FLORIDA HEALTH INSURANCE 2 – 40 PRACTICE EXAM 3
MEDICAL EXPENSES QUESTIONS AND ANSWERS 100%
CORRECT
Comprehensive Medical Expense Insurance combines which of the following
coverage in one policy:
A) Basic Hospital/Surgical and Major Medical
B) Disability Income and Accidental Death and Dismemberment
C) Disability Income and Basic Hospital/Surgical
D) Major Medical and Accidental Death and Dismemberment – CORRECT ANSWER: A)
Basic Hospital/Surgical and Major Medical
If the client goes out of the network for services on a PPO:
A) There is no coverage
B) The amount paid will be reduced
C) The PPO coverage is excess
D) Out of pocket expenses are negotiated - CORRECT ANSWER: B) The amount paid
will be reduced
Third party administrator (TPAs) do all of the following EXCEPT:
A) Marketing
B) Underwriting
C) Provide coverage
D) Claims processing - CORRECT ANSWER: C) Provide coverage
A (basic hospital) health insurance service plan:
A) Pays hospital only for specific services stated in the policy
B) Pays the hospital directly for claims incurred by low income persons
C) Pays the hospital or doctor directly as provided by the service plan
D) Pays the hospital or doctor directly as provided by the service plan - D) Pays the
hospital or doctor directly as provided by the service plan
All of the following are true about HMOs Except:
A) They offer a limited choice of doctors
B) Covered individuals are known as subscribers
C) Ambulatory services are covered on an out patient basis
D) Treatment must always be pre-authorized by a primary care physician - CORRECT
ANSWER: C) Ambulatory services are covered on an out patient basis
Major Medical Expense plans do not contain a:
A) Deductible
B) Co-insurance requirement
C) Schedule of benefits
MEDICAL EXPENSES QUESTIONS AND ANSWERS 100%
CORRECT
Comprehensive Medical Expense Insurance combines which of the following
coverage in one policy:
A) Basic Hospital/Surgical and Major Medical
B) Disability Income and Accidental Death and Dismemberment
C) Disability Income and Basic Hospital/Surgical
D) Major Medical and Accidental Death and Dismemberment – CORRECT ANSWER: A)
Basic Hospital/Surgical and Major Medical
If the client goes out of the network for services on a PPO:
A) There is no coverage
B) The amount paid will be reduced
C) The PPO coverage is excess
D) Out of pocket expenses are negotiated - CORRECT ANSWER: B) The amount paid
will be reduced
Third party administrator (TPAs) do all of the following EXCEPT:
A) Marketing
B) Underwriting
C) Provide coverage
D) Claims processing - CORRECT ANSWER: C) Provide coverage
A (basic hospital) health insurance service plan:
A) Pays hospital only for specific services stated in the policy
B) Pays the hospital directly for claims incurred by low income persons
C) Pays the hospital or doctor directly as provided by the service plan
D) Pays the hospital or doctor directly as provided by the service plan - D) Pays the
hospital or doctor directly as provided by the service plan
All of the following are true about HMOs Except:
A) They offer a limited choice of doctors
B) Covered individuals are known as subscribers
C) Ambulatory services are covered on an out patient basis
D) Treatment must always be pre-authorized by a primary care physician - CORRECT
ANSWER: C) Ambulatory services are covered on an out patient basis
Major Medical Expense plans do not contain a:
A) Deductible
B) Co-insurance requirement
C) Schedule of benefits
