Exam Questions Ch11 Health, Disability, and Long-Term Care - Personal Finance 13e Answer Key + Test Bank by Jack Kapoor. DOCX document preview.

Exam Questions Ch11 Health, Disability, and Long-Term Care

Personal Finance, 13e (Kapoor)

Chapter 11 Health, Disability, and Long-Term Care Insurance

1) The United States has the lowest per capita medical expenditures of any industrialized country in the world.

Difficulty: 2 Medium

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

2) Affordable health care has become one of the most important social issues of our time.

Difficulty: 1 Easy

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

3) One reason for the high and rising costs of health care is the use of sophisticated and expensive technologies.

Difficulty: 1 Easy

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

4) One way to reduce your own medical costs is to stay well.

Difficulty: 1 Easy

Topic: Personal costs of health care

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

5) The prescription to stay healthy includes getting sufficient rest, relaxation, and exercise.

Difficulty: 1 Easy

Topic: Personal costs of health care

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

6) Health club membership is a form of protection to alleviate the financial burdens individuals suffer from illness or injury.

Difficulty: 2 Medium

Topic: Personal costs of health care

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

7) Group health insurance will cover you, but not your immediate family.

Difficulty: 2 Medium

Topic: Group health insurance

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

8) Individual health insurance covers either one person or a family.

Difficulty: 1 Easy

Topic: Health insurance policy provisions

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

9) Very few group health insurance policies have a coordination of benefits provision.

Difficulty: 2 Medium

Topic: Coordination of benefits

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

10) A good health insurance plan should offer basic coverage for hospital and doctor bills.

Difficulty: 1 Easy

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

11) A good health insurance plan should impose no unreasonable exclusions.

Difficulty: 1 Easy

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

12) More people have hospital insurance than any other kind of health insurance.

Difficulty: 1 Easy

Topic: Insurance

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

13) People often buy surgical expense insurance in combination with hospital expense insurance and physician expense insurance.

Difficulty: 1 Easy

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

14) Physician expense insurance coverage excludes visits to the doctor's office, x-rays, and lab tests.

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

15) Basic health insurance coverage includes hospital expense insurance, surgical expense insurance, and physician expense insurance.

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

16) A deductible provision requires the policyholder to pay a basic amount before the policy benefits begin.

Difficulty: 1 Easy

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

17) Hospital expense insurance pays part or the full amount of hospital bills for room, board, and other charges.

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

18) Surgical expense insurance pays part or the full amount of the surgeon's fees for an operation.

Difficulty: 1 Easy

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

19) Physician expense insurance helps pay for physician's care that does not involve surgery.

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

20) A recent study by Americans for Long-Term Care Security found that one out of five Americans over age 30 is at risk of needing some form of long-term care within the next 12 months.

Difficulty: 3 Hard

Topic: Long-term care insurance

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

21) A coinsurance provision requires the policyholder to share the expenses beyond the deductible amount.

Difficulty: 1 Easy

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

22) A stop-loss provision requires the policyholder to pay up to a certain amount, after which the insurance company pays 100 percent of all remaining covered expenses.

Difficulty: 2 Medium

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

23) A hospital indemnity policy pays benefits directly to the hospital only when you are hospitalized.

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

24) The hospital indemnity policy is a good substitute for basic or major medical protection.

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

25) Dread disease and cancer policies are usually very good values.

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

26) Long-term care insurance was virtually unknown 50 years ago, but it is now growing faster than any other form of insurance.

Difficulty: 1 Easy

Topic: Long-term care insurance

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

27) Blue Cross plans provide for surgical and medical services performed by physicians.

Difficulty: 2 Medium

Topic: Group health insurance

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

28) Blue Shield plans provide hospital care benefits on essentially a "service type" basis.

Difficulty: 2 Medium

Topic: Group health insurance

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

29) Preferred provider organizations combine the best elements of the fee-for-service and HMO systems.

Difficulty: 1 Easy

Topic: Preferred provider and other organizations

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

30) Part A of Medicare pays for all covered services for inpatient hospital care after you pay a single annual deductible.

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

31) Medigap insurance, intended to supplement Medicare, is sold and serviced by the federal government.

Difficulty: 1 Easy

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

32) Medicaid is administered by each state within certain broad federal requirements and guidelines.

Difficulty: 2 Medium

Topic: Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

33) Medicare does not cover the medical expenses of private-duty nursing care.

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

34) The two best-known sources of government health insurance are Medicare and Medicaid.

Difficulty: 2 Medium

Topic: Medicare and its supplements; Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

35) Medicare originally had two parts: hospital insurance and medical insurance.

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

36) Medicare hospital insurance is financed from a portion of the Social Security tax.

Difficulty: 1 Easy

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

37) To get Medicare medical insurance, you must sign up for it and pay a monthly premium.

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

38) Care in a skilled nursing facility beyond 100 days per benefit period is approved and covered by Medicare.

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

39) Medicare covers routine checkups, dental care, most immunizations, cosmetic surgery, routine foot care, eyeglasses, and hearing aids.

