Loma 280 Chapter 13 Exam 2025
Questions and Answers
activities of daily living (ADL) - ✔✔The activities of eating, bathing, dressing,
continence, toileting, or transferring into or out of a bed, chair, or wheelchair
basic medical expense coverage - ✔✔Medical expense insurance coverage provid-ing
separate benefits for each type of covered medical care cost. This typically provides
benefits for hospital, surgical, and physicians' expenses
benefit period - ✔✔The time during which the insurer agrees to pay income benefits to
the insured under a disability income or long-term care insurance policy
benefit trigger - ✔✔A long-term care insurance policy requirement specifying the
conditions that establish an insured's eligibility to receive long-term care benefits.
calendar-year deductible - ✔✔A deductible that applies to the total of all allowable
expenses an insured incurs during a given calendar year
cognitive impairment - ✔✔A reduction in a person's ability to think, reason, or
remember.
coinsurance - ✔✔An expense participation requirement imposed by many medical
expense plans; the requirement, generally, is a specified percentage of all allow-able
expenses that remain after the insured has paid the deductible and that must be paid by
the insured
comprehensive major medical policy - ✔✔A medical expense insurance policy that
combines the coverages provided by both a supplemental major medical policy and an
underlying basic medical expense policy
COPYRIGHT © 2025 BY OLIVIA WEST, ALL RIGHTS RESERVED 1
, copayment - ✔✔A specified, fixed amount paid by a managed care plan member to a
network provider when she receives services from the provider
cost-of-living adjustment (COLA) benefit - ✔✔A disability income insurance benefit
that provides for periodic increases in the disability income benefit amount that the
insurer will pay to a disabled insured; these increases usually correspond to increases in
the cost of living.
daily benefit amount - ✔✔Under a long-term care insurance policy, the maximum
amount the insurer will pay for each day of an insured's long-term care at a care facility
or in the patient's home
deductible - ✔✔A fiat dollar amount of eligible medical expenses that the insured must
pay before the insurer begins making any benefit payments under a medical expense
insurance policy
dental expense coverage - ✔✔Medical expense insurance coverage that provides ben-
efits for routine dental examinations, preventive dental work, and dental proce-dures
needed to treat tooth decay and diseases of the teeth and jaw.
disability buyout coverage - ✔✔Disability income insurance coverage that provides
benefits designed to fund the buyout of a partner's or owner's interest in a busi-ness
should he become disabled
disability income coverage - ✔✔Health insurance coverage that provides income
replacement benefits to an insured who is unable to work because of sickness or injury.
elimination period - ✔✔The specific amount of time that the insured must be disabled
before becoming eligible to receive disability income benefits or the specific amount of
time the insured must be receiving long-term care before becoming eligible to receive
long-term care benefits
first-dollar coverage - ✔✔Medical expense coverage under which the insurer begins to
reimburse the insured for eligible medical expenses without first requiring an out-of-
pocket contribution from the insured
future purchase option benefit - ✔✔A disability income benefit that grants the insured
the right to increase the benefit amount in accordance with increases in the insured's
earnings.
COPYRIGHT © 2025 BY OLIVIA WEST, ALL RIGHTS RESERVED 2
Questions and Answers
activities of daily living (ADL) - ✔✔The activities of eating, bathing, dressing,
continence, toileting, or transferring into or out of a bed, chair, or wheelchair
basic medical expense coverage - ✔✔Medical expense insurance coverage provid-ing
separate benefits for each type of covered medical care cost. This typically provides
benefits for hospital, surgical, and physicians' expenses
benefit period - ✔✔The time during which the insurer agrees to pay income benefits to
the insured under a disability income or long-term care insurance policy
benefit trigger - ✔✔A long-term care insurance policy requirement specifying the
conditions that establish an insured's eligibility to receive long-term care benefits.
calendar-year deductible - ✔✔A deductible that applies to the total of all allowable
expenses an insured incurs during a given calendar year
cognitive impairment - ✔✔A reduction in a person's ability to think, reason, or
remember.
coinsurance - ✔✔An expense participation requirement imposed by many medical
expense plans; the requirement, generally, is a specified percentage of all allow-able
expenses that remain after the insured has paid the deductible and that must be paid by
the insured
comprehensive major medical policy - ✔✔A medical expense insurance policy that
combines the coverages provided by both a supplemental major medical policy and an
underlying basic medical expense policy
COPYRIGHT © 2025 BY OLIVIA WEST, ALL RIGHTS RESERVED 1
, copayment - ✔✔A specified, fixed amount paid by a managed care plan member to a
network provider when she receives services from the provider
cost-of-living adjustment (COLA) benefit - ✔✔A disability income insurance benefit
that provides for periodic increases in the disability income benefit amount that the
insurer will pay to a disabled insured; these increases usually correspond to increases in
the cost of living.
daily benefit amount - ✔✔Under a long-term care insurance policy, the maximum
amount the insurer will pay for each day of an insured's long-term care at a care facility
or in the patient's home
deductible - ✔✔A fiat dollar amount of eligible medical expenses that the insured must
pay before the insurer begins making any benefit payments under a medical expense
insurance policy
dental expense coverage - ✔✔Medical expense insurance coverage that provides ben-
efits for routine dental examinations, preventive dental work, and dental proce-dures
needed to treat tooth decay and diseases of the teeth and jaw.
disability buyout coverage - ✔✔Disability income insurance coverage that provides
benefits designed to fund the buyout of a partner's or owner's interest in a busi-ness
should he become disabled
disability income coverage - ✔✔Health insurance coverage that provides income
replacement benefits to an insured who is unable to work because of sickness or injury.
elimination period - ✔✔The specific amount of time that the insured must be disabled
before becoming eligible to receive disability income benefits or the specific amount of
time the insured must be receiving long-term care before becoming eligible to receive
long-term care benefits
first-dollar coverage - ✔✔Medical expense coverage under which the insurer begins to
reimburse the insured for eligible medical expenses without first requiring an out-of-
pocket contribution from the insured
future purchase option benefit - ✔✔A disability income benefit that grants the insured
the right to increase the benefit amount in accordance with increases in the insured's
earnings.
COPYRIGHT © 2025 BY OLIVIA WEST, ALL RIGHTS RESERVED 2
