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Chapter 15

Self-Assessment Quiz

Self-Assessment Quiz

This activity contains 10 questions.

	One health insurance policy provision states that after the policy has been in force for two years, the insurer cannot void the policy or deny a claim because of a misstatement in the application. This provision is called the   grace period provision. renewal provision. preexisting conditions clause. time limit on certain defenses provision.

	All of the following are current health care problems in the United States EXCEPT   uneven quality of medical care. universal access to medical care. rising health care expenditures. waste and inefficiency in the medical system.

	Which of the following statements is (are) true with respect to disability income insurance? A standard definition of disability is used in all disability income insurance policies. The longer the elimination period in a disability income insurance policy, the higher the premium for the policy.   both I and II I only neither I nor II II only

	Curtis purchased a major medical policy. The policy has a calendar-year deductible of $500 and 80-20 coinsurance. Curtis was hospitalized with a covered illness on January 23rd. This hospitalization was his first claim under the major medical policy for the calendar year. His covered medical expenses were $20,500. How much of this amount will the insurer pay, and how much will Curtis be required to pay?   The insurer will pay $16,900 and Curtis will pay $3,600. The insurer will pay $20,000 and Curtis will pay $500. The insurer will pay $15,900 and Curtis will pay $4,600. The insurer will pay $16,000 and Curtis will pay $4,500.

	All of the following are typically covered under hospital-surgical insurance plans EXCEPT   disability income payments to the insured. surgical fees charged for an operation. cost of a hospital room and miscellaneous hospital expenses. physician’s in-hospital benefits.

	Paula, a 42 year-old surgeon, purchased disability income insurance. The policy defined disability as "the inability to perform the duties of your own occupation" for the first two years. After two years, disability is defined as "inability to perform the duties of any occupation for which you are reasonably suited by education, experience, and training." The policy would replace three-fourths of lost income after a six-month elimination period, with benefits payable until age 65. Recently, Paula was severely injured in an automobile accident in which her hands were crushed and had to be amputated. Which of the following statements is true regarding the benefits that Paula will receive under her disability income policy?   Benefits under the policy will begin immediately. The policy will replace one hundred percent of Paula’s lost income. Paula will receive disability benefits for life, no matter how long she lives. Paula will receive disability benefits for at least two years.

	Under one method of determining how much to reimburse a surgeon for a surgical procedure, surgeons are paid their normal fee as long as it is what is usually paid for the procedure in the same geographic region. This method reimburses surgeons according to   a relative value schedule. reasonable and customary charges. an hourly rate schedule. a surgical schedule.

	Long-term care insurance policies include a provision that determines whether the insured is eligible to receive benefits. One example of this provision requires the insured to be unable to perform a certain number of activities of daily living in order to qualify for benefits. What is this policy provision used in long-term care insurance policies called?   elimination period provision benefit period provision benefit trigger provision continuance provision

	Which of the following statements is (are) true with respect to shopping for health insurance? Dread disease policies are a wise purchase. Deductibles and elimination periods can be used to reduce premiums.   II only neither I nor II both I and II I only

	A provision is used in individual health insurance policies to control adverse selection. Under this provision, the insurer does not have to pay for claims resulting from impairments that were present prior to the effective date of the policy. This policy provision is called the   preexisting conditions clause. benefit period clause. elimination period provision. time limit on certain defenses provision.

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