Difficulty: 3 Hard

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

40) Medicare covers the cost of care received outside the United States, Canada, and Mexico.

Difficulty: 1 Easy

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

41) Medicare was never intended to pay all medical costs.

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

42) Medicare supplement insurance is a government-sponsored program.

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

43) Title XIX of the Social Security Act provides for a program of medical assistance to certain low-income individuals and families, known as Medicaid.

Difficulty: 2 Medium

Topic: Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

44) Medicaid is financed by both state and federal funds.

Difficulty: 1 Easy

Topic: Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

45) Very few members of the Medicaid population are also covered by Medicare.

Difficulty: 2 Medium

Topic: Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

46) Medicaid differs from Medicare because eligibility for Medicaid depends on having very low income and assets.

Difficulty: 3 Hard

Topic: Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

47) Because Medicaid coverage is very limited, people using it need to purchase supplemental insurance.

Difficulty: 3 Hard

Topic: Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

48) Disability income insurance provides regular cash income lost by employees as the result of an accident or illness.

Difficulty: 2 Medium

Topic: Disability insurance coverages and provisions

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

49) Once a person is eligible, Medicaid provides more benefits than does Medicare.

Difficulty: 3 Hard

Topic: Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

50) Disability income insurance is probably the least neglected form of available insurance protection.

Difficulty: 2 Medium

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

51) Every year, 12% of the adult U.S. population suffers a long-term disability.

Difficulty: 3 Hard

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

52) Good disability plans pay when you are unable to work at your regular job; poor disability plans pay only when you are unable to work at any job.

Difficulty: 1 Easy

Topic: Disability income policy comparisons

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

53) Disability benefits begin on the first day you become disabled.

Difficulty: 2 Medium

Topic: Disability insurance coverages and provisions

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

54) Generally, disability income policies with shorter waiting periods have lower premiums.

Difficulty: 2 Medium

Topic: Disability insurance coverage considerations

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

55) You should seek a disability income policy that pays benefits for life.

Difficulty: 2 Medium

Topic: Disability insurance coverage considerations

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

56) You should look for a disability income policy that waives premium payments while you are disabled.

Difficulty: 2 Medium

Topic: Disability insurance coverage considerations

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

57) The premium for noncancelable and guaranteed renewable coverage for a disability income policy is higher, but the coverages are well worth the extra cost.

Difficulty: 2 Medium

Topic: Disability insurance coverage considerations

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

58) Many employers provide disability income protection for their employees through group insurance plans.

Difficulty: 1 Easy

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

59) Most salaried workers in the United States do not participate in the Social Security program.

Difficulty: 1 Easy

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

60) It is best for you to get routine care and recommended preventive services from a primary care provider rather than a hospital's emergency department.

Difficulty: 2 Medium

Topic: Health insurance claims and payments

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

61) Which country has the highest per capita medical expenditures of any industrialized country in the world?

A) Australia

B) Britain

C) Canada

D) Denmark

E) United States

Difficulty: 2 Medium

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

62) Which of the following groups has undertaken innovative activities to contain the costs of health care?

A) Employers

B) Labor unions

C) Health insurers

D) Consumers

E) All of these

Difficulty: 2 Medium

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

63) Which of the following is an innovative way concerned groups are containing health care costs?

A) Incentives to encourage preventive care

B) Encouragement of prepaid group practices

C) Establishment of community health education programs

D) Encouragement by doctors for patients to pay cash for routine medical care

E) All of these

Difficulty: 2 Medium

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

64) What are some possible reasons for high and rising costs of health care?

A) The use of sophisticated and expensive technologies

B) Rapid average earnings growth for health care professionals

C) Duplication of tests

D) The increasing number and longevity of elderly people

E) All of these

Difficulty: 1 Easy

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Analyze

Accessibility: Keyboard Navigation

Gradable: automatic

65) What is one of the best ways for you to avoid the high cost of illness?

A) Get sufficient rest.

B) Gain a little extra weight.

C) Smoke and drink.

D) Drive dangerously.

E) Avoid relaxation.

Difficulty: 1 Easy

Topic: Personal costs of health care

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Remember; Understand

Accessibility: Keyboard Navigation

Gradable: automatic

66) Most group health insurance plans in the United States are sponsored by:

A) victims of communicable diseases.

B) individuals with families.

C) single individuals with no dependents.

D) elderly individuals.

E) employers.

Difficulty: 2 Medium

Topic: Group health insurance

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

67) Which type of health insurance plan may not provide benefits for the major portion of your medical care bills?

A) Group health insurance

B) Life insurance

C) Medicare

D) Medicaid

E) Disability income insurance

Difficulty: 2 Medium

Topic: Group health insurance

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

68) Harry Morgan gets a bad case of the flu and ends up in the hospital for three days. Which part of his basic health insurance coverage should help pay for this stay?

A) Hospital expense

B) Surgical expense

C) Physician expense

D) Major medical expense

E) Medicare Part B

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Analyze

Accessibility: Keyboard Navigation

Gradable: automatic

69) Joe Johnson needs surgery for appendicitis. Which part of his basic health insurance coverage should help pay for the surgeon's fees?

