VERIFIED!!
"Which medical plan covers doctor visits while the insured is in the hospital and physical therapy
treatments following release from the hospital?
- limited medical policy
- basic hospital expense policy
- comprehensive major medical insurance
- supplementary major medical insurance - CORRECT ANSWER=> comprehensive major medical
insurance"
"Which is NOT a managed care provider?
- health maintenance organizations (HMOs)
- preferred provider organizations (PPOs)
- provider sponsored organizations (PSOs)
- medical expense plans (MEPs) - CORRECT ANSWER=> medical expense plans (MEPs)"
"Jamie is 37 years old, but her friends insist that she looks younger than her age. She applies for a health
insurance policy and on the application states that she is 27 years old. When the insurer discovers the
truth, what will it probably do?
- cancel the policy
- reduce the benefits
- increase the premium
- refer the matter to the state's Attorney General's office - CORRECT ANSWER=> reduce the benefits"
"The special needs plan (SNP) under Medicare Advantage is NOT available to those persons who:
- are institutionalized
- are eligible for Medicare and Medicaid
- are severely disabled
- are suffering from minor chronic medical conditions - CORRECT ANSWER=> are suffering from minor
chronic medical conditions"
"Which coverage does a person who is eligible for Medicare buy from a private insurer?
- Medicare Part A
- Medicare Part B
- Medicare Advantage
- Medicaid - CORRECT ANSWER=> Medicare Advantage"
,"For purposes of group health insurance, a small employer is defined in Florida as any person or entity
that employs no more than how many employees?
- 100
- 50
- 20
- 2 - CORRECT ANSWER=> 50"
"Which of the following optional health insurance policy provisions applies specifically to disability
income insurance policies?
- the relation of earnings to insurance provision
- the unpaid premium provision
- the cancellation provision
- the conformity with state statutes provision - CORRECT ANSWER=> the relation of earnings to
insurance provision"
"Gracie has a Medicare Advantage policy and needs emergency care while traveling. However, there are
no network providers nearby. What should she do?
- delay treatment until she locates a provider within the network
- see any suitable provider even if outside the network
- seek a provider in another network
- submit her expenses to her insurer for reimbursement - CORRECT ANSWER=> see any suitable
provider even if outside the network"
"Which is NOT considered an activity of daily living (ADL) for purposes of qualifying for long-term care
insurance benefits?
- eating
- dressing
- bathing
- driving - CORRECT ANSWER=> driving"
"HMOs operate within geographic areas that are called:
- provider networks
- service areas
- covered areas
- managed care areas - CORRECT ANSWER=> service areas"
"HIPAA guarantees the availability of health insurance coverage in the individual market for eligible
individuals who have had at least how many months of aggregate creditable coverage?
, -6
- 12
- 18
- 24 - CORRECT ANSWER=> 18"
"What kind of policy only covers cancer, stroke, heart attack, and Parkinson's disease?
- medical surgical expense policy
- catastrophic medical policy
-limited disability policy
- specified disease policy - CORRECT ANSWER=> specified disease policy"
"Eddie bought a Medicare supplement policy five years ago and now suffers from dementia. What can
the insurer do in light of Eddie's current health status?
- cancel the policy
- increase the premium
- decrease the amount of coverage
- keep the policy in force - CORRECT ANSWER=> keep the policy in force"
"In 2006, federal legislation expanded Medicare to provide prescription drug coverage through:
- Part C
- a revised Medigap program
- Part D
- Part A - CORRECT ANSWER=> Part D"
"Which statement about maternity coverage in group and individual health plans is correct?
- Individual and group plans must cover maternity care.
- Individual and group plans that cover maternity care must cover the services of midwives and birth
centers.
- Individual and group plans must provide up to $10,000 in benefits for maternity care.
- Individual and group plans that cover maternity care may limit the length of hospital stays. - CORRECT
ANSWER=> Individual and group plans that cover maternity care must cover the services of midwives
and birth centers."
"Which statement accurately describes the MIB (Medical Information Bureau)?
- It contains the complete medical history of insurance applicants.
- It collects medical information about insurance applicants and gives that information to member
insurance companies.
- It lists the type of policies denied to applicants due to medical conditions.