Life & Health: Chapter 12 Quiz

The correct term for the time deductible in Disability Income policies is the Elimination Period. This period refers to the amount of time that must pass after a disability occurs before the policyholder starts receiving benefits. The other options are incorrect terms that do not accurately describe this concept.

Medical Expense policies typically cover immediate medical costs, while Disability Income policies provide regular payments to replace lost income due to disability, usually on a periodic basis.

Disability Income policies typically have a time deductible where benefits are not paid out until after a certain waiting period, while Medical Expense policies do not have this feature. Life Insurance and Auto Insurance policies also do not typically have a time deductible.

Disability Income insurance provides coverage for wage earners who are unable to work due to a disability, whereas Medical Expense insurance covers medical costs regardless of employment status. Life Insurance provides financial protection in case of death, and Home Insurance covers damages to a home and its contents.

Medical Expense policies typically have a dollar deductible, whereas Disability Income policies do not have a deductible. Homeowner's Insurance and Life Insurance also typically do not have dollar deductibles related to medical expenses.

Ambulatory care refers to medical services provided on an outpatient basis, meaning the patient does not require to be admitted to a hospital for treatment. Therefore, the correct term synonymous with ambulatory care is outpatient care.

Blue Cross organizations are primarily managed at the state level, overseeing health insurance plans within a specific state. While there may be local or regional offices, the primary management and operations are typically handled at the state level rather than the national or regional level.

In HMO or PPO health insurance plans, primary care physicians act as gatekeepers, overseeing and coordinating all aspects of their patients' health care.

Fee for Service Medical Expense policies typically pay for care based on what is considered to be common, normal, or expected in a medical context, which is referred to as 'usual'.

HMOs commonly pay doctors a fixed amount per patient, regardless of the services provided, which is known as capitation.

PPOs usually pay doctors based on negotiated fee for service agreements, where the reimbursement rate is pre-determined through negotiations.

A noncancellable insurance policy guarantees the insured the right to renew the policy at the same premium rate, while other options do not necessarily provide this level of premium guarantee.

Disability Income policies typically pay benefits at different intervals, ranging from weekly to monthly. While the other options may apply to some types of insurance policies, they are not commonly associated with Disability Income policies.

Conditionally Renewable policies typically have specific conditions under which the insured may not be able to renew the policy, such as changing to a dangerous job. The incorrect answers do not align with the typical conditions that would affect policy renewal.

An Exclusion Rider is typically a provision added to an insurance policy that excludes coverage for certain risks or conditions. An Impairment Rider is another term used to describe this type of provision.

Medical Expense benefits are typically not taxed as they are considered reimbursements for necessary healthcare costs. However, there may be certain circumstances or specific types of benefits that could be subject to taxation. Overall, most medical expense benefits are not taxed.

Disability Income benefits can be taxed, but it depends on the type of disability income. Group Disability Income is typically taxed, while Individual Disability Income may not be taxed. Short-term Disability Income may or may not be taxed depending on the specific circumstances.

A Concurrent Review is done in real-time while the insured is still receiving care. A Retrospective Review is done after the care has been provided. A Pre-Authorization Review is done before the care is provided. A Utilization Review focuses on the appropriateness, necessity, and efficiency of the care provided.

The correct answer is 10 as it is the standard number of days typically required for a Free Look period in health policies. Offering a shorter period, such as 5 days, may not provide sufficient time for policyholders to review and consider the policy. Conversely, a longer period like 15 or 30 days may be overly generous and could potentially increase administrative costs for insurance companies.

Exclusions, pre-existing conditions, and probationary periods are all tools used by insurance companies to mitigate the adverse effects of adverse selection, which refers to the tendency of those with higher risk to seek out insurance coverage more often than those with lower risk.

Noncancellable Renewal provision is often found in Disability Income policies to provide guaranteed renewability without changes in premium or coverage terms.

Choosing a doctor on a PPO list of preferred providers often means the individual will have lower out-of-pocket costs due to negotiated rates with the insurance provider.

Medical Expense insurance typically covers the medical expenses of the entire family, including doctor visits, hospital stays, and other medical services. Disability Income insurance, on the other hand, provides income replacement if the policyholder is unable to work due to a disability. Life Insurance provides a payout to beneficiaries upon the policyholder's death, and Homeowners Insurance covers damages to the home and personal property.

Health Insurance policies typically exclude coverage for military related injuries, as they are usually covered by separate Military benefits or Veterans Affairs programs. Accidental injuries are usually covered under Health Insurance policies.

At age 65, individuals can make penalty-free withdrawals from their HSA for non-medical expenses, only paying income tax. This is due to the fact that at age 65, contributions to HSAs are no longer subject to the 20% penalty for non-qualified withdrawals.

When the deductible is higher, it means that the policyholder will have to pay more out of pocket before the insurance coverage kicks in. This generally results in a lower premium because the insurance company's potential financial risk is reduced.

In Medical Expense policies, occupational losses are typically excluded as they fall under the purview of worker's compensation insurance instead.

Disability Income policies typically cover occupational losses, providing financial protection in case an individual is unable to work due to a disability.

An acute condition is a health condition that develops suddenly and requires timely medical attention for proper treatment. Unlike a preexisting condition, which refers to a health issue that existed prior to seeking medical care.

Preexisting conditions are typically excluded temporarily from insurance coverage due to their existing nature and potential impact on the policy's terms and conditions.