A) Hospital expense

B) Surgical expense

C) Physician expense

D) Major medical expense

E) Medicare Part B

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Analyze

Accessibility: Keyboard Navigation

Gradable: automatic

70) Julie Cumbie was playing softball and got hurt sliding into second base. She gets an x-ray at her doctor's office to make sure her ankle isn't broken. Which part of her basic health insurance coverage should help pay for this x-ray?

A) Hospital expense

B) Surgical expense

C) Physician expense

D) Major medical expense

E) Medicare Part B

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Analyze

Accessibility: Keyboard Navigation

Gradable: automatic

71) Jamal Walker developed a serious infection and spent 6 months in his hospital's intensive care unit. What part of his health insurance policy would be the most useful for helping to pay for this?

A) Hospital expense

B) Surgical expense

C) Physician expense

D) Major medical expense

E) Medicare Part B

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Analyze

Accessibility: Keyboard Navigation

Gradable: automatic

72) Nathan Drummond has three different insurance policies. He has been injured in an accident and has incurred $30,000 in medical bills. There is a provision in all of his insurance contracts that ensures the total benefits he receives from all sources is limited to 100% of allowable medical expenses. What is this provision called?

A) Coordination of benefits

B) Deductible

C) Coinsurance

D) Stop-loss provision

E) Waiver of premium

Difficulty: 2 Medium

Topic: Coordination of benefits

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

73) Sophie Bennett must pay $500 for doctor's visits each year before her insurance company will make any payments for doctor's visits. What is this requirement called? 

A) Coordination of benefits

B) Deductible

C) Coinsurance

D) Stop-loss provision

E) Waiver of premium

Difficulty: 2 Medium

Topic: Insurance terminology

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

74) Sophie Bennett is required to pay 20 percent of her medical costs after the deductible has been paid. What is this requirement called?

A) Coordination of benefits

B) Deductible

C) Coinsurance

D) Stop-loss provision

E) Waiver of premium

Difficulty: 2 Medium

Topic: Insurance terminology

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

75) Sophie Bennett has personally paid a total of $6,000 in medical costs this year, which is the out-of-pocket limit listed in her insurance plan. At this point, there is a provision in her insurance contract that requires her insurance company to pay 100% of her medical costs for the remainder of the year. What provision is this likely to be?

A) Coordination of benefits

B) Hospital indemnity clause

C) Coinsurance

D) Stop-loss provision

E) Major medical expense provision

Difficulty: 2 Medium

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

76) Raymond Carter has a type of all-inclusive health insurance that has a very low deductible and pays for hospital, surgical, medical, and other bills under one plan. What type of insurance does he have?

A) Comprehensive major medical

B) Hospital indemnity

C) Long-term care

D) Cancer

E) Disability income

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

77) Chris Jones has an insurance policy that pays benefits to him in cash when he is hospitalized. What type of insurance would this be?

A) Comprehensive major medical

B) Hospital indemnity

C) Long-term care

D) Cancer

E) Disability income

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

78) Karen Bloomberg was seriously injured in a car accident and is paralyzed from the waist down. Luckily, she has an insurance policy that will pay for someone to come in and help with her daily activities such as bathing, dressing, and household chores. What type of insurance policy is this likely to be?

A) Comprehensive major medical

B) Hospital indemnity

C) Long-term care

D) Cancer

E) Disability income

Difficulty: 2 Medium

Topic: Long-term care insurance

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

79) Joan Wilder receives a phone call from a salesperson who tries to sell her an insurance policy by scaring her about her high risk of death from this disease. She knows that this type of insurance policy is notoriously a poor value, so she politely declines. What type of insurance policy did this salesperson likely try to sell her?

A) Comprehensive major medical

B) Hospital indemnity

C) Long-term care

D) Cancer

E) Disability income

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

80) Which provision in a health insurance policy states that you will pay a flat dollar amount each time you receive a covered medical service?

A) Daily benefit

B) Benefit period

C) Policy limit

D) Elimination period

E) Copayment

Difficulty: 1 Easy

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

81) Marcia Fuller has an insurance policy that she and her three daughters, ages 5, 9, and 11, are entitled to benefits under. Which provision in her insurance policy is defined by this list of covered members? 

A) Eligibility

B) Assigned benefits

C) Benefit limits

D) Guaranteed renewable

E) Exclusions and limitations

Difficulty: 2 Medium

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

82) Dean Thomas has an insurance policy that cannot be cancelled unless he fails to pay his premium when due. Which provision in his insurance policy would specify this?

A) Eligibility

B) Assigned benefits

C) Benefit limits

D) Guaranteed renewable

E) Exclusions and limitations

Difficulty: 2 Medium

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

83) Darren Chase has an insurance policy that will only pay for a maximum of 60 days of hospitalization during a year. Which provision in his insurance policy would specify this?

