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TEXAS HEALTH INSURANCE EXAM 2023
Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -100 Questions and Answers
-Format: Multiple-choice / Flashcard
Question 1: What is the name of the process used when an insurance company seeks reimbursement from another person's insurance company for money paid out on a health insurance claim?
Answer:
Subrogation
Question 2: Copayment
Answer:
An arrangement in which an insured must pay a specified amount for services 'up front' and the provider pays the remainder of the cost.
Question 3: Single Premium life insurance
Answer:
a policy in which a lump sum of cash is paid into the policy and then builds interest with a fixed rate
Question 4: Basic Hospital Expense Insurance
Answer:
Coverage that provides benefits for room, board and miscellaneous hospital expenses for a certain number of days during a hospital stay.
Question 5: Alzheimer's disease
Answer:
A disease that causes the victim to become dysfunctional due to degeneration of brain cells and severe memory loss.
Question 6: Coercion
Answer:
An unfair trade practice in which an insurer uses physical or mental force to persuade an applicant to buy insurance.Question 7: Susie is 75 years old and takes a lot of prescription medication. What plan would you recommend for Susie to supplement her basic Medicare coverage?
- Medigap
- Part D
- Part A
- Part B
- Medicap
Answer:
- Part D
Question 8: Alien Insurer
Answer:
An insurance company that is incorporated outside the United States.
Question 9: Concealment
Answer:
The withholding of known facts in which, if material, can void a contract.Question 10: Justine is in the final stages of a battle with cancer. What type of care does she require?
- Rehabilitation
- Hospital
- Hospice
- Terminable
Answer:
- Hospice
Question 11: Accidental Death and Dismemberment
Answer:
An insurance policy which pays a specified amount or a specified multiple of the insured's benefit if the insured dies, loses his/her sight, or loses two limbs due to an accident.
Question 12: Certificate of authority
Answer:
A document that authorizes a company to start conducting business and specifies the kind(s) of insurance a company can transact. It is illegal for an insurance company to transact insurance without this certificate.
Question 13: Death Benefit
Answer:
The amount payable upon the death of the person whose life is insured.
Question 14: cease and disist order
Answer:
a demand of a person to stop committing an action that is in violation of a provision Question 15: What type of Medicare plan is run by a private company and provides Type A and Type B coverage?
Answer:
Medicare Advantage Plan (MAP) Question 16: Brenda operates a custom jewelry shop in a big city. The rent is sky high, so if Brenda is not available to operate the business and generate revenue, the shop would be in serious financial trouble. What type of policy will protect Brenda's business?
A. IME
- Business operations policy
- Personal disability
D. BOE
Answer:
- BOE (business overhead expense)
- No, he can get a waiver and obtain benefits immediately
- He is eligible for a reduced waiting period of 60 days
- No, there is typically no waiting period for Medicare
- Yes, but he will have to wait the customary 24 months
Question 17: Siddique was just approved for Social Security Disability Insurance (SSDI) benefits. He wants to sign up for Medicare. He thinks that there is a waiting period to become eligible for Medicare but he was also disabled for thirty six months before the SSDI benefits were approved. Does he need to wait to obtain Medicare benefits?
Answer:
- No he can get a waiver and obtain benefits immediately.
- First dollar coverage
- Out-of-pocket maximum
- Non-contributory
- Deductible
Question 18: All but which of the following are HDHP benefit areas, according to federal regulations?
Answer:
- Non-contributory
Question 19: In what year does the "donut hole" come to an end?
2025 2020 2022 2030 2040
Answer:
2020
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