FLORIDA 240 LICENSE EXAM NEWEST EXAM |
QUESTIONS AND CORRECT ANSWERS |
GRADED A+ | VERIFIED ANSWERS | LATEST
VERSION
Which of the following statements is true about most Blue Cross/Blue
Shield organizations? ---------CORRECT ANSWER-----------------They are
nonprofit organizations
Which of these is considered a true statement regarding Medicaid? ---------
CORRECT ANSWER-----------------Funded by both state and federal
governments
Which of the following types of organizations are prepaid group health
plans, where members pay in advance for the services of participating
physicians and hospitals that have agreements? ---------CORRECT
ANSWER-----------------HMO
Which of these statements is INCORRECT regarding a Preferred Provider
Organization (PPO)? ---------CORRECT ANSWER-----------------PPO's are
NOT a type of managed care systems
J is a subscriber to a plan which contracts with doctors and hospitals to
provide medical benefits at a preset price. What type of plan does J belong
to? ---------CORRECT ANSWER-----------------health maintenance
organization
,Which of the following organizations would make reimbursement payments
directly to the insured individual for covered medical expenses? ---------
CORRECT ANSWER-----------------Commercial insurer
The percentage of an individual's Primary Insurance Amount (PIA)
determines the benefits paid in which of the following programs? ---------
CORRECT ANSWER-----------------Social Security Disability Income
Which type of provider is known for stressing preventative medical care? ---
------CORRECT ANSWER-----------------Health Maintenance Organizations
(HMO's)
Which of the following statements BEST defines usual, customary, and
reasonable (UCR) charges? ---------CORRECT ANSWER-----------------The
maximum amount considered eligible for reimbursement by an insurance
company under a health plan
Which of the following phrases refers to the fees charged by a healthcare
professional? ---------CORRECT ANSWER-----------------Usual, customary,
and reasonable expenses
Comprehensive Major Medical policies usually combine: ---------CORRECT
ANSWER-----------------Major Medical with Basic Hospital/Surgical coverage
Which of these options can an individual use their medical flexible spending
account to pay for? ---------CORRECT ANSWER-----------------prescription
drugs
,Which of the following BEST describes a Hospital Indemnity policy? ---------
CORRECT ANSWER-----------------Coverage that pays a stated amount per
day of a covered hospitalization
Which of the following is NOT a limited benefit plan? ---------CORRECT
ANSWER-----------------Life insurance policies
An insured covered by a group Major Medical plan is hospitalized after
sustaining injuries that resulted from an automobile accident. Assuming the
plan had a $1,000 deductible and an 80/20 Coinsurance clause, how much
will the INSURED be responsible to pay with $11,000 in covered medical
expenses? ---------CORRECT ANSWER-----------------$3,000
Deductibles are used in health policies to lower: ---------CORRECT
ANSWER-----------------overuse of medical services
All of the following statements about Major Medical benefits are true,
EXCEPT: ---------CORRECT ANSWER-----------------Benefits have no
maximum limit
Major Medical policies typically: ---------CORRECT ANSWER-----------------
contain a deductible and coinsurance
In Major Medical Expense policies, what is the intent of a Stop Loss
provision? ---------CORRECT ANSWER-----------------Limits an insured's out-
of-pocket medical expenses
, What type of policy would only provide coverage for specific types of
illnesses (cancer, stroke, etc)? ---------CORRECT ANSWER-----------------
Dread disease insurance
A Disability Income policyowner suffers a disability which was due to the
same cause as a previous disability. Both disabilities occurred within a five-
month period. The insurer may cover the second disability without a new
elimination period under the: ---------CORRECT ANSWER-----------------
Recurrent Disability provision
When an insured has the same disability within a specified time period and
the insurance company provides the same benefits without a new waiting
period, the second disability is covered under which of the following
benefits? ---------CORRECT ANSWER-----------------Recurrent Disability
P received Disability income benefits for 3 months then returns to work.
