Hawaii Health Exam Questions With 100% Correct Answers 2024, Exams of Nursing

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Hawaii Health Exam Questions With

100% Correct Answers 2024

What is the best way to make a change on an application for insurance? - Correct Answer-Start over with a fresh application What is the entire contract in health insurance underwriting? - Correct Answer-The application and the policy issued What entities make up the Medical Information Bureau? - Correct Answer-Insurers Who must sign a health insurance application? - Correct Answer-The policyowner, the insured and the agent In health insurance, the policy itself and the insurance application form what? - Correct Answer-The entire contract Whose responsibilty is it to inform an applicant for health insurance about the insurer's information gathering practices? - Correct Answer-The agent

When should an agent obtain a Statement of Good Health from the insured? - Correct Answer-When the premium was paid upon policy delivery and not at the time of application What information are the members of the Medical Information Bureau required to report? - Correct Answer- Adverse medical information about the applicants or insured Who is responsible for paying the cost of a medical examination required in the process of underwriting? - Correct Answer-Insurer What is the term used for a written request for an insurer to issue an insurance contract based on the provided information. - Correct Answer-Application If an agent makes a correction on the application for health insurance, who must initial the correct answer? - Correct Answer-The applicant If an insurer decides to obtain medical information from different sources in order to determine the insurability of an

applicant, who must be notified of the investigation - Correct Answer-The applicant If an underwriter requires extensive information about the applicant's medical history, what report will best serve this purpose? - Correct Answer-Attending Physician's Statement What are the three types of basic medical expense insurance? - Correct Answer-Hospital, surgical and medical What type of hospital policy pays a fixed amount each day that the insured is in the hospital - Correct Answer-Hospital indemnity What is the main principle of an HMO plan? - Correct Answer-Preventive care What does the amount of disability benefit that an insured can receive depend on? - Correct Answer-The insureds income at the time of policy application How can an HMO member see a specialist - Correct Answer-Referral by the primary care physician

Can an insured who belongs to a POS plan use an out-of- network physician? - Correct Answer-Yes, but the copays and deductibles may be higher What is the purpose of COBRA? - Correct Answer-To allow continuation of health insurance coverage for terminated employees Why do HMOs encourage members to get regular checkups

• Correct Answer-To help catch health problems early when treatment has the greatest chance for success In order to be eligible for coverage by an HSA, an individual must also be covered by what type of health plan - Correct Answer-High Deductible Health Plan (HDHP) What is a fee-for-service health plan? - Correct Answer- Under a fee-for-service plan, providers receive payments for each service provided Who do individual insureds receive as proof of their group health coverage? - Correct Answer-Certificate of Insurance

What is the purpose of a buy-sell agreement for health insurance policies? - Correct Answer-To specify how the business will pass between owners when one of them dies or becomes disabled What is the capital sum in Accidental Death and Dismemberment (AD&D) coverage? - Correct Answer-A percentage of the principal sum What types of injuries and services will be excluded from major medical coverage? - Correct Answer-Injuries caused by war, intentionally self-inflicted injuries, injuries covered by workers compensation, regular dental/vision/hearing care, custodial care, and elective cosmetic surgery What is the term for a period of time immediately following a disability during which benefits are not payable - Correct Answer-Elimination period Who chooses a primary care physician in an HMO plan? - Correct Answer-The individual member What are the two types of Flexible Spending Accounts? - Correct Answer-Health care accounts and dependent care accounts

What is the primary purpose of disability income insurance?

• Correct Answer-To replace income lost due to a disability What is the role of the gatekeeper in an HMO plan? - Correct Answer-To control costs for the services of specialists What type of health insurance would pay for hiring a replacement for an important employee who becomes disabled? - Correct Answer-Key-person disability insurance How are HMO territories typically divided? - Correct Answer-Geographic areas In health insurance, what is considered a sickness? - Correct Answer-An illness that first arises while the policy is in force With key person disability insurance, who pays the policy premiums? - Correct Answer-The business (employer) Can Alzheimer's disease be excluded from coverage under a long-term care policy? - Correct Answer-No, organic

cognitive disorders, such as Alzheimer's or Parkinson's must be covered Under what type of care do insurers negotiate contracts with health care providers to allow subscribers access to health care services at a favorable cost? - Correct Answer- Preferred Provider Organization (PPO) What types of groups are eligible for group health insurance

• Correct Answer-Employer-sponsored and association- sponsored groups In what type of health plans are providers paid for services in advance, regardless of the services provided - Correct Answer-Prepaid plans What is the purpose of respite care in long-term care insurance - Correct Answer-To provide relief for a major caregiver (usually a family member) Who are the parties in a group health contract - Correct Answer-The employer and the insurer

In group insurance, what is the name of the policy - Correct Answer-Master policy What is a probationary period in group health insurance? - Correct Answer-The period of time that must lapse before an employee is eligible for group health coverage When can an irrevocable beneficiary be changed? - Correct Answer-With the written consent of the beneficiary Who decides which optional provisions would be included in a health policy - Correct Answer-The insurance company What health policy provision states to whom the claim benefits must be paid? - Correct Answer-Payment of claims What is the purpose of the coinsurance provision in health insurance - Correct Answer-To prevent overutilization of the policy benefits What provision provides for the sharing of expenses between the insured and the insurance company - Correct Answer- Coinsurance

