Health 5 Flashcards
According to the Affordable Care Act, what are the cost-sharing requirements for preventive care?
No cost sharing
Why: The Act requires that 100% of preventive care be covered without cost sharing. Preventive care includes routine checkups, screenings and counseling to prevent health problems.
Under a fully contributory health plan, how are benefits received by the employee?
Income Tax free
Why: In a fully contributory plan, because the employee pays the entire cost, the income benefits are received income tax by the employee.
What type of disabilities will be covered by occupational coverage?
Disabilities that result from accidents or sickness that occur on or off the job
Why: Occupational coverage provides benefits for disabilities resulting from accidents or sicknesses that occur on or off the job.
According to the coordination of benefits provision, if both parents have coverage for a child from their employers policies, which policy will pay first?
The order of payment will be determined by birthday rule.
Why: If both parents name their children as dependents under their group policies, the coverage of the parent whose birthday is the earliest in the year will be considered primary.
What type of insurance covers an employee who is hurt on the job?
Workers Compensation
Why: Workers compensation benefits are payable when a worker is injured by a work-related accident, regardless of fault or negligence.
How are individually owned disability income benefits taxed once received by the insured?
Disability benefits are not taxed; they are received income tax free
Why: Disability income benefits, including those for medical expense and long-term care policies, are received income tax free by the individual.
What benefits are provided by Medicare Part C?
Expanded benefits for a free through private insurance programs such as HMOs or PPOs
Why: Medicare Advantage (Part C) allows people to receive all of their health care services through available provider organizations. To be eligible for Part C, an individual must be enrolled in Parts A and B.
How many consecutive months of coverage must long-term care insurance provide?
12 Months
Why: Long-term care policies must provide coverage for at least 12 consecutive months in a setting other than care unit of a hospital.
What part of Medicare is known as medical insurance?
Part B
Why: Medicare Part B, Medical Insurance, covers doctor’s expenses and a variety of other medical services and supplies that are not covered by hospital insurance.
Who qualifies for Medicare coverage?
People age 65 or older, or anyone who has been entitled to Social Security disability income benefits for 2 years, or who has chronic kidney disease
Why: Medicare is for people age 65 and older for anyone, regardless of age, who has been entitled to social security disability benefits for 2 years or has end-stage renal disease (ESRD).
Who qualifies for medicaid?
People with insufficient income
Why: Medicaid is a federal and state funded program for those whose income and resources are insufficient to meet the cost of necessary medical care.
How are benefits of a group Accidental Death and Dismemberment (AD&D) policy received?
Income Tax Free
Why: The benefits of a group AD&D policy are received income tax free.
How are excess funds in an employee’s health savings account (HSA) handled?
The funds can be carried forward to the next year
Why: Excess funds in an employee’s HSA are carried over to the following year. HSAs feature tax-deferred growth and enable the insured to pay for medical expenses with pre-tax income.
How are benefits received by the business from key person disability insurance?
Income Tax Free
Why: Key person disability income benefits are received income tax free by the business.
In group medical and dental expense insurance, what percentage of premium paid by the employer is deductible as a business expense?
100%
Why: For group medical and dental expense insurance, any premium paid by the employer is deductible as a business expense.
