Download Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update and more Exams Nursing in PDF only on Docsity! Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update 2023) Comprehensive Medical Expense Insurance combines which of the following coverage in one policy: A) Basic Hospital/Surgical and Major Medical B) Disability Income and Accidental Death and Dismemberment C) Disability Income and Basic Hospital/Surgical D) Major Medical and Accidental Death and Dismemberment - Correct Answer ✅A) Basic Hospital/Surgical and Major Medical If the client goes out of the network for services on a PPO: A) There is no coverage B) The amount paid will be reduced C) The PPO coverage is excess D) Out of pocket expenses are negotiated - Correct Answer ✅B) The amount paid will be reduced Third party administrator (TPAs) do all of the following EXCEPT: A) Marketing B) Underwriting Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update 2023) Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update 2023) C) Provide coverage D) Claims processing - Correct Answer ✅C) Provide coverage A (basic hospital) health insurance service plan: A) Pays hospital only for specific services stated in the policy B) Pays the hospital directly for claims incurred by low income persons C) Pays the hospital or doctor directly as provided by the service plan D) Pays the hospital or doctor directly as provided by the service plan - Correct Answer ✅D) Pays the hospital or doctor directly as provided by the service plan All of the following are true about HMOs Except: A) They offer a limited choice of doctors B) Covered individuals are known as subscribers C) Ambulatory services are covered on an out patient basis D) Treatment must always be pre-authorized by a primary care physician - Correct Answer ✅C) Ambulatory services are covered on an out patient basis Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update 2023) Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update 2023) All are true about Preferred Provider Organizations (PPOs), EXCEPT: A) They may only be started by hospitals B) Coverage may be reduced for out-of-network services C) They may be started by insurance companies in order to compete with HMOs D) Clients are known as subscribers - Correct Answer ✅A) They may only be started by hospitals HMOs generally provide preventative care in all of the following areas EXCEPT: A) Well baby care B) Hearing loss exams for adults C) Physical exams D) Wellness clinics - Correct Answer ✅B) Hearing loss exams for adults Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update 2023) Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update 2023) Which of the following statements is true about the deductibility of premiums and the taxation of benefits on a non-contributory Group medical expense purchased by an employer for employees: A) Premiums are tax deductible for the employer but benefits are not taxed to the employee B) Premiums are not tax deductible for the employer but benefits are taxed to the employee C) Premiums are tax deductible for the employer, but benefits are taxed to the employee - Correct Answer ✅A) Premiums are tax deductible for the employer but benefits are not taxed to the employee If an insured with a major medical policy with no deductible and 80/20 co- insurance has a $1,000 claim, the insured must pay: A) $800 B) $200 C) $1000 - Correct Answer ✅B) $200 Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update 2023) Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update 2023) If an insured with a major medical policy with a $100 deductible and 80/20 co-insurance has a $1,100 claim, how much will the insurer pay: A) $800 B) $880 C) $200 D) $220 - Correct Answer ✅C) $800 Health Insurance Florida 2-40 Practice Exam Questions #3 - Medical Expenses (Latest Update 2023)