Tennessee Health Insurance Exam (Latest Update) Questions and Answers (GRADED A), Exams of Nursing

Download Tennessee Health Insurance Exam (Latest Update) Questions and Answers (GRADED A) and more Exams Nursing in PDF only on Docsity! Tennessee Health Insurance Exam (Latest Update) Questions and Answers (GRADED A) Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to The insured. Items stipulated in the contract that the insurer will not provide coverage for are found in the . Exclusions The insurance policy, together with the policy application and any added riders form what is known as Entire contract Which of the following would basic medical expense coverage NOT cover? Surgeon's Services An insurance producer is defined as A person licensed to sell insurance In terms of parties to a contract, which of the following does NOT describe a competent party? The person must have at least completed secondary education How does a member of an HMO see a specialist? The primary care physician refers the member. A 63-year-old man is planning to be employed until age 68.When will he be eligible for Medicare? Age 65, regardless of his employment status The mode of premium payment is defined as the frequency and the amount of the premium payment Which of the following provisions is mandatory for health insurance policies? Physical examination and autopsy. Alexander has a policy with his ex-wife as its beneficiary. What provision allows him to change the beneficiary to his new wife? Change of beneficiary The insured's health policy only pays for medical costs related to accidents. Which of the following types of policies does the insured have? Accident-only Which provision allows the policyholder a period of time, while coverage is in force, to examine a health insurance policy and determine whether or not to keep it? Free Look Period How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company? Within 90 days or as soon as reasonably possible, but not to exceed 1 year Note: The "proof of loss" provision states the claimant must submit a proof of loss within 90 days; however, if it is not possible to comply, the time parameter is extended to 1 year. The one-year limit does not apply if the claimant is not legally competent to comply with this provision Am insurance company has published a brochure that inaccurately portrays the advantages of a particular insurance policy. What is this an example of? False advertising Note:False advertising is the illegal practice of advertising or circulating materials that are untrue, deceptive, or misleading. Hospital indemnity/hospital confinement indemnity policy will provide payment based on The number of days confined in a hospital According to the PPACA rules, what percentage of health care costs will be covered under a bronze plan? 60% If a producer was licensed at the time he sold an insurance policy but no longer holds a valid license, what happens to the commission earned for the sale? It will be paid to the producer since he was licensed at the time of the sale. Which of the following statements is correct? A) HMOs may pay for services not covered by Medicare B) HMOs do not pay for services covered by Medicare C) Medicare Advantage is Medicare provided by an approved Health Maintenance Organization only D) All HMOs and PPOs charge premiums beyond what is paid by Medicare HMOs may pay for services not covered by Medicare Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within a) 90 days of a loss. b) 20 days of a loss. c) 30 days of a loss. d) 60 days of a loss. 90 days of a loss Which of the following is INCORRECT concerning Medicaid? a) It provides medical assistance to low-income people who cannot otherwise provide for themselves. b) It pays for hospital care, outpatient care, and laboratory and X-ray services. c) The federal government provides about 56 cents for every Medicaid dollar spent. d) It is solely a federally administered program. It is solely a federally administered program. Which of the following is considered a qualifying event under COBRA? Divorce Marriag e Relocati on Promoti on Divorce An agent offers his client free tickets to a sporting event in exchange for the purchase of an insurance policy. The agent is guilty of Rebating And insurance pays her major medical insurance premium annually on March 1. Last March she forgot to mail her premium to the insurance company. On March 19, she had an accident and broke her leg. They insurance company would? Pay the claim