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The primary eligibility requirement for Medicaid Benefits is based upon?
A. Whether the claimant is insurable on the private market
B. Age
C. Number of Dependents
D. Need
Correct Answer: D. Need
Medicaid is provided to those in need.
If a mother delivers her baby through a C-section, the minimum hospital stay is
A. 24 hours
B. 48 hours
C. 96 hours
D. 120 hours
Correct Answer: C. 96 hours for C-section, 48 hours for vaginal.
How is Medicare primarily funded?
A. Federal Tax Money
B. Insureds
C. Nonprofit organizations
D. State Tax
Correct Answer: A. Federal Tax Money
A is supported by Social Security Payroll, Part B is supported by premiums from
Beneficiaries. Some funds come from general tax.
Can an individual who belongs to a POS plan use an out-of-network physician?
A. Yes, and they may use an preferred physician, even if not part of the HMO
,b. No
C. Yes, but they must use the POS physician first
D. Yes, but the must use the HMO physician first.
Correct Answer: A. Yes, the may use a preferred physician, even if not part of
the HMO.
Contracts that are prepared by one party and submitted to the other party on a
take-it-or leave it basis are classified as
A. Binding
B Contacts of Adhesion
C. Unilateral Contracts
D. Aleatory Contracts
Correct Answer: B. Contracts of Adhesion. Going to adhere to something that
the company says.
Which type of care re-establishes functional use to natural teeth?
A. Functionality
B. Repair
C. Restorative
D. Fillings
Correct Answer: C. Restorative . It restores the teeth.
All of the policies of credit life or credit health insurance must be delivered or
issues for delivery in Kentucky only by
A. unlicensed person
B. The Commissioner
C. A separate, third party insurance
D. An insurer authorized to do insurance business, and such policies must be
issued only through holders of licenses issued by the Commissioner.
Correct Answer: D. An insurer authorized to do insurance business, and such
policies must be issued only through holders of licenses issued by the
Commissioner.
Which of the following will vary the length of the grace period in health
insurance?
A. length of time insured
B. The term of policy
C. The mode of the premium payment
D. The length of any elimination period
,Correct Answer: C. The mode of the premium payment
7 days on a weekly premium, 10 days on a monthly, 31 days on anything more.
How soon following the occurrence of a covered loss must an insured submit
written proof of such loss to the insurance company?
A. as soon as possible
B. Within 20 days
C. Within 60 days
D. Within 90 days or as soon as reasonably possible, but not to exceed 1 year.
Correct Answer: D. Within 90 days or as soon as reasonably possible, but not to
exceed 1 year.
Under a health insurance policy, benefits, other than deaths benefits, that have
not otherwise been assigned, will be paid to
A. Beneficiary
B. The spouse
C. The Insured
D. The creditors.
Correct Answer: C. The Insured
------- policies pay for loss of income due to period of disability while ---------
policies cover medical and surgical expenses.
A. Key Person, Extended covered
B. Extended coverage, Key Person
C. Disability Income, Medical Expense
D. Disability Expense, Medical Expense
Correct Answer: C. Disability Income, Medical Expense
If an insured is covered on an expense-incurred basis under multiple insurers
whom are not informed about the other sources of coverage before loss then
Correct Answer: Each insurer should pay a proportionate share of the claim.
If a individual applying for life insurance says he went to the doctor for nausea
but failed to say he was also having chest pains, what is this
A. Concealment
B. Misrepresentation
C. Fraud
D. Warranty
Correct Answer: A. Concealment
He concealed his other symptoms.
, What is the purpose of Cobra?
A. Provide coverage for the dependents
B. Provide health coverage for low income
C. To protect insureds against insurers.
D. Continuation of coverage for terminated employees
Correct Answer: D. Continuation of coverage for terminated employees
Jason is insured under his employers group health insurance. He splits the cost
of the premiums with his employer. Example of
A. Noncontributory Plan
B. Half and Half
C. A co-pay plan
D. A contributory plan
Correct Answer: D. A contributory plan
Both parties contribute
Prior to Purchasing a Medigap policy, a person must be enrolled in
A. Medicare part A & B
B. All four parts of Medicare
C. Any private insurance policy
D. Only part A
Correct Answer: A. Medicare part A & B
Bridges the gap between.
Which is NOT true regarding Basic Surgical Expense coverage?
A. Contracts include a surgical schedule
B. It is commonly written in conjunction w Hospital expenses
C. Coverage is unlimited
D. There is no deductible
Correct Answer: C. Coverage is unlimited
Because of the history of cancer in her family, Julie purchased a policy that
specifically covers the expense of treating cancer. Her policy would be
classified as what type of policy?
a)Term Health Policy
b)Dread Disease Policy
c)Family History Cancer Policy
d)Specified Health Policy