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Health Insurance Questions With Complete Solutions

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Health Insurance Questions With Complete Solutions

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  • January 10, 2024
  • 4
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
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LeCrae
Health Insurance Questions With Complete Solutions

A 70-year old insured individual has suffered from kidney failure for the
past 24 months. She is covered by her spouse's large-group employer plan.
How will Medicare be utilized in this situation? Correct Ans - "Will
be the secondary insurer and pay for claims not fully covered by the group
plan".

An HMO that involves a partnership of physicians and other providers who
practice out of a central facility is called a(n) Correct Ans - Group
HMO

Under group health insurance, a certificate of coverage is issued to the
Correct Ans - Employee

The Commissioner is responsible for all of the following EXCEPT
Correct Ans - Recommending insurers

In which of the following situations would the insurer be liable for a loss?
Correct Ans - Because the insured did not commit or participate in the
felony, the loss will be covered.

Which of the following provides Medicare supplement policies?
Correct Ans - Private insurance companies

Maria is a Preferred Provider Organization (PPO) subscriber and received
care from an out-of-network provider. Which of the following is the likely
result? Correct Ans - Care is covered

No Long-Term Care policy may exclude pre-existing conditions for a period
of more than Correct Ans - 6 months

The election of COBRA for continuation of health coverage will Correct
Ans - Maintain the same coverage and increase premium

In accident and health plans, premiums paid less frequent than monthly
require a minimum grace period of at least Correct Ans - 31 days
The grace period for health policies is no less than 7 days for weekly

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