A) Eligibility

B) Assigned benefits

C) Benefit limits

D) Guaranteed renewable

E) Exclusions

Difficulty: 2 Medium

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

84) Benjamin Northcutt has an insurance policy that does not cover cosmetic surgery like the nose job he would like to have. Which provision in his insurance policy would specify this?

A) Eligibility

B) Assigned benefits

C) Benefit limits

D) Guaranteed renewable

E) Exclusions and limitations

Difficulty: 2 Medium

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

85) A good health insurance plan should:

A) impose unreasonable exclusions.

B) provide at least a $2 million lifetime maximum for each family member.

C) pay 100 percent for out-of-hospital expenses.

D) provide at least 120 days' hospital room and board in full.

E) limit your out-of-pocket expenses to no more than $1,000 per year.

Difficulty: 3 Hard

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

86) Which type of insurance is usually bought in combination with hospital expense and surgical expense insurance?

A) Disability income

B) Comprehensive major medical

C) Umbrella

D) Hospital indemnity

E) Physician's expense

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

87) Which type of health insurance includes two features (a deductible provision and a coinsurance provision) to help keep the premium within the policyholder's means?

A) Disability income

B) Major medical expense

C) Hospital indemnity

D) Physician's expense

E) Surgical expense

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

88) A good health insurance plan should:

A) pay at least 90 percent for out-of-hospital expenses after a yearly deductible.

B) provide at least 100 days' hospital room and board in full.

C) provide at least a $1 million lifetime maximum for each family member.

D) impose unreasonable exclusions.

E) limit out-of-pocket expenses to no more than $10,000 a year.

Difficulty: 2 Medium

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

89) Which one of the following provisions requires that the policyholder pay a basic amount before the policy benefits begin?

A) Coinsurance

B) Stop loss

C) Deductible

D) Self-insurance

E) Incontestable

Difficulty: 2 Medium

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

90) ________ is a type of major medical insurance that has a very low deductible amount and is offered without a separate basic plan.

A) Comprehensive major medical insurance

B) Major Medical expense insurance

C) Physician's expense insurance

D) Hospital expense insurance

E) Surgical expense insurance

Difficulty: 3 Hard

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

91) Which health insurance policy pays benefits only when you are hospitalized, but pays these benefits in cash which you can use for medical, nonmedical, or supplementary expenses?

A) Hospital indemnity

B) Interim or short-term

C) Disability income

D) Comprehensive major medical

E) Major medical expense

Difficulty: 3 Hard

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

92) Dental expense insurance provides reimbursement for:

A) oral examinations.

B) fillings.

C) extractions.

D) inlays.

E) All of these

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

93) According to your textbook, the average benefit paid under a hospital indemnity policy: 

A) is almost always excellent buys.

B) should be purchased at an early age.

C) does not justify the premium cost.

D) should be purchased only by older people.

E) is meant for couples with two or three children.

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

94) Which type of health insurance is notoriously a poor value?

A) Individual health

B) Group health

C) Dread disease

D) Dental

E) Vision

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

95) Which of the following statements is not true?

A) Physician expense insurance coverage normally excludes visits to the doctor's office, x-rays, and lab tests.

B) Basic health insurance coverage includes hospital expense insurance, surgical expense insurance, and physician expense insurance.

C) A deductible provision requires the policyholder to pay a basic amount before the policy benefits begin.

D) A good health insurance plan should impose no unreasonable exclusions.

E) A hospital indemnity policy is not a substitute for basic or major medical protection.

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

96) Which one of the following would be your best selection if you could only choose one of the following types of insurance?

A) A basic plan combined with a major medical expense plan

B) Combined dental and vision plan

C) Dread disease and cancer plan

D) Long-term care

E) Accident

Difficulty: 3 Hard

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

97) Which type of insurance protects your ability to earn income?

A) Life

B) Liability

C) Disability income

D) Car

E) Home and property

Difficulty: 2 Medium

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

98) Health insurance is not available from:

A) private insurance companies.

B) Blue Cross and Blue Shield.

C) HMOs.

D) PPOs.

E) home health care agencies.

Difficulty: 2 Medium

Topic: Group health insurance

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

99) Which one of the following is not a provider of health insurance?

A) Fraternal organizations

B) Trade unions

C) Government programs such as Medicare

D) Health Insurance Industry Association

E) Blue Cross and Blue Shield

Difficulty: 2 Medium

Topic: Group health insurance

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

100) Most private insurance companies sell health insurance policies to ________, who in turn offer them as fringe benefits. 

A) individuals

B) families

C) employers

D) employees

E) non-profit organizations

Difficulty: 3 Hard

Topic: Group health insurance

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

101) Which health insurance plan directly employs or contracts with selected physicians to provide managed health care services in exchange for a fixed, prepaid monthly premium?

A) Blue Cross

B) Blue Shield

C) Medicare

D) Medicaid

E) HMO

Difficulty: 2 Medium

Topic: Health maintenance organizations

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

102) Hospital insurance (Part A) and medical insurance (Part B) are characteristics of:

A) Blue Cross.

B) Blue Shield.

C) Medicare.

D) Medicaid.

