TENNESSEE HEALTH LATEST
INSURANCE LICENSE
REVIEW EXAM
Which of the following statements concerning Medicare Part B is correct?
A) It is provided automatically to anyone who qualifies for Part A.
B) It pays on a first dollar basis.
C) It pays 100% of Medicare's standards for reasonable charges.
D) It pays for physician services, diagnostic tests, and physical therapy. -
ANSWERS-D) It pays for physician services, diagnostic tests, and physical
therapy. For those who have purchased the coverage, Part B pays 80% of out-
patient medical cost after a deductible has been met. Part B covers physician and
outpatient hospital services, and other medical and health services, such as
diagnostic tests, and physical therapy.
Which of the following statements is CORRECT concerning the relationship
between Medicare and HMOs?
A) HMOs do not pay for services covered by Medicare.
B) Medicare Advantage is Medicare provided by an approved HMO only.
C) All HMOs and PPOs charge premiums beyond what is paid by Medicare.
D) HMOs may pay for services not covered by Medicare. - ANSWERS-D) HMOs
may pay for services not covered by Medicare. The advantages of an HMO or PPO
for a Medicare recipient may be that there are no claims forms required, almost any
medical problem is covered for a set fee so health care costs can be budgeted, and
the HMO or PPO may pay for services not usually covered by Medicare or
END OF
PAGE
1
, TENNESSEE HEALTH LATEST
INSURANCE LICENSE
REVIEW EXAM
Medicare supplement policies, such as prescriptions, eye exams, hearing aids, or
dental care.
In an individual long-term care insurance plan, the insured is able to deduct the
premiums from taxes. What income taxation will be imposed on the benefits
received? - ANSWERS-No tax - Daily benefits from the LTC policy are received
income tax free, as long as they do not exceed the daily cost of long-term care.
In addition to participation requirements, how does an insurer guard against
adverse selection when underwriting group health? - ANSWERS-By requiring that
the insurance be incidental to the group - the group must be formed for some
reason OTHER than getting insurance
Which of the following is NOT a Medicaid qualifier?
A) Insurability
B) Income level
C) Age
D) Residency - ANSWERS-A) Insurability
An insured's cancelable health insurance policy is being cancelled. One day before
the policy is scheduled to end, he is involved in a major accident and is
END OF
PAGE
2
, TENNESSEE HEALTH LATEST
INSURANCE LICENSE
REVIEW EXAM
hospitalized for a week. Which of the following best describes the coverage that he
would receive?
A) No benefits at all
B) Full benefits as if the policy were still completely in effect
C) One day of full benefits
D) Minimal benefits for the duration of the hospital stay - ANSWERS-B) Full
benefits as if the policy were still completely in effect - If the insured is in the
midst of a claim at the time of cancellation, the insurance company must continue
to honor the claim.
A Limited Insurance Representative is an individual, other than an insurance
producer, who may solicit or negotiate contacts for certain types of insurance
which includes all of the following EXCEPT
A) Automobile physical damage insurance
B) Crop hail insurance
C) Portable electronics insurance
D) Mortgage guaranty insurance - ANSWERS-A) Automobile physical damage
insurance - A property insurance license is required to write automobile physical
damage coverage
END OF
PAGE
3
INSURANCE LICENSE
REVIEW EXAM
Which of the following statements concerning Medicare Part B is correct?
A) It is provided automatically to anyone who qualifies for Part A.
B) It pays on a first dollar basis.
C) It pays 100% of Medicare's standards for reasonable charges.
D) It pays for physician services, diagnostic tests, and physical therapy. -
ANSWERS-D) It pays for physician services, diagnostic tests, and physical
therapy. For those who have purchased the coverage, Part B pays 80% of out-
patient medical cost after a deductible has been met. Part B covers physician and
outpatient hospital services, and other medical and health services, such as
diagnostic tests, and physical therapy.
Which of the following statements is CORRECT concerning the relationship
between Medicare and HMOs?
A) HMOs do not pay for services covered by Medicare.
B) Medicare Advantage is Medicare provided by an approved HMO only.
C) All HMOs and PPOs charge premiums beyond what is paid by Medicare.
D) HMOs may pay for services not covered by Medicare. - ANSWERS-D) HMOs
may pay for services not covered by Medicare. The advantages of an HMO or PPO
for a Medicare recipient may be that there are no claims forms required, almost any
medical problem is covered for a set fee so health care costs can be budgeted, and
the HMO or PPO may pay for services not usually covered by Medicare or
END OF
PAGE
1
, TENNESSEE HEALTH LATEST
INSURANCE LICENSE
REVIEW EXAM
Medicare supplement policies, such as prescriptions, eye exams, hearing aids, or
dental care.
In an individual long-term care insurance plan, the insured is able to deduct the
premiums from taxes. What income taxation will be imposed on the benefits
received? - ANSWERS-No tax - Daily benefits from the LTC policy are received
income tax free, as long as they do not exceed the daily cost of long-term care.
In addition to participation requirements, how does an insurer guard against
adverse selection when underwriting group health? - ANSWERS-By requiring that
the insurance be incidental to the group - the group must be formed for some
reason OTHER than getting insurance
Which of the following is NOT a Medicaid qualifier?
A) Insurability
B) Income level
C) Age
D) Residency - ANSWERS-A) Insurability
An insured's cancelable health insurance policy is being cancelled. One day before
the policy is scheduled to end, he is involved in a major accident and is
END OF
PAGE
2
, TENNESSEE HEALTH LATEST
INSURANCE LICENSE
REVIEW EXAM
hospitalized for a week. Which of the following best describes the coverage that he
would receive?
A) No benefits at all
B) Full benefits as if the policy were still completely in effect
C) One day of full benefits
D) Minimal benefits for the duration of the hospital stay - ANSWERS-B) Full
benefits as if the policy were still completely in effect - If the insured is in the
midst of a claim at the time of cancellation, the insurance company must continue
to honor the claim.
A Limited Insurance Representative is an individual, other than an insurance
producer, who may solicit or negotiate contacts for certain types of insurance
which includes all of the following EXCEPT
A) Automobile physical damage insurance
B) Crop hail insurance
C) Portable electronics insurance
D) Mortgage guaranty insurance - ANSWERS-A) Automobile physical damage
insurance - A property insurance license is required to write automobile physical
damage coverage
END OF
PAGE
3
