NJ Health Insurance Practice Exam Questions with Verified Solutions

NJ Health Insurance Practice Exam Questions with Verified Solutions A service that charges a flat fee for medical care provided at its own clinic is called a: Select one: a. Risk Retention Group. b. Blue Cross/Blue Shield organization. c. Health Maintenance organization. d. Multiple Employer Trust (MET). c. Health Maintenance organization. HMOs provide the Health Care coverage, as well as the medical care itself (including prescription medication). HMO members are allowed to go to hospitals, physicians, or clinics that are part of the plan, or to outside providers on a referred basis, after seeing the HMO physician (the gatekeeper physician). Medicaid is primarily used to: Select one: a. Pay for medical expenses of the elderly. b. Pay medical aid to those injured as the result of tornadoes or other natural disasters. c. Pay for medical expenses of the needy. d. Provide supplemental medical expenses for those on Medicare. c. Pay for medical expenses of the needy. Medicaid is a joint state and Federal Government program that provides Health care for U.S. citizens and resident aliens with low income. Suicide and self-inflicted injuries are examples of policy: Select one: a. Exclusions. b. Supplemental coverages. c. Riders. d. Non-Forfeiture clauses. a. Exclusions. COBRA allows a departing employee to have which of the following conversion privileges from the Group Health coverage of the company he or she is leaving? Select one: a. Allows Life coverage conversion privileges, but no Health policy conversions b. Remain in the employer's group