She is able to work one month before her condition returns, leaving her
disabled once again. What would the insurance company most likely regard
this second period of disability as? ---------CORRECT ANSWER---------------
--Recurrent Disability
A disability elimination period is best described as a ---------CORRECT
ANSWER-----------------time deductible
Z owns a Disability Income policy with a 30-day Elimination period. Z
contracts pneumonia that leaves him unable to work from January 1 until
January 15. Z then becomes disabled from an accident on February 1 and
QUESTIONS AND CORRECT ANSWERS |
GRADED A+ | VERIFIED ANSWERS | LATEST
VERSION
Which of the following statements is true about most Blue Cross/Blue
Shield organizations? ---------CORRECT ANSWER-----------------They are
nonprofit organizations
Which of these is considered a true statement regarding Medicaid? ---------
CORRECT ANSWER-----------------Funded by both state and federal
governments
Which of the following types of organizations are prepaid group health
plans, where members pay in advance for the services of participating
physicians and hospitals that have agreements? ---------CORRECT
ANSWER-----------------HMO
Which of these statements is INCORRECT regarding a Preferred Provider
Organization (PPO)? ---------CORRECT ANSWER-----------------PPO's are
NOT a type of managed care systems
J is a subscriber to a plan which contracts with doctors and hospitals to
provide medical benefits at a preset price. What type of plan does J belong
to? ---------CORRECT ANSWER-----------------health maintenance
organization
,Which of the following organizations would make reimbursement payments
directly to the insured individual for covered medical expenses? ---------
CORRECT ANSWER-----------------Commercial insurer
The percentage of an individual's Primary Insurance Amount (PIA)
determines the benefits paid in which of the following programs? ---------
CORRECT ANSWER-----------------Social Security Disability Income
Which type of provider is known for stressing preventative medical care? ---
------CORRECT ANSWER-----------------Health Maintenance Organizations
(HMO's)
Which of the following statements BEST defines usual, customary, and
reasonable (UCR) charges? ---------CORRECT ANSWER-----------------The
maximum amount considered eligible for reimbursement by an insurance
company under a health plan
Which of the following phrases refers to the fees charged by a healthcare
professional? ---------CORRECT ANSWER-----------------Usual, customary,
and reasonable expenses
Comprehensive Major Medical policies usually combine: ---------CORRECT
ANSWER-----------------Major Medical with Basic Hospital/Surgical coverage
Which of these options can an individual use their medical flexible spending
account to pay for? ---------CORRECT ANSWER-----------------prescription
drugs
,Which of the following BEST describes a Hospital Indemnity policy? ---------
CORRECT ANSWER-----------------Coverage that pays a stated amount per
day of a covered hospitalization
Which of the following is NOT a limited benefit plan? ---------CORRECT
ANSWER-----------------Life insurance policies
An insured covered by a group Major Medical plan is hospitalized after
sustaining injuries that resulted from an automobile accident. Assuming the
plan had a $1,000 deductible and an 80/20 Coinsurance clause, how much
will the INSURED be responsible to pay with $11,000 in covered medical
expenses? ---------CORRECT ANSWER-----------------$3,000
Deductibles are used in health policies to lower: ---------CORRECT
ANSWER-----------------overuse of medical services
All of the following statements about Major Medical benefits are true,
EXCEPT: ---------CORRECT ANSWER-----------------Benefits have no
maximum limit
Major Medical policies typically: ---------CORRECT ANSWER-----------------
contain a deductible and coinsurance
In Major Medical Expense policies, what is the intent of a Stop Loss
provision? ---------CORRECT ANSWER-----------------Limits an insured's out-
of-pocket medical expenses
, What type of policy would only provide coverage for specific types of
illnesses (cancer, stroke, etc)? ---------CORRECT ANSWER-----------------
Dread disease insurance
A Disability Income policyowner suffers a disability which was due to the
same cause as a previous disability. Both disabilities occurred within a five-
month period. The insurer may cover the second disability without a new
elimination period under the: ---------CORRECT ANSWER-----------------
Recurrent Disability provision
When an insured has the same disability within a specified time period and
the insurance company provides the same benefits without a new waiting
period, the second disability is covered under which of the following
benefits? ---------CORRECT ANSWER-----------------Recurrent Disability
P received Disability income benefits for 3 months then returns to work.
She is able to work one month before her condition returns, leaving her
disabled once again. What would the insurance company most likely regard
this second period of disability as? ---------CORRECT ANSWER---------------
--Recurrent Disability
A disability elimination period is best described as a ---------CORRECT
ANSWER-----------------time deductible
Z owns a Disability Income policy with a 30-day Elimination period. Z
contracts pneumonia that leaves him unable to work from January 1 until
January 15. Z then becomes disabled from an accident on February 1 and
