Health insurance Test Flashcards
In long-term care insurance, a person who is unable to independently perform the activities essential to daily living because of physical or cognitive impairment is said to be?
Functionally impaired
Medical expense insurance providing benefits on a reimbursement basis reimburses?
Insureds of their medical expenses
In group health insurance, a group with a high average age usually has?
Above average total health claims
When several members of a family insured under the same major medical policy are involved in an accident, the coverage usually requires?
Only one individual deductible needs to be satisfied for all injuries the family received in the accident
If an individual filed a claim under two individual health insurance policies issued by the same insurer, the insurer might return?
The premium amount paid for coverage, which would cause combined benefits to exceed a maximum benefit amount
What does Medicare Supplemental insurance cover?
Part of the cost of certain hospital and medical services
Concurrent review is a form of utilization review that is performed?
During the course of the patients treatment
Health insurer’s are prohibited from discrimination based on an individual’s?
Genetic make-up
Under which disability income provision might an insured be considered totally disabled, even if working, following the loss of sight in both eyes?
Presumptive total disability
A producer or agent who negligently replaces health insurance for a client creates potential liability for?
Errors and ommissions
How does the Medicare Supplement at-home recovery benefit defer from the Medicare home health care benefit?
The Medicare Supplement Benefit covers assistance with daily living
An insured currently has group coverage issued by different insurance companies. How will payment for medical expenses typically be handled when both group policies provide coverage?
Payment will be made in accordance with the policies coordination of benefits provisions
Ambulatory services under case management provisions try to moniter?
The cost effectiveness of out patient services
One objective of a concurrent review provision in group health insurance is to?
Monitor the length of stay in the hospital once the patient has been admitted
What type of health insurance should be purchased by a person who wants coverage for hospital bills in the event of an accidental injury?
Medical expense
