Insurance Quiz 1

What type of policy would only provide coverage for specific types of illnesses (cancer, stroke, etc)?

• MEWA

• Blanket insurance

• Dread disease insurance

• Disability insurance

Select the appropriate response: Basic Medical Expense insurance:

• normally has a deductible and coinsurance

• covers an illness but not an accident

• pays for lost wages while hospitalized

• has lower benefit limits than Major Medical insurance

Which of the following statements BEST defines usual, customary, and reasonable (UCR) charges?

• The maximum premium an insurer can charge for their health insurance based on geography

• The maximum amount an employer can contribute to a contributory health plan

• The maximum deductible an insured can be charged

• The maximum amount considered eligible for reimbursement by an insurance company under a health plan

Select the appropriate response: This type of deductible provision states that should more than one family member be involved in a common accident, or suffer the same illness, only one individual deductible amount shall be applied.

• Individual deductible

• Corridor deductible

• Family maximum deductible

• Common accident deductible

Which of the following types of health coverage frequently uses a deductible?

• Major Medical policy

• Basic Surgical policy

• Basic Hospital policy

• Worker's Compensation

Which of the following statements BEST describes the intent of a Coinsurance clause in a Major Medical policy?

• Discourages overutilization of the insurance coverage

• Minimizes the need for deductibles

• Discourages adverse selection

• Minimizes the waiting period

A comprehensive major medical health insurance policy contains an Eligible Expenses provision which identifies the types of health care services that are covered. All of the following health care services are typically covered, EXCEPT for:

• hospital charges

• physician fees

• experimental and investigative services

• nursing services

An individual has a Major Medical policy with a $5,000 deductible and an 80/20 Coinsurance clause. How much will the INSURED have to pay if a total of $15,000 in covered medical expenses are incurred?

• $2,000

• $5,000

• $7,000

• $10,000

Which of the following BEST describes a Hospital Indemnity policy?

• Coverage that reimburses an insured for surgeon expenses

• Coverage that pays a stated amount per day of a covered hospitalization

• Coverage that replaces lost income due to hospitalization

• Coverage that pays for hospital room and board

Which of the following phrases refers to the fees charged by a healthcare professional?

• Deductible

• Coinsurance

• Usual, customary, and reasonable expenses

• Hospital expense