E) HMO.

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

103) Which medical expense is covered by Medicare?

A) Acupuncture

B) Immunizations

C) Private-duty nursing

D) Routine checkups

E) Hospice care

Difficulty: 3 Hard

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

104) Medigap is sold or serviced by:

A) Medicare.

B) Medicaid.

C) private insurance companies.

D) the federal government.

E) State governments.

Difficulty: 3 Hard

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

105) Which one of the following is a correct statement about the administrative costs of the health care system in the U.S.?

A) Consumes 1% of healthcare dollars

B) Considered ethical to spend a high percentage on administrative costs

C) Americans pay less for health care than those living in Canada's socialized system

D) Includes enrolling beneficiaries and checking eligibility

E) Includes rebates to customers for good health checkups

Difficulty: 2 Medium

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

106) Which one of the following is a source of government health insurance?

A) Blue Cross

B) Blue Shield

C) Medicare

D) HMO

E) PPO

Difficulty: 1 Easy

Topic: Medicare and its supplements

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

107) Which one of the following is a source of government health insurance that is administered by each state?

A) Blue Cross

B) Blue Shield

C) National Institutes of Health

D) HMO

E) Medicaid

Difficulty: 1 Easy

Topic: Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

108) Hospital insurance is which part of Medicare?

A) Part A

B) Part B

C) Part C

D) Part D

E) Part E

Difficulty: 1 Easy

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

109) Medical insurance is which part of Medicare?

A) Part A

B) Part B

C) Part C

D) Part D

E) Part E

Difficulty: 1 Easy

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

110) The hospital insurance portion of Medicare helps pay for:

A) inpatient hospital care.

B) inpatient care in a skilled nursing facility.

C) home health care.

D) hospice care.

E) All of these

Difficulty: 3 Hard

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

111) Medicare medical insurance helps pay for:

A) inpatient hospital care.

B) doctors' services.

C) home health care.

D) hospice care.

E) inpatient care in a skilled nursing facility.

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

112) Medicare medical insurance is:

A) mandatory.

B) financed by corporations.

C) voluntary, and you must sign up for coverage.

D) state supported and partially funded by the National Institutes of Health.

E) paid for by state governments.

Difficulty: 3 Hard

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

113) Which of the following statements is not correct about Medicaid?

A) The Social Security Act created Medicaid in 1965.

B) Medicaid is a program of medical assistance to certain low-income individuals and families.

C) Medicaid is administered by each state within certain federal guidelines.

D) Medicaid is financed by both state and federal funds.

E) Medicaid is provided to wealthy individuals.

Difficulty: 3 Hard

Topic: Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

114) Because you feel young and healthy now, you may overlook the very real need for which type of insurance?

A) Disability income

B) Automobile

C) Dental

D) Vision care

E) Liability

Difficulty: 1 Easy

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

115) Disability:

A) is universally unacceptable.

B) has several definitions.

C) is determined by the American Council of Life Insurance.

D) has been formalized by the National Disability Council.

E) is provided by the Insurance Information Institute.

Difficulty: 2 Medium

Topic: Disability definitions

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

116) Good disability plans pay when you are:

A) unable to work at your regular job.

B) unable to work at any job.

C) unable to work at a related job.

D) ill even for a short period.

E) fired from your regular job.

Difficulty: 2 Medium

Topic: Disability income policy comparisons

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

117) With disability income insurance, benefits usually begin:

A) on the first day of disability.

B) between 30 and 90 days after the disability occurs.

C) on the 10th day of disability.

D) one year after the start of the disability.

E) on the 15th day of disability.

Difficulty: 2 Medium

Topic: Disability insurance coverages and provisions

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

118) The waiting period in disability income insurance is called the ________ period.

A) exclusion

B) no benefit

C) coverage

D) trade-off

E) elimination

Difficulty: 2 Medium

Topic: Disability definitions

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

119) Generally, disability income policies with longer waiting periods:

A) have higher premiums.

B) have lower premiums.

C) have about the same premium as those with shorter periods.

D) are issued by smaller insurance companies.

E) are issued by larger insurance companies.

Difficulty: 1 Easy

Topic: Disability insurance coverage considerations

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

A) your employer pays part or all of the cost.

B) you pay all the cost.

C) your union pays all the cost.

D) the Social Security Administration pays most of the premium.

E) the Veterans Administration foots the bill.

Difficulty: 2 Medium

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

121) Most insurers limit disability benefits from all sources of insurance to no more than ________ percent of your take-home pay.

A) 30-40

B) 40-50

C) 50-60

D) 60-70

E) 70-80

Difficulty: 2 Medium

Topic: Disability insurance coverages and provisions

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

122) John Gleason is permanently disabled while on the job. Which of the following is the most likely source of disability income for John?

A) His employer

B) Social Security

C) Worker's compensation

D) An individual insurance policy

E) His health insurance policy

Difficulty: 2 Medium

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

123) Which one of the following is true regarding group health insurance?

