

receive a tax credit for their health insurance premium if they are unemployed.

C

receive low-interest government loans to finance their health insurance.

D

receive coverage under Medicare if they are not covered by a private health insurance plan.

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Question 6
Multiple Choice

Which of the following statements regarding health care expenditures in the United States is (are) true?
I)As a nation, the U.S. spends significantly more per-person on health care than most other industrialized nations.
II)Health care expenditures in the U.S. are high because everyone is covered by a health insurance plan.

Choose correct answer/s
A
I only
B
II only
C
both I and II
D
neither I nor II
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Question 7
Multiple Choice

Individual medical expense insurance sold in the Health Insurance Marketplace is characterized by which of the following?

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A
narrow range of benefits
B
no lifetime benefit limits
C
no exclusions
D
first-dollar coverage
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Question 8
Multiple Choice

Prior to passage of the Affordable Care Act, insurers could go back to the date a health insurance policy became effective and render the policy void due to a clerical error. This practice, which is prohibited under the Affordable Care Act except in cases of fraud or intentional misrepresentation of a material fact, is called

Choose correct answer/s
A
estoppel.
B
retention.
C
rescission.
D
reformation.
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Question 9
Multiple Choice

Under the Affordable Care Act, if a health insurer does not meet the minimum loss ratio requirement, the insurer must

Choose correct answer/s
A
pay a fine to the federal government.
B
issue rebates to the people the insurer covered.
C
not sell any health insurance for a period of one year.
D
reduce the premium on the policies it sells the following year.
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Question 10
Multiple Choice

Purposes of the coinsurance provision in medical expense insurance policies include which of the following?
I)to reduce premiums
II)to prevent overutilization of policy benefits

Choose correct answer/s
A
I only
B
II only
C
both I and II
D
neither I nor II
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Question 11
Multiple Choice

The effect of an annual out-of-pocket limit in an individual medical expense policy is to

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A
limit the lifetime benefits payable under the policy.
B
put a cap on annual benefits the insurer will pay.
C
prevent the insured from receiving duplicate benefits if medical expenses are also covered under workers compensation insurance.
D
cover 100 percent of eligible medical expenses after an insured has incurred a specified amount of annual out-of-pocket expenses.
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Question 12
Multiple Choice

All the following are common exclusions in a medical expense insurance policy EXCEPT

Choose correct answer/s
A
dental care.
B
surgeons' fees.
C
long-term care.
D
routine eye care.
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Question 13
Multiple Choice

Kristen has an individual medical expense policy with a $1,000 calendar-year deductible, a $5,000 annual out-of-pocket limit, and a 20 percent coinsurance requirement. Kristen was hospitalized for a surgical procedure in March, her first health care treatment received during the year. The total bill was $20,000. Considering the deductible and coinsurance, how much of this amount must Kristen pay?

Choose correct answer/s
A
$4,400
B
$4,800
C
$5,000
D
$5,100
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Question 14
Multiple Choice

Dirk required surgery for a kidney impairment. His total bill for medical services was $50,000. Dirk has a medical expense policy with a $1,000 calendar-year deductible and a $5,000 annual out-of-pocket limit. His coinsurance percentage is 20 percent. The out-of-pocket limit applies to coinsurance only. Assuming this surgery and hospitalization were the first medical care that Dirk received during the year and that all of the hospital services were eligible for coverage under the policy, how much of the $50,000 bill will the insurer pay?

Choose correct answer/s
A
$39,000
B
$39,200
C
$40,000
D
$44,000
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Question 15
Multiple Choice

Which of the following statements about long-term care insurance is (are) true?
I)Long-term care insurance is inexpensive, especially if purchased at older ages.
II)Purchasers have a choice of daily benefits and benefit periods.

Choose correct answer/s
A
I only
B
II only
C
both I and II
D
neither I nor II
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Question 16
Multiple Choice

Which of the following statements is (are) true concerning benefit payments under long-term care insurance?
I)Expense-incurred policies pay for actual charges up to a specified daily limit.
II)Per diem policies pay a specified daily benefit regardless of the charges incurred.

Choose correct answer/s
A
I only
B
II only
C
both I and II
D
neither I nor II
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Question 17
Multiple Choice

All of the following statements about long-term care insurance are true EXCEPT

Choose correct answer/s
A
Premiums can be reduced by electing shorter elimination periods.
B
A common benefits trigger is the inability to perform a certain number of activities of daily living.
C
Protection against inflation is usually made available as an optional benefit.
D
Policies currently sold are guaranteed renewable.
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Question 18
Multiple Choice

Which of the following statements about disability and disability income insurance is (are) true?
I)Most disability income policies replace 100 percent of gross earnings.
II)The probability of being disabled before age 65 is much higher than commonly believed.

Choose correct answer/s
A
I only
B
II only
C
both I and II
D
neither I nor II
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Question 19
Multiple Choice

Which of the following statements about individual disability income policies is true?

Choose correct answer/s
A
Benefits are typically paid only for disabilities resulting from sickness.
B
Benefits paid for partial disabilities are usually greater than benefits paid by the same policy for total disabilities.
C
Most policies pay a benefit equal to 100 percent of the disabled person's lost income.
D
Many policies provide or make available a residual disability benefit for persons who are able to work but at a reduced income.
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Question 20
Multiple Choice

All of the following statements about individual disability income policies are true EXCEPT

Choose correct answer/s
A
Premiums are often waived while a person is disabled but must be resumed if the insured recovers.
B
At the time of purchase, the insured can choose the length of the benefit period from among several available options.
C
In order to encourage rehabilitation, benefits may be continued during periods of vocational training.
D
Most disability income insurance policies contain an elimination period of 10 or fewer days.
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