Health Insurance MCQs

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The Albuquerque HMO’s contracting physicians are paid employees working on the staff of the HMO, operating in a clinic setting at the HMO’s phys...






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Star HMO contracts with 14 medical groups to increase accessibility to providers as a convenience for subscribers. Each of the medical groups is pai...






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The Provider’s Choice HMO was started by a group of individual physicians who each operate out of their own offices. The physicians are paid on a ...






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Gwyneth’s HMO requires that she receive health care services from a specified, limited number of health care providers chosen by the HMO. Gwyneth ...






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All of the following are examples of managed care plans except






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A method of payment in which a provider is paid a specific fee monthly for each subscriber is known as






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Calvin is hit by a car while traveling out of state. When the bill for his emergency services arrives, Calvin’s HMO will probably






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The Gargantuan Garage company funds its own claims, but it uses another company to make sure the plan is run correctly, acting as a liaison between ...






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Julia has a policy that will pay any expenses that she incurs due to inhospital medical treatment, as well as some of the expenses she incurs on an o...






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George has a policy that will provide him an income if he is disabled from illness or injury and recuperating at home. George probably has a






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When a health insurance policy becomes effective, unless it is canceled, it will stay in force






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Legally, the policy is considered delivered in all of the following situations except:






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An insurer might require personal delivery






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No loss-no gain legislation






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A statement that assures benefits provided under the old policy will continue under the new policy is






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Restrictions applying to the replacement of Medicare supplement policies






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Ally pays for her health insurance monthly. Her identical twin Georgia has the same policy, but pays annually. Which of them probably pays more for ...






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Health insurance coverage never applies until






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The grace period varies according to






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Mike allows his policy to lapse and then applies for reinstatement using the company’s required application. The company does not inform Mike eith...






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The maximum time during which suit can be filed is






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Which of the following is not a required provision under the Uniform Provisions Model Act?






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Which of the following is an optional provision under the Uniform Provisions Model Act?






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Cindy has a claim for $2,000, and a past due premium of $200. The insurer will






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If Lois cancels her health insurance policy, the insurer will






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Carmen gets her health insurance policy on May 1, and on May 3 she decides she doesn’t want it and returns it to the company. On May 6, she is hit...






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CeeCee’s policy is guaranteed renewable. Which of the following may the insurer not do?






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George has a noncancelable policy. Which of the following may the insurer do?






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The longer the benefit period






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Which definition of total disability is more favorable to the insured?






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Which of the following statements is not true about partial disability?






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Brandon injures his back working at a warehouse. Six months later, he is well enough to go back to work lifting boxes. Two weeks into working, however...






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Lee is helping a friend move his pool table when he strains his back, causing a disability. The insurer declines coverage, saying the injury was not...






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Most often, LTD policies provide benefits






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Which of the following statements is not true regarding the future increase option rider?






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Full disability benefits will generally be paid for the lifetime of the insured if total disability due to sickness begins at age






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Which of the following statements is true regarding social security disability benefits?






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The benefit that pays the regular total disability benefit during the elimination period when the insured is hospitalized is known as the






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Carmen falls and breaks her leg, incurring $2,000 in medical expenses. Her policy pays the entire amount. Carmen has a






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A combination of basic medical expense coverage and major medical expense coverage is






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Maternity benefits must be provided on the same basis as non maternity benefits






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Among individual policies that include coverage for mental infirmities, the benefit will generally be






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A hospice






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The dollar limit beyond which the insurer no longer participates in payment of expenses is the






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The expenses that must be incurred before major medical benefits begin to be paid is the






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A deductible that runs between the first dollar coverage of a basic policy and the comprehensive coverage of a supplemental policy is known as a






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Which of the following would be most likely to be covered under a medical expense policy?






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Comprehensive dental policies






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Which of the following is not likely to be considered nonroutine dental care?






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For nonroutine treatments, a comprehensive dental policy generally pays






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The main difference between a prepaid dental plan and a comprehensive dental plan is that






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Hospital indemnity insurance pays






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Vision care insurance is generally needed to cover all of the following except






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Prescription drug policies generally exclude






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Credit health insurance covers






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The amount of coverage available under a credit insurance policy is generally limited to






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The creditor must notify the debtor that he or she may be covered by the group insurance plan






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A type of policy covering doctor visits while the insured is in the hospital is






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Which of the following is not part of the qualification process for legal dependency?






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When both parents have employer-provided group coverage, the children are covered under






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Under the coordination of benefits rule, the primary company pays






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Carla enrolls in group insurance when she is eligible under her employer’s plan. Because of an administrative error, her enrollment form is never ...






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What is the federal law that requires employers with more than 20 employees to include in their group insurance plan a continuation of benefits prov...






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What is the federal law that extends the minimum continuation of coverage period from 18–29 months for qualified beneficiaries disabled at the time...






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Which of the following provisions is not a part of HIPAA?






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Which of the following is considered a disqualifying event under COBRA?






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Under OBRA, an employer may terminate COBRA coverage because of coverage under another health plan






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The Age Discrimination in Employment Act applies to employees who are






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Carla is 67 and eligible for social security and medicare. When she comes out of retirement to work at a large corporation which provides health ben...






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Medicare Part A covers all of the following except






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For each benefit period, medicare will pay the full cost of up to






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Medicare will pay the entire cost for skilled nursing facility care for the first






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Medicare Part A provides coverage for all of the following kinds of care except






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Medicare Part B provides coverage for all of the following kinds of care except






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Which of the following statements about medicare supplement plans is false?






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In order to be compensable as interpreted in workers compensation law, an injury must meet all of the following criteria except






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Medicare supplement policies are also known as






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Early long-term care policies were






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Which of the following individuals is most likely to be rated a substandard risk under an LTC policy?






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Which of the following is the type of care most people will require at some time during their later years?






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Virtually all of the current LTC policies are guaranteed renewable. This means that






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When waiver of premium applies






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Typically, the expenses incurred in a hospice will be






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The elimination period may be thought of as






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Which of the following is not considered an activity of daily living for the purposes of qualifying a person for LTC benefits?






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Nursing home care is generally covered by






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Which of the following individuals would be least likely to be a good candidate for an LTC policy?






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Medicare Part A hospital insurance is primarily funded by






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Social security taxes are paid by employees with






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Premiums for individually owned health policies may be deductible if the taxpayer’s medical expenses exceed






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The premiums paid by a company for group health for its employees are






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Benefits paid by individually owned accident, health, disability, or longterm care policies generally are






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Qualified group long-term care coverage






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Individual disability insurance premiums






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An individual who is considered chronically ill must be recertified as such






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Blue Cross and Blue Shield are






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In the administration of a group health insurance plan, if there is a clerical error concerning the information about an insured, that person’s cov...






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For employer-paid (noncontributory) group health insurance, the percentage of eligible group members that must be covered is






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One of the reasons why many group disability insurance policies are written on a nonoccupational basis is that






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A disability that prevents a person from performing one or more of the regular duties of that person’s job and that is a condition that will last ...