Medical Expense Insurance PASSED Exam
Questions and CORRECT Answers
In Major Medical Expense policies, what is the intent of a Stop Loss provision?
-Limits an insurer's premium increases
-Limits an insurer's liability
-Limits an insured's out-of-pocket medical expenses
-Limits an insured's coverage for pre-existing conditions - Correct Answer- limits an
insured's out-of-pocket medical expenses
Which of the following costs would a Basic Hospital/Surgical policy likely cover?
-Surgically removing a facial birthmark
-Care given at a nursing home
-Treating a wound from a soldier injured at war
-Lost income caused by a hospital stay - Correct Answer- surgically removing a facial
birthmark
Q is hospitalized for 3 days and receives a bill for $10,100. Q has a Major Medical policy
with a $100 deductible and 80/20 coinsurance. How much will Q be responsible for paying
on this claim?
$2,100
$2,020
$2,000
$100 - Correct Answer- $2,100
For which of the following expenses does a Basic Hospital policy pay?
Hospital room and board
Prescription medication
Surgical fees
Physician's fees - Correct Answer- hospital room and board
In order to establish a Health Reimbursement Arrangement (HRA), it MUST
, -be offered in conjunction with other employer provided health benefits
-limit the benefits to prescription drugs only
-be established by the employer
-limit the amount of money the employee can contribute toward the account - Correct
Answer- be established by the employer
Which of the following situations does a Critical Illness plan cover?
Asthma
Leukemia
Alcohol rehabilitation
Severe car accident - Correct Answer- leukemia
Basic Hospital and Surgical policy benefits are
lower than the actual expenses incurred
higher than the actual expenses incurred
normally subject to deductibles
normally subject to coinsurance - Correct Answer- lower than the actual expenses
Which of these options can an individual use their medical flexible spending account to pay
for?
Vitamins and supplements
Prescription drugs
Household expenditures
Cosmetic procedures - Correct Answer- prescription drugs
A prospective insured completes and signs an application for health insurance but
intentionally conceals information about a pre-existing heart condition. The company issues
the policy. Two months later, the insured suffers a heart attack and submits a claim. While
processing the claim, the company discovers the pre-existing condition. In this situation, the
company will
-continue coverage but request a corrected application
-deny coverage and increase premiums
Questions and CORRECT Answers
In Major Medical Expense policies, what is the intent of a Stop Loss provision?
-Limits an insurer's premium increases
-Limits an insurer's liability
-Limits an insured's out-of-pocket medical expenses
-Limits an insured's coverage for pre-existing conditions - Correct Answer- limits an
insured's out-of-pocket medical expenses
Which of the following costs would a Basic Hospital/Surgical policy likely cover?
-Surgically removing a facial birthmark
-Care given at a nursing home
-Treating a wound from a soldier injured at war
-Lost income caused by a hospital stay - Correct Answer- surgically removing a facial
birthmark
Q is hospitalized for 3 days and receives a bill for $10,100. Q has a Major Medical policy
with a $100 deductible and 80/20 coinsurance. How much will Q be responsible for paying
on this claim?
$2,100
$2,020
$2,000
$100 - Correct Answer- $2,100
For which of the following expenses does a Basic Hospital policy pay?
Hospital room and board
Prescription medication
Surgical fees
Physician's fees - Correct Answer- hospital room and board
In order to establish a Health Reimbursement Arrangement (HRA), it MUST
, -be offered in conjunction with other employer provided health benefits
-limit the benefits to prescription drugs only
-be established by the employer
-limit the amount of money the employee can contribute toward the account - Correct
Answer- be established by the employer
Which of the following situations does a Critical Illness plan cover?
Asthma
Leukemia
Alcohol rehabilitation
Severe car accident - Correct Answer- leukemia
Basic Hospital and Surgical policy benefits are
lower than the actual expenses incurred
higher than the actual expenses incurred
normally subject to deductibles
normally subject to coinsurance - Correct Answer- lower than the actual expenses
Which of these options can an individual use their medical flexible spending account to pay
for?
Vitamins and supplements
Prescription drugs
Household expenditures
Cosmetic procedures - Correct Answer- prescription drugs
A prospective insured completes and signs an application for health insurance but
intentionally conceals information about a pre-existing heart condition. The company issues
the policy. Two months later, the insured suffers a heart attack and submits a claim. While
processing the claim, the company discovers the pre-existing condition. In this situation, the
company will
-continue coverage but request a corrected application
-deny coverage and increase premiums
