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ExamFX Health Final Exam with correct answers.
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ExamFX Health Final Exam with correctanswers
Surgeon's fees are NOT covered under... - correct answer-Basic Hospital Expense Coverage
... cover hospital room and board, and miscellaneous hospital expenses, such as lab and x-ray charges,
medicines, use of operating room and supplies, while the insured is confined in a hospital. - correct
answer-Hospital expense policies
Which of the following best describes the "first-dollar coverage" principle in basic medical insurance? -
correct answer-The insured is not required to pay a deductible.
Insurance plans that cover all basic medical spending, with little or no patient payment. - correct
answer-First-dollar coverage
In a relative value system of determining coverage for a given procedure, what term describes the total
amount payable per point? - correct answer-Conversion factor
What are the three basic coverages for medical expense insurance? - correct answer-Hospital, Surgical,
Medical
Basic medical policies and major medical policies are commonly grouped into... - correct answer-Medical
expense insurance
Surgeon's services are NOT covered under what? - correct answer-Basic Medical Expense Coverage
Which of the following disability income policies would have the highest premium? - correct answer-15-
day waiting period/ 10-year benefit period
A specified dollar amount that the insured must pay first before the insurance company will pay the
policy benefits. - correct answer-A deductible
,Absorb the smaller claims, while the coverage provided under the policy will absorb the larger claims.
The higher the rate is, the lower the premium is. - correct answer-The purpose of a deductible is to
The Patient Protection and Affordable Care Act mandates that insurers provide coverage for adult
children of the insured up to the age of... - correct answer-26
This law extends coverage for children of the insured to age 26, regardless of their marital status,
residency, financial dependence on their parents, or eligibility to enroll in their employer's plan. - correct
answer-The Patient Protection and Affordable Care Act
Insured Z's health insurance policy year begins in January. His policy contains a carry-over provision. In
November, he has a small claim which is less than his deductible. Which of the following is true? -
correct answer-The insured may carry over the amount of this year's expenses to next year, which will
help satisfy next year's deductible.
Under this, if the insured did not incur sufficient medical costs during the year to meet the deductible,
any medical expenses incurred during the last three months may be carried forward to the next year,
offsetting the total deductible costs for that year. - correct answer-Carry over provision
In major medical insurance policies, when the insured's share of coinsurance reaches a certain amount,
the insured is no longer obligated to pay it. This feature is known as... - correct answer-Stop-loss
The stop-loss amount is the maximum amount that the insured pays out of pocket during the year.
When the insured's out-of-pocket expenses reach the stop-loss, the insurance company... - correct
answer-Provides coverage at 100% of eligible expenses for the remainder of the year.
What is the typical deductible for basic surgical expense insurance? - correct answer-$0
As with other types of basic medical expensive coverage... - correct answer-There is no deductible, but
coverage is limited.
Which of the following applies to partial disability benefits? - correct answer-Payment is limited to a
certain period of time.
, The partial disability benefit is typically 50% of the total disability benefit, and is... - correct answer-
limited to a certain period of time
Another term used to describe "no deductible" is... - correct answer-First-dollar basis
The provision that provides for the sharing of expenses between the insured and the insurance company
is... - correct answer-Coinsurance
The larger the percentage that is paid by the insured... - correct answer-The lower the required premium
will be.
Premiums are not tax deductible as a business expense in - correct answer-Key Person Disability Income
Insurance
In this type of disability insurance, the contract is owned by the business, the premium is paid by the
business, and the business is the beneficiary. - correct answer-Key Person Disability
What is the initial period of time specified in a disability income policy that must pass, after the policy is
in force, before a loss can be covered? - correct answer-Probationary period
Which of the following provides coverage on a first-dollar basis? - correct answer-Basic expense
Will provide coverage on a first-dollar basis meaning no deductible. After the limits of the basic policy
are exhausted, the insured must pay a corridor deductible before the major coverage will pay benefits. -
correct answer-A basic expense policy
In disability income insurance, the time between the onset of an injury or sickness and when benefits
begin is known as the... - correct answer-Elimination period
Insurance sold to small business owners for the purpose of reimbursing the policyholder for business
overhead expenses during a period of total disability. - correct answer-Business Overhead Expense (BOE)
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