A) Provides coverage for you and your immediate family

B) Covers all of your health insurance needs

C) Comprises 100% of all health insurance issued by health and life insurance companies

D) Typically covers all of an individual's medical costs

E) Always requires proof of insurability

Difficulty: 3 Hard

Topic: Group health insurance

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

124) Which of the following is not a way that you can reduce your own medical costs?

A) Ask your physician and pharmacist if a less expensive generic drug is available.

B) Save time and do not review billing statements from medical providers.

C) Practice preventative care and stay well.

D) Consider participating in a flexible spending account if your employer offers it.

E) Ask your doctor if you can follow up by phone instead of visiting the office.

Difficulty: 2 Medium

Topic: Personal costs of health care

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

125) Which of the following is not a key provision of the Patient Protection and Affordable Care Act of 2010?

A) Offers tax credits for small businesses to make employee coverage more affordable

B) Eliminates copayments for preventive services

C) Encourages insurance companies to drop people from coverage when they get sick

D) Restricts the use of annual limits to ensure access to needed care in all plans

E) Increases funds for Community Health Centers

Difficulty: 2 Medium

Topic: Medical costs; Health care laws and regulations

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

126) Renee Carson's health insurance policy includes a $500 deductible and a coinsurance provision requiring her to pay 20 percent thereafter. Her medical bills total $7,000. What amount is she required to pay personally? 

A) $1,800

B) $500

C) $1,300

D) $5,000

E) $7,000

Explanation: $7,000 − $500 = $6,500; $6,500 × 20% =$1,300; $500 + $1,300 = $1,800

Difficulty: 3 Hard

Topic: Health insurance claims and payments

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Apply

Accessibility: Keyboard Navigation

Gradable: automatic

127) The Affordable Health Act of 2010 requires new health plans to allow young people to remain on their parents' insurance policy until what age?

A) 23

B) 24

C) 25

D) 26

E) 27

Difficulty: 1 Easy

Topic: Health care laws and regulations

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

128) Every year, what percent of the adult U.S. population suffers a long-term disability?

A) 12

B) 14

C) 18

D) 23

E) 25

Difficulty: 2 Medium

Topic: Disability definitions

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

129) As a national average, a year in a nursing home can cost over:

A) $32,000.

B) $49,000.

C) $63,000.

D) $97,000.

E) $100,000.

Difficulty: 2 Medium

Topic: Long-term care insurance

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

130) Physician expense insurance coverage excludes which of the following:

A) Visits to the doctor's office

B) X-rays

C) Surgery

D) Lab tests

E) General physician care

Difficulty: 3 Hard

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

131) Up to how many days of care in a skilled nursing facility are covered by Medicare?

A) 30

B) 60

C) 85

D) 100

E) 120

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

132) Medicare covers the cost of care in what countries besides the United States?

A) Japan

B) India

C) Germany

D) Mexico and Canada

E) Mexico, Canada, and Germany

Difficulty: 2 Medium

Topic: Medicare and its supplements

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

133) According to The Center for Medicare and Medicaid Services, health insurance includes both medical expense insurance and:

A) disability income insurance.

B) unemployment income insurance.

C) retirement income insurance.

D) life insurance.

E) dental insurance.

Difficulty: 2 Medium

Topic: Insurance terminology

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

134) Group health insurance plans comprise about ________ percent of all the health insurance issued by health and life insurance companies.

A) 60

B) 70

C) 80

D) 90

E) 100

Difficulty: 2 Medium

Topic: Insurance terminology

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

135) A sign that your group health coverage needs supplementing would be:

A) it covers a minor portion of your dental bills.

B) it covers a major portion of your hospital charges.

C) it covers a major portion of your doctor bills.

D) it covers over 50% of the going rate for surgical procedures.

E) it covers a minor portion of your hospital, doctor, and surgical charges.

Difficulty: 2 Medium

Topic: Group health insurance

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

136) Which of the following factors has not contributed to rising health costs?

A) An aging population

B) An overweight population

C) The cost of prescription drugs

D) The growing number of insured

E) Advancements in medical technology

Difficulty: 2 Medium

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

137) In the U.S., administrative costs consume nearly ________ percent of health care dollars.

A) 1

B) 5

C) 10

D) 11

E) 15

Difficulty: 2 Medium

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

138) If your employer pays the premium for long-term care, then the ________ treats it as a tax-deductible expense for the employer.

A) National Association of Insurance Commissioners

B) U.S. Administration on Aging

C) Medicare.gov

D) Longtermcare.gov

E) Health Insurance Portability and Accountability Act of 1996

Difficulty: 2 Medium

Topic: Long-term care insurance

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

139) Which of the following is not listed in your book as offering group health insurance plans?

A) Large government employers

B) Health and fitness clubs

C) Labor unions

D) Professional associations

E) Large private employers

Difficulty: 2 Medium

Topic: Group health insurance

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

140) Which type of health insurance covers diagnosing and treating glaucoma, eyeglasses, and eye surgery?

A) Surgical expense

B) Vision care

C) Physician's expense

D) Medicare Part B

E) Major medical

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

141) Which provision in a health insurance policy prevents you from collecting benefits from two or more group policies that would in total exceed the actual charges?

