ExamFX Health Final Exam UPDATED
ACTUAL Questions and CORRECT
Answers
Basic Hospital Expense Coverage - CORRECT ANSWER - Surgeon's fees are NOT
covered under...
Hospital expense policies - CORRECT ANSWER - ... cover hospital room and board, and
miscellaneous hospital expenses, such as lab and x-ray charges, medicines, use of operating
room and supplies, while the insured is confined in a hospital.
The insured is not required to pay a deductible. - CORRECT ANSWER - Which of the
following best describes the "first-dollar coverage" principle in basic medical insurance?
First-dollar coverage - CORRECT ANSWER - Insurance plans that cover all basic
medical spending, with little or no patient payment.
Conversion factor - CORRECT ANSWER - In a relative value system of determining
coverage for a given procedure, what term describes the total amount payable per point?
Hospital, Surgical, Medical - CORRECT ANSWER - What are the three basic coverages
for medical expense insurance?
Medical expense insurance - CORRECT ANSWER - Basic medical policies and major
medical policies are commonly grouped into...
Basic Medical Expense Coverage - CORRECT ANSWER - Surgeon's services are NOT
covered under what?
15-day waiting period/ 10-year benefit period - CORRECT ANSWER - Which of the
following disability income policies would have the highest premium?
,A deductible - CORRECT ANSWER - A specified dollar amount that the insured must
pay first before the insurance company will pay the policy benefits.
The purpose of a deductible is to - CORRECT ANSWER - Absorb the smaller claims,
while the coverage provided under the policy will absorb the larger claims. The higher the rate is,
the lower the premium is.
26 - CORRECT ANSWER - The Patient Protection and Affordable Care Act mandates
that insurers provide coverage for adult children of the insured up to the age of...
The Patient Protection and Affordable Care Act - CORRECT ANSWER - This law
extends coverage for children of the insured to age 26, regardless of their marital status,
residency, financial dependence on their parents, or eligibility to enroll in their employer's plan.
The insured may carry over the amount of this year's expenses to next year, which will help
satisfy next year's deductible. - CORRECT ANSWER - Insured Z's health insurance policy
year begins in January. His policy contains a carry-over provision. In November, he has a small
claim which is less than his deductible. Which of the following is true?
Carry over provision - CORRECT ANSWER - Under this, if the insured did not incur
sufficient medical costs during the year to meet the deductible, any medical expenses incurred
during the last three months may be carried forward to the next year, offsetting the total
deductible costs for that year.
Stop-loss - CORRECT ANSWER - In major medical insurance policies, when the
insured's share of coinsurance reaches a certain amount, the insured is no longer obligated to pay
it. This feature is known as...
Provides coverage at 100% of eligible expenses for the remainder of the year. - CORRECT
ANSWER - The stop-loss amount is the maximum amount that the insured pays out of
pocket during the year. When the insured's out-of-pocket expenses reach the stop-loss, the
insurance company...
, $0 - CORRECT ANSWER - What is the typical deductible for basic surgical expense
insurance?
There is no deductible, but coverage is limited. - CORRECT ANSWER - As with other
types of basic medical expensive coverage...
Payment is limited to a certain period of time. - CORRECT ANSWER - Which of the
following applies to partial disability benefits?
limited to a certain period of time - CORRECT ANSWER - The partial disability benefit is
typically 50% of the total disability benefit, and is...
First-dollar basis - CORRECT ANSWER - Another term used to describe "no deductible"
is...
Coinsurance - CORRECT ANSWER - The provision that provides for the sharing of
expenses between the insured and the insurance company is...
The lower the required premium will be. - CORRECT ANSWER - The larger the
percentage that is paid by the insured...
Key Person Disability Income Insurance - CORRECT ANSWER - Premiums are not tax
deductible as a business expense in
Key Person Disability - CORRECT ANSWER - In this type of disability insurance, the
contract is owned by the business, the premium is paid by the business, and the business is the
beneficiary.