What will determine the length of the grace period in a health insurance policy? - Correct Answer-The mode of the premium payout What is a deductible in a health insurance policy? - Correct Answer-A specified dollar amount that the insured must pay before the insurer will pay the policy benefits What health policy provision prevents the insured from bringing a lawsuit against the insurance company for at least 60 days after proof of loss is provided - Correct Answer- Legal actions Under an individual disability income policy, the benefits must be paid on at least what schedule? - Correct Answer- Monthly Where can an irrevocable beneficiary be changed? - Correct Answer-With the written consent of the beneficiary What health policy provision describes the insured's right to cancel coverage - Correct Answer-Renewability provision

What does the free-look period allow the insured to do? - Correct Answer-Return the policy for a full refund of premium within a specified time period (usually 10 days) What will determine the length of the grace period in a health insurance policy - Correct Answer-The mode of the premium payment What health policy provision defines the insured's duty to provide the insurer with reasonable notice in the event of a loss? - Correct Answer-Notice of claim What provision provides for the sharing of expenses between the insured and the insurance company - Correct Answer- Coinsurance What section of a health insurance policy lists the service for which the insurer will not provide coverage - Correct Answer-Exclusions Which health insurance provision describes the insured's right to cancel coverage - Correct Answer-Renewal provision

If a health insurance policy has a 31 day grace period, what does that mean - Correct Answer-The policy remains in effect for 31 days after the premium is due and not paid What is the purpose of the coinsurance provision in health insurance policies - Correct Answer-To prevent overutilization of the policy benefits What health policy provision allows the insured a period of time to examine the policy and determine whether keep it? - Correct Answer-Free-look period What is the name of the act by the insured to voluntarily give up insurance - Correct Answer-Cancellation According to the Reinstatement provision, once a lapsed policy is reinstated, how soon will coverage be available for accidents - Correct Answer-Immediately According to the Time Limit on Certain Defenses provision in health insurance policies, when can an insurer contest fraudulent misstatements on a health insurance application - Correct Answer-Any time while the policy is in force

The insured on a health policy misstated his age on the insurance application. If this misrepresentation is discovered, what will happen to the policy - Correct Answer- The benefit amount payable under the policy will be adjusted to the insured's correct age If the insured pays a monthly premium for health insurance, how long would the grace period be on the policy? - Correct Answer-10 days Who pays the expense for an autopsy under the physical examination and autopsy provision - Correct Answer-The insurer What will happen to a health insurance policy if the premium has not been paid by the end of the grace period - Correct Answer-The policy will be cancelled What is the main difference between coinsurance and copay? - Correct Answer-Copay is a set dollar amount; coinsurance is a percentage of the expenses What health policy provision states to whom the claim benefits must be paid - Correct Answer-Payment of claims

After the elimination period, a totally disabled insured qualified for benefits from a disability income policy that has a waiver of premium rider. What will happen to the premium that was paid into the policy during the elimination period? - Correct Answer-Premium will be refunded A waiver of premium provision may be included with what type of health insurance policies - Correct Answer-Disability income What is a probationary period in group health insurance - Correct Answer-The period of time that must lapse before an employee is eligible for group health coverage What are usual/reasonable and customary charges based on? - Correct Answer-Average charge for a given procedure in the specific geographic area How will changing one's occupation to be more hazardous affect the health insurance policy in force - Correct Answer- Claim benefits will be reduced to what the premium would have bought for a more hazardous occupation

What part of Medicare is known as hospital insurance? - Correct Answer-Part A How many parts does Medicare have? - Correct Answer- Parts A-D What benefit is based on a primary insurance amount? (PIA) - Correct Answer-Social Security disability benefit How many pints of blood will be paid for by Medicare Supplement core benefits? - Correct Answer-First 3 pints In which Medicare supplemental policies are the core benefits found? - Correct Answer-All plans (A-N) What is the required free look period for Medicare Supplement policies? - Correct Answer-30 days What is another name for Medicare advantage plans? - Correct Answer-Part C How does someone qualify for Social Security disability income benefits? - Correct Answer-The insured must have

the proper insured status, meet the definition of disability and satisfy the waiting period Who qualifies for Medicare coverage? - Correct Answer- 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 Who is eligible for Part B Medicare? - Correct Answer-Part B is optional, and is offered to everyone who enrolls in Part A What part of Medicare is known as medical insurance? - Correct Answer-Part B Who qualifies for Medicaid? - Correct Answer-Persons with insufficient income When is the initial enrollment period for Medicare Part A - Correct Answer-When an individual first becomes eligible for Medicare, starting 3 months before turning 65 and ending 3 months after the 65th birthday.

At what age do individuals qualify for Medicare? - Correct Answer-Age 65 What Medicare part helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care? - Correct Answer-Part A Medicare Part A will pay for what type of services? - Correct Answer-Inpatient hospital care, skilled nursing facility care, home health care and hospice care What Medicare part will cover lab services or diagnostic tests? - Correct Answer-Part B What is the purpose of Medicare Supplement plans? - Correct Answer-To fill in the gaps in Medicare coverage What is another name for Old Age, Survivors, and Disability Insurance benefits - Correct Answer-Social Security How is Part B Medicare funded? - Correct Answer-By monthly premiums and from the general revenues of the federal government?

If an individual is covered by Medicare and is also covered by his employers health plan, which plan would be considered primary? - Correct Answer-The employer plan What Medicare part provides a prescription drug benefit? - Correct Answer-Part D What is another name for Medicare Supplement plans? - Correct Answer-Medigap An insured with Medicare Part D has reached the initial benefit limit and must now pay a portion of prescription drugs cost/ What is the term for this gap in coverage? - Correct Answer-The donut hole Who issues Medigap policies? - Correct Answer-Private insurers What benefits are provided by Medicare Part C? - Correct Answer-Expanded benefits for a fee through private insurance programs such as HMOs or PPOs