A) Coordination of benefits

B) Assigned benefits

C) Benefit limits

D) Guaranteed renewable

E) Exclusions and limitations

Difficulty: 2 Medium

Topic: Coordination of benefits

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.; 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

142) Which provision in a health insurance policy explains the circumstances under which the insurance company can end your health insurance policy?

A) Coordination of benefits

B) Assigned benefits

C) Cancellation and termination

D) Guaranteed renewable

E) Exclusions and limitations

Difficulty: 2 Medium

Topic: Coordination of benefits

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.; 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

143) If you are 35 years old now, your chances of experiencing a three-month or longer disability before you reach age 65 are _____percent, according to the National Association of Insurance Commissioners.

A) 25%

B) 30%

C) 40%

D) 50%

E) 75%

Difficulty: 3 Hard

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

144) To qualify for disability income under Social Security, you must be totally disabled for ________ months or more, and you must be unable to do any work.

A) 1

B) 3

C) 6

D) 9

E) 12

Difficulty: 2 Medium

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

145) Jose Gonzales is purchasing disability income insurance. He should aim for a benefit amount that, when added to other income, will equal ________ percent of his gross pay.

A) 40

B) 50 to 60

C) 60 to 70

D) 70 to 80

E) 90

Difficulty: 2 Medium

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

146) Which of the following is not a source of disability income?

A) Your employer

B) Social Security

C) Worker's compensation

D) Unemployment compensation

E) Group union disability benefits

Difficulty: 2 Medium

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

147) People are more likely to lose their incomes due to ________ than death.

A) retirement

B) unemployment

C) a layoff

D) disability

E) war

Difficulty: 2 Medium

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

148) According to the Government Accountability Office, fraud and abuse account for nearly ________ percent of all dollars spent on health care.

A) 10

B) 11

C) 15

D) 20

E) 25

Difficulty: 3 Hard

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

149) By 2026, annual health care spending is expected to grow to almost ________ percent of GDP.

A) 1

B) 10

C) 11

D) 15

E) 20

Difficulty: 3 Hard

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

150) Which of the following requires large employers to provide health insurance coverage to all employees?

A) The COBRA of 1986

B) The HIPAA of 1996

C) The Centers for Medicaid Services

D) The Centers for Medicare Services

E) The Tax Cuts and Jobs Act of 2017

Difficulty: 2 Medium

Topic: Health care laws and regulations

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

151) A recent industry survey estimated that ________ percent of employed Americans are enrolled in some form of managed care.

A) 85

B) 75

C) 50

D) 40

E) 25

Difficulty: 3 Hard

Topic: Types of medical insurance coverage

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

152) Which of the following plans is a hybrid that combines characteristics of both HMOs and PPOs?

A) Medicaid

B) PPO

C) POS

D) HMO

E) Medicare

Difficulty: 3 Hard

Topic: Types of medical insurance coverage

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

153) What should you do if your health insurer denies medical treatment or coverage?

A) Write a formal complaint letter.

B) Review your policy and explanation of benefits.

C) Contact your insurer and keep detailed records of your contacts.

D) Request documentation from your doctor to support your case.

E) All of these

Difficulty: 2 Medium

Topic: Policy holder rights and protections

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: automatic

154) In the case of divorce, federal law provides that coverage under a former spouse's medical plan can be continued for ________ months if the former spouse works for a company with 20 or more employees.

A) 12

B) 36

C) 48

D) 60

E) indefinitely

Difficulty: 2 Medium

Topic: Health care laws and regulations

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

155) Services that may be available in your community to help meet long-term care needs include:

A) visiting nurses

B) home health aides

C) home-delivered meals

D) adult day care centers

E) All of these

Difficulty: 3 Hard

Topic: Long-term care insurance

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

156) Which of the following is true regarding the difference between a reimbursement policy and an indemnity policy for health insurance provisions?

A) A reimbursement policy is based on the actual expenses you incur.

B) An indemnity policy is based on the actual expenses you incur.

C) A reimbursement policy is based on specified benefits regardless of actual expenses.

D) An indemnity policy is based on actual expenses regardless of specified benefits.

E) There is no difference between these two.

Difficulty: 3 Hard

Topic: Health insurance policy provisions

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

157) Home health care does not include:

A) home health agencies

B) doctor offices

C) home care aid organizations

D) hospices

E) facilities that care for the terminally ill

Difficulty: 2 Medium

Topic: Health care agencies and services

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: automatic

158) Besides preventive care, HMOs provide a comprehensive range of other health care services. What are they?

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: manual

159) The Wilson family has health insurance coverage that pays 50 percent of out-of-hospital expenses after a $1,200 deductible per person. Mrs. Wilson incurred doctor and prescription medication expenses of $3,850. What amount would the insurance company pay and what amount will the Wilson family pay?

