OLAHI - Oklahoma Life Accident and Health Insurance Exam

Question 21: The part of Medicare that helps pay for physician services, outpatient care, durable medical equipment, and preventive services, and that requires beneficiaries to pay a monthly premium, is the medical insurance portion of Medicare. Which part of Medicare is described here?

Part A

Part C

Part D

Part B

Question 22: A Medicare beneficiary chooses to receive all Part A and Part B benefits, and often prescription drug coverage, through a single private plan approved by Medicare, such as a health maintenance organization or preferred provider organization plan. Which part of Medicare provides this private plan option?

Part A

Part B

Part C

Medicaid

Question 23: The part of Medicare that helps beneficiaries pay for prescription drugs, offered through private plans approved by Medicare that beneficiaries may join for an additional premium, is the drug coverage portion of the program. Which part of Medicare is described here?

Part D

Part A

Part B

Part C

Question 24: A private insurance policy is sold to fill the gaps in original Medicare, such as the deductibles and coinsurance amounts that Medicare does not pay, and its benefits are standardized into lettered plans. Which of the following describes this type of coverage?

A Medicare Advantage plan

A long-term care policy

A disability income policy

A Medicare supplement policy

Question 25: A joint federal and state program provides health coverage to people with limited income and resources, and unlike Medicare it can pay for extended custodial nursing home care for those who qualify financially. Which of the following programs is described here?

Medicare Part A

Medicaid

A Medicare supplement

Social Security

Question 26: A long-term care policy pays benefits for care that helps a person with routine daily activities such as bathing, dressing, eating, and moving about, provided in the person's home or a facility over an extended period. Which of the following best describes the kind of care this policy is designed to cover?

Acute hospital care

Emergency surgery

Long-term custodial care

Outpatient physician care

Question 27: Long-term care policies commonly determine when benefits begin by measuring whether the insured needs help with a certain number of basic self-care tasks, such as bathing, dressing, eating, toileting, transferring, and continence. Which of the following terms names these basic self-care tasks?

Activities of daily living

Instrumental activities

Cognitive functions

Presumptive disabilities

Question 28: A long-term care policy includes an option that increases the daily benefit amount over time to help the coverage keep pace with the rising cost of care, so the benefit is not eroded by years of price increases before it is used. Which of the following features is described here?

The elimination period

The free-look provision

A guaranteed insurability rider

Inflation protection

Question 29: A long-term care policy that meets federal standards allows the insured to deduct qualifying premiums within limits and receive benefits income tax free, in exchange for meeting benefit-trigger and consumer-protection requirements set by federal law. Which of the following describes such a policy?

A non-qualified policy

A guaranteed issue policy

A tax-qualified policy

A hospital indemnity policy

Question 30: A long-term care policy provides different benefit levels for skilled nursing care ordered by a physician, intermediate care, and custodial care that assists with daily activities, recognizing that people need different intensities of care. Which of the following best describes skilled nursing care?

Daily nursing care under a physician's orders

Help with bathing and dressing only

Occasional homemaker services

Care requiring no medical supervision

Question 31: A federal law allows employees and their dependents who lose group health coverage because of certain qualifying events, such as termination of employment or reduction in hours, to continue that group coverage for a limited time by paying the premium themselves. Which of the following laws provides this continuation right?

HIPAA

COBRA

ERISA

The Fair Credit Reporting Act

Question 32: A federal law limits how long a group health plan may exclude coverage for preexisting conditions and lets a person reduce that exclusion period with credit for prior continuous coverage, improving the portability of health coverage between jobs. Which of the following laws provides these protections?

COBRA

The Sherman Act

The Social Security Act

HIPAA

Question 33: An employer provides health coverage to its workers under a single contract issued to the employer, and the individual employees receive certificates of coverage rather than their own separate policies, with the group treated as one underwriting unit. Which of the following describes this arrangement?

