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The Patient Protection And Affordable Care Act of 2010


A) Prohibits denying coverage to children with preexisting medical conditions.
B) Bans insurance companies from dropping people from coverage when they get sick.
C) Eliminates co-pays for preventive services.
D) Ensures consumers have access to an effective appeals process to appeal decisions by the health insurance plan.
E) All of these are true.

F) A) and E)
G) C) and D)

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Peter has a health insurance policy that includes a deductible of $1,000, a coinsurance of 20%, and a stop-loss of $4,000. If his total bill is $20,000, how much will he pay?


A) $1,000
B) $3,800
C) $4,000
D) $4,800
E) $19,000

F) A) and E)
G) B) and D)

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Which of the following activities is NOT a step being taken to reduce health care costs?


A) Community health education programs motivate people to take better care of themselves.
B) Physicians encourage patients to pay cash for routine medical care and lab tests.
C) Programs to carefully review health care fees are available.
D) Involvement in community health planning can help achieve a better balance between health needs and health care resources.
E) All of these activities can reduce health care costs.

F) D) and E)
G) B) and D)

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Which of the following about individual health insurance policies is NOT correct?


A) They can cover individuals.
B) They are used by the self-employed.
C) They can provide family coverage.
D) All insurance companies that offer this type of policy are required to charge the same rates.
E) They can be purchased directly from the company of your choice.

F) All of the above
G) B) and D)

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Managed care health plans include HMOs, PPOs, and POSs.

A) True
B) False

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Two-thirds of all health insurers use prescription data to deny coverage to some individuals (and families) and to charge higher premiums to others.

A) True
B) False

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As health care costs continue to grow, it is projected that the Medicare program will be bankrupt by the year 2035 if no changes are made.

A) True
B) False

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Under the Patient Protection and Affordable Care Act of 2010, which of the following is NOT correct?


A) Requires new health care plans to allow adult children to remain on their parents' insurance policy until age 26.
B) Most insurers must provide preventive care screenings without charging deductibles or co-pays.
C) Employers must offer continuing coverage through COBRA for up to 24 months after you leave your job.
D) Prohibits denying coverage to children with preexisting medical conditions.
E) Expands the Medicaid program for the nation's poorest individuals.

F) C) and D)
G) A) and C)

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Which of the following is NOT a type of health insurance available to individuals or employees?


A) Dental expense insurance
B) Hospital indemnity policy
C) Dread disease policy
D) Minor medical indemnity insurance
E) Vision care insurance

F) B) and C)
G) D) and E)

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Blue Cross and Blue Shield are


A) Health maintenance organizations (HMO) .
B) Private insurance companies.
C) Statewide organizations.
D) Types of Medicare.
E) Preferred provider organizations (PPO) .

F) D) and E)
G) B) and D)

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Nancy is studying the health insurance plan options offered by her employer. She wants a policy that will have the insurance pay a percentage of her medical expenses after she meets her deductible. She should review the


A) Deductible.
B) Coinsurance.
C) Stop-loss provision.
D) Hospital indemnity policy.
E) Dread disease policy.

F) A) and B)
G) B) and D)

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A Medigap policy fills the gap between medicare payments and medical costs not covered by


A) Home health care agencies.
B) Hospital and medical service plans.
C) Medicare.
D) Medicaid.
E) Private insurance companies.

F) C) and D)
G) B) and E)

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Sandy went to the doctor three times, and each appointment cost $200. Her copayment was $25 per visit. How much was Sandy required to pay in total for her three visits?


A) $25
B) $75
C) $175
D) $200
E) $525

F) All of the above
G) A) and B)

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Cynthia was charged $300 for a specialist office visit. Her indemnity policy will pay $125. What amount will she have to pay?


A) $425
B) $300
C) $175
D) $125
E) None of the above

F) D) and E)
G) B) and E)

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Everyone qualifies for COBRA.

A) True
B) False

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A health insurance plan should include all of the following "must-haves" except


A) Offer basic coverage for hospital and doctor bills.
B) Impose no unreasonable exclusions.
C) Limit out-of-pocket expenses to no more than $3,000 to $5,000 per year.
D) Provide at least 120 days' hospital room and board in full.
E) Provide a lifetime maximum level of coverage of up to $50,000.

F) D) and E)
G) A) and B)

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Which of the following is incorrect?


A) Disability income insurance provides regular cash income when you're unable to work because of a disability.
B) Disabilities can include pregnancy, a non-work-related accident, or an illness.
C) The exact definition of disability varies from insurer to insurer.
D) A bad disability policy pays you if you cannot work at your regular job.
E) Disability can cause even greater financial problems than death.

F) B) and E)
G) None of the above

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A Medicare Advantage Plan (Part C) combines your Part A (Hospital) and Part B (Medical) coverages into one plan.

A) True
B) False

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The Health Insurance Portability and Accountability Act of 1996 set new federal standards to ensure that workers would not lose their health insurance if they changed jobs.

A) True
B) False

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Medicaid covers


A) Lab services.
B) Skilled nursing and home health services.
C) Prescription drugs.
D) Eyeglasses.
E) All of these.

F) B) and E)
G) A) and D)

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