Difficulty: 3 Hard

Topic: Health insurance claims and payments

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Apply

Accessibility: Keyboard Navigation

Gradable: manual

160) Jacob, an assembly line worker at a motorcycle manufacturing plant, has take-home pay of $1,200 a week. He is injured in an accident that kept him off work for 12 weeks. His disability insurance coverage replaces 60 percent of his earnings after a six-week waiting period. What total amount would he receive in disability benefits?

Difficulty: 2 Medium

Topic: Disability insurance coverages and provisions

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Apply

Accessibility: Keyboard Navigation

Gradable: manual

161) Why does health care cost so much?

The high and rising costs of health care are attributable to many factors, including:

∙ The use of sophisticated, expensive technologies.

∙ Duplication of tests and sometimes duplication of technologies that yield similar results.

∙ Increases in the variety and frequency of treatments, including allegedly unnecessary tests.

∙ The increasing number and longevity of elderly people.

∙ Regulations that result in cost shifting rather than cost reduction.

∙ The increasing number of accidents and crimes that require emergency medical services.

∙ Limited competition and restrictive work rules in the health care delivery system.

∙ Labor intensiveness and rapid average earnings growth for health care professionals and executives.

∙ Using more expensive medical care than necessary, such as going to an emergency room with a bad cold.

∙ Built-in inflation in the health care delivery system.

∙ Aging baby boomers' use of more health care services, whether they're going to the doctor more often or snapping up pricier drugs, from Celebrex to Viagra.

∙ Other major factors that cost billions of dollars each year, including fraud, administrative waste, malpractice insurance, excessive surgical procedures, a wide range of prices for similar services, and double health coverage.

According to the Government Accountability Office, fraud and abuse account for nearly 10 percent of all dollars spent on health care. 

Difficulty: 2 Medium

Topic: Medical costs

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: manual

162) What does health insurance include, and what is its importance in personal financial planning?

Difficulty: 2 Medium

Topic: Personal costs of health care

Learning Objective: 11-02 Define health insurance and disability income insurance and explain their importance in financial planning.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: manual

163) Name the five basic types of health insurance?

Difficulty: 2 Medium

Topic: Types of medical insurance coverage

Learning Objective: 11-03 Analyze the benefits and limitations of the various types of health care coverage.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: manual

164) Identify the sources of health care insurance.

Difficulty: 2 Medium

Topic: Group health insurance

Learning Objective: 11-04 Evaluate private sources of health insurance and health care.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: manual

165) What are the two best-known sources of government health care insurance?

Difficulty: 1 Easy

Topic: Medicare and its supplements; Medicaid

Learning Objective: 11-05 Appraise the sources of government health care programs.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: manual

166) What is disability income insurance? What are the major sources of disability income insurance?

Disability income insurance benefits provide regular cash income lost by employees as the result of an accident or illness. Sources of disability income insurance include your employer, Social Security, worker's compensation, the Veterans Administration pension disability benefits, civil service disability benefits for government workers, state vocational rehabilitation benefits, state welfare benefits for low-income people, Aid to Families with Dependent Children, group union disability benefits, automobile insurance that provides benefits for disability from an auto accident, and private insurance.

Difficulty: 3 Hard

Topic: Disability income and its sources

Learning Objective: 11-06 Recognize the need for disability income insurance.

Bloom's: Remember

Accessibility: Keyboard Navigation

Gradable: manual

167) What are some things that you can do to reduce your personal health care costs?

As health care costs continue to rise, there are a few steps that you can take to reduce your own medical costs.

∙ Consider participating in a flexible spending account if your employer offers it.

∙ Consider a high-deductible health plan that provides medical insurance coverage and a tax-free opportunity to save for future medical needs.

∙ Ask your physician and pharmacist if a less expensive generic drug is available.

∙ Consider using a mail-order or legitimate online pharmacy, especially if you will take a drug for a long period.

∙ Most states offer free or low-cost coverage for children under 19 who do not have health insurance. Visit www.insurekidsnow.gov or call 1-877-KIDS-NOW for more information.

∙ Many states offer State Pharmacy Assistance Programs that help pay for prescription drugs based on financial need, age, or medical condition.

∙ If your doctor wants you to return for a follow-up visit, ask if it is really necessary or can you follow up by phone.

∙ If your doctor suggests a nonurgent procedure, ask for information and some time to think about it. Research the suggested treatment on Web MD (www.webmd.com) and compare costs on Health Care Blue Book (www.healthcarebluebook.com) or New Choice Health (www.newchoicehealth.com).

∙ Review billing statements from medical providers for billing errors.

∙ Appeal unfair decisions by your health plan. (Read the accompanying How To feature box.)

∙ Practice preventive care and stay well.

Difficulty: 2 Medium

Topic: Personal costs of health care

Learning Objective: 11-01 Explain why the costs of health insurance and health care have been increasing.

Bloom's: Understand

Accessibility: Keyboard Navigation

Gradable: manual

Document Information

Document Type:
DOCX
Chapter Number:
11
Created Date:
Aug 21, 2025
Chapter Name:
Chapter 11 Health, Disability, and Long-Term Care Insurance
Author:
Jack Kapoor

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