Individual health insurance

A specified disease policy

Group health insurance

A Medicare supplement

Question 34: Several small employers that are members of the same trade association band together to provide health benefits to their employees through a shared arrangement, spreading risk across the participating employers. Which of the following describes this multiple-employer arrangement?

A multiple employer welfare arrangement

A health maintenance organization

A Medicare Advantage plan

A specified disease plan

Question 35: A health plan covers services such as routine cleanings and exams, fillings and extractions, and more complex work like crowns and bridges, often with different benefit levels for preventive, basic, and major categories of care. Which of the following types of coverage is described here?

Disability income insurance

Long-term care insurance

A hospital indemnity plan

Dental insurance

Question 36: A required uniform provision in a health policy gives the insured a set number of days after the premium due date to pay a late premium and keep the coverage in force, so a short delay in payment does not immediately end the coverage. Which of the following provisions is described here?

The reinstatement provision

The grace period

The elimination period

The time limit on certain defenses

Question 37: A required health policy provision states that after the policy has been in force for a stated period, the insurer may not deny a claim or void the policy on the ground that a condition existed before the policy took effect, similar to incontestability in life insurance. Which provision is this?

The grace period

The reinstatement provision

The time limit on certain defenses

The coordination of benefits

Question 38: A federal law reshaped individual and group health coverage by requiring plans to cover a set of essential health benefits, barring denial of coverage for preexisting conditions, and letting young adults stay on a parent's plan to a stated age. Which of the following laws is described here?

The Affordable Care Act

The Fair Credit Reporting Act

The Sherman Antitrust Act

The National Labor Relations Act

Question 39: A required uniform provision in a health policy sets a period, such as ten days at the start of the policy, during which a sickness that first appears will not be covered, to discourage buying coverage after symptoms begin. Which of the following provisions is described here?

The grace period

The free-look provision

The reinstatement provision

The probationary period

Question 40: A disability income policy states the maximum length of time it will pay benefits for a single period of disability, such as two years, five years, or to age sixty-five, once benefits have begun after the waiting period. Which of the following terms describes this maximum length of payment?

The elimination period

The probationary period

The benefit period

The grace period

OLAHI Oklahoma Life Accident and Health Insurance Exam - Set 5 - Part 2

Question 21: The part of Medicare that helps pay for physician services, outpatient care, durable medical equipment, and preventive services, and that requires beneficiaries to pay a monthly premium, is the medical insurance portion of Medicare. Which part of Medicare is described here?

Question 23: The part of Medicare that helps beneficiaries pay for prescription drugs, offered through private plans approved by Medicare that beneficiaries may join for an additional premium, is the drug coverage portion of the program. Which part of Medicare is described here?

Question 24: A private insurance policy is sold to fill the gaps in original Medicare, such as the deductibles and coinsurance amounts that Medicare does not pay, and its benefits are standardized into lettered plans. Which of the following describes this type of coverage?

Question 25: A joint federal and state program provides health coverage to people with limited income and resources, and unlike Medicare it can pay for extended custodial nursing home care for those who qualify financially. Which of the following programs is described here?

Question 28: A long-term care policy includes an option that increases the daily benefit amount over time to help the coverage keep pace with the rising cost of care, so the benefit is not eroded by years of price increases before it is used. Which of the following features is described here?

Question 34: Several small employers that are members of the same trade association band together to provide health benefits to their employees through a shared arrangement, spreading risk across the participating employers. Which of the following describes this multiple-employer arrangement?

Question 36: A required uniform provision in a health policy gives the insured a set number of days after the premium due date to pay a late premium and keep the coverage in force, so a short delay in payment does not immediately end the coverage. Which of the following provisions is described here?

Question 39: A required uniform provision in a health policy sets a period, such as ten days at the start of the policy, during which a sickness that first appears will not be covered, to discourage buying coverage after symptoms begin. Which of the following provisions is described here?

Don't Want to Study?