FL Statutes, Rules, and regulations to HealthInsurance-Chapter 12-Quiz With Complete Solutions

FL Statutes, Rules, and regulations to HealthInsurance-Chapter 12-Quiz With Complete Solutions Question 1 of 15 Under a Florida Health insurance policy, medical coverage of a newborn begins AAt birth. B7 days after birth. C21 days after birth. D30 days after birth. - answerA. At birth. Correct! Coverage for a newborn begins at birth in the state of Florida. Question 2 of 15 Most HMOs operate through what type of system? AA group formed principally for the purpose of obtaining HMO coverage BA group enrollment system either at their place of employment or as a member of an association CIndividual fee-for-service system DIndividual subscribers - answerB. A group enrollment system either at their place of employment or as a member of an association Most HMOs operate almost exclusively through a group enrollment system, in which each member pays a fixed monthly premium, whether or not they have used the services of the HMO that month. Question 3 of 15 In a long-term care policy, pre-existing condition limitations AMust appear as a separate paragraph and be clearly labeled. BApply to 12 months from the effective date of coverage. CNever have specific exclusions. DAre not permitted. - answerA. Must appear as a separate paragraph and be clearly labeled. Correct! If there are any limitations in the policy with respect to pre-existing conditions these limitations must appear in a separate paragraph in the policy labeled "Pre-existing Condition Limitations." A long-term care policy cannot deny a claim for losses incurred more than 6 months from the effective date of coverage because of a pre-existing condition. Chapter: Florida Statutes, Rules, and Regulations Pertinent to Health Insurance Question 4 of 15 Coverage of a newborn includes all of the following EXCEPT ACongenital defects BCosts associated with prematurity. CTransportation costs of up to $3,000 if medically necessary. DBirth abnormalities. - answerC. transportation costs of up to $3,000 if medically necessary. Correct! Coverage includes injury or sickness, congenital defects, birth abnormalities, or prematurity, and transportation costs of up to $1,000 if certified as medically necessary. Question 5 of 15 A child is dependent upon her parents for support because of a physical disability. Coverage may be continued beyond the normal limiting age when the child ABecomes a full-time student. BIs incapable of self-sustaining employment. CCannot afford coverage on her own. DBecomes an inpatient at a hospital due to an emergency situation. Correct! Coverage beyond the normal limiting age may continue if a handicapped child is incapable of self-sustaining employment. - answerB Is incapable of self-sustaining employment. Correct! Coverage beyond the normal l