CA Life and Health Exam Prep 1

In the medical insurance field, the term coinsurance means that an insured person

• Has coverage under two or more policies

• Has to pay a portion of covered expenses

• Is covered in full, after paying the deductible amount

• Has coverage under his or her own policy and under the spouse's policy

Answer explanation

The term coinsurance means the insured will have to pay a portion of the covered expenses. Usually the insured pays 20% and the company pays 80% within a given range.

The principle purpose of the Medicaid program is to assist in providing medical care to persons who are

• Not covered by Medicare

• Over the age of 65

• Unable to afford to the medical care they need

• Not covered by any individual insurance plan

Answer explanation

Medicaid is a joint federal-state program designed to provide health care to people who are unable to afford

Sally is not feeling well so her mother takes her to the doctor. The doctor tells her she has strep throat, gives her medication, and sends her home to recover. What type of insurance would be used?

• Automobile

• Life

• Homeowners

• Health

• Disability

The type of insurance that provides protection against financial loss from medical bills is called

• health insurance
• coinsurance
• life insurance
• premium

A fixed amount you pay for a covered health care service, usually when you get the service.

• Deductible

• Copay

• Premium

a federal health insurance program for persons 65 years of age and older is:

• private insurance

• group insurance

• medicare

• medicaid

If someone gets their health insurance through Medicaid, that means ...

• They are likely to pay all of their insurance premium and get a tax refund or credit when they file their taxes.

• They earn too much money to qualify for low-income subsidies.

• They are definitely a senior citizen since Medicaid is a government program specifically meant to help seniors.

• Their insurance premium is likely covered by the Federal and/or state government.

The amount you owe before your health insurance begins to reimburse a claim.

• deductible
• premium
• owed amount

Because an insurer writes the policy language and the insured has little or not control over the content, any ambiguity in the wording is usually resolved in favor of the insured. Because the design and wording of a policy are in the hands of the insurer, insurance policies are said to be

• Unilateral contracts

• Contracts of indemnity

• Aleatory contracts

• Contracts of adhesion

Answer explanation

Because the insurer drafts the language of the contract, the insured simply adheres to the terms

Suppose an insurance contract contains inconsistent or contradictory provisions. Various parts of the contract are printed, typewritten, and handwritten. In seeking to determine the original intent, a court is likely to rely on

• The handwritten material first, then the typewritten, and then the printed

• The typewritten material first, then the printed, and then the handwritten

• The printed material first, then the printed, and then the handwritten

• All parts of the contract, giving equal importance to each

Answer explanation

Any handwritten material will be considered first because it probably reflects last minute revisions of the terms. After that the typewritten material will be considered and then the printed material.