ACTUAL Questions and CORRECT
Answers
Basic Hospital Expense Coverage - CORRECT ANSWER - Surgeon's fees are NOT
covered under...
Hospital expense policies - CORRECT ANSWER - ... cover hospital room and board, and
miscellaneous hospital expenses, such as lab and x-ray charges, medicines, use of operating
room and supplies, while the insured is confined in a hospital.
The insured is not required to pay a deductible. - CORRECT ANSWER - Which of the
following best describes the "first-dollar coverage" principle in basic medical insurance?
First-dollar coverage - CORRECT ANSWER - Insurance plans that cover all basic
medical spending, with little or no patient payment.
Conversion factor - CORRECT ANSWER - In a relative value system of determining
coverage for a given procedure, what term describes the total amount payable per point?
Hospital, Surgical, Medical - CORRECT ANSWER - What are the three basic coverages
for medical expense insurance?
Medical expense insurance - CORRECT ANSWER - Basic medical policies and major
medical policies are commonly grouped into...
Basic Medical Expense Coverage - CORRECT ANSWER - Surgeon's services are NOT
covered under what?
15-day waiting period/ 10-year benefit period - CORRECT ANSWER - Which of the
following disability income policies would have the highest premium?
,A deductible - CORRECT ANSWER - A specified dollar amount that the insured must
pay first before the insurance company will pay the policy benefits.
The purpose of a deductible is to - CORRECT ANSWER - Absorb the smaller claims,
while the coverage provided under the policy will absorb the larger claims. The higher the rate is,
the lower the premium is.
26 - CORRECT ANSWER - The Patient Protection and Affordable Care Act mandates
that insurers provide coverage for adult children of the insured up to the age of...
The Patient Protection and Affordable Care Act - CORRECT ANSWER - This law
extends coverage for children of the insured to age 26, regardless of their marital status,
residency, financial dependence on their parents, or eligibility to enroll in their employer's plan.
The insured may carry over the amount of this year's expenses to next year, which will help
satisfy next year's deductible. - CORRECT ANSWER - Insured Z's health insurance policy
year begins in January. His policy contains a carry-over provision. In November, he has a small
claim which is less than his deductible. Which of the following is true?
Carry over provision - CORRECT ANSWER - Under this, if the insured did not incur
sufficient medical costs during the year to meet the deductible, any medical expenses incurred
during the last three months may be carried forward to the next year, offsetting the total
deductible costs for that year.
Stop-loss - CORRECT ANSWER - In major medical insurance policies, when the
insured's share of coinsurance reaches a certain amount, the insured is no longer obligated to pay
it. This feature is known as...
Provides coverage at 100% of eligible expenses for the remainder of the year. - CORRECT
ANSWER - The stop-loss amount is the maximum amount that the insured pays out of
pocket during the year. When the insured's out-of-pocket expenses reach the stop-loss, the
insurance company...
, $0 - CORRECT ANSWER - What is the typical deductible for basic surgical expense
insurance?
There is no deductible, but coverage is limited. - CORRECT ANSWER - As with other
types of basic medical expensive coverage...
Payment is limited to a certain period of time. - CORRECT ANSWER - Which of the
following applies to partial disability benefits?
limited to a certain period of time - CORRECT ANSWER - The partial disability benefit is
typically 50% of the total disability benefit, and is...
First-dollar basis - CORRECT ANSWER - Another term used to describe "no deductible"
is...
Coinsurance - CORRECT ANSWER - The provision that provides for the sharing of
expenses between the insured and the insurance company is...
The lower the required premium will be. - CORRECT ANSWER - The larger the
percentage that is paid by the insured...
Key Person Disability Income Insurance - CORRECT ANSWER - Premiums are not tax
deductible as a business expense in
Key Person Disability - CORRECT ANSWER - In this type of disability insurance, the
contract is owned by the business, the premium is paid by the business, and the business is the
beneficiary.
