QUESTIONS AND ANSWERS COMPLETE
HEALTH INSURANCE STUDY GUIDE LICENSE
EXAM PREP PRACTICE TEST
UPDATED QUESTIONS AND ANSWERS 100% VERIFIED EXAM PREP
, Actual Charge The amount a physician or supplier actually bills for a particular service or supply
Adhesion A contract offered on a "take-it-or-leave-it" basis by an insurer, in which the insured's only
option is to accept or reject the contract. Any ambiguities in the contract will be settled in
favor of the insured
Admitted (Authorized) Insurer An insurance company authorized and licensed to transact insurance in a particular state
Adult Day Care A program for impaired adults that attempts to meet their health, social, and functional
needs in a setting away from their homes
Adverse Selection The tendency of risks with higher probability of loss to purchase and maintain insurance
more often than the risks who present lower probability
Agent An individual who is licensed to sell, negotiate, or effect insurance contracts on behalf of
the insurer
Aleatory A contract in which participating parties exchange unequal amounts. Insurance contracts
are this in that the amount the insured will pay in premiums is unequal to the amount the
insurer will pay in the event of a loss
Alien Insurer An insurance company that is incorporated outside the USA
Apparent Authority The appearance or the assumption of authority based on the actions, words, or deeds of
the principal or because of circumstances the principal created
Approved Amount The amount Medicare determines to be reasonable for a service that is covered under
Part B of Medicare
Assignment A claim to a provider or medical supplier to receive payments directly from Medicare
Attained Age The age of the insured at a determined date
Attending Physician's Statement (APS) A statement usually obtained from the applicant's doctor
Avoidance A method of dealing with risk (e.g. if a person wanted to avoid the risk of being killed in
an airplane crash, he/she might choose never to fly in a plane)