Kentucky Health Insurance Exam (Latest 2024/ 2025 Update) Questions and Verified Answers| 100 % Correct| Grade A

Kentucky Health Insurance Exam (Latest 2024/ 2025 Update) Questions and Verified Answers| 100 % Correct| Grade A Q: Medicare is funded mostly by 1. Nonprofit organizations. 2. Insureds. 3. Federal taxes. 4. State taxes. Answer: Federal Taxes Q: Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to 1. The spouse of the insured. 2. The insured. 3. Creditors. 4. Beneficiary of the death benefit. Answer: The insured Q: What coverage, written in conjunction with hospital expense policies, covers surgeons' fees, anesthesiologist, and the operating room? 1. Basic Medical Expense 2. Major Medical Expense 3. Stop Loss 4. Basic Surgical Expense Answer: Basic Surgical Expense Q: Which of the following is NOT covered under Basic Hospital Expense Coverage? 1. Surgeons' fees 2. Hospital room and board 3. Lab charges 4. X-ray charges Answer: Surgeons' fees Q: Which statement accurately describes group disability income insurance? 1. In long-term plans, monthly benefits are limited to 75% of the insured's income. 2. There are no participation requirements for employees. 3. Short-term plans provide benefits for up to 1 year. 4. The extent of benefits is determined by the insured's income. Answer: The extent of benefits is determined by the insured's income. Q: If a member of a Blue Cross/Blue Shield (BC/BS) obtains medical treatment from a nonparticipating provider, the insurer will pay 1. The amount that would have been paid to a participating provider. 2. Nothing: BC/BS is a closed panel system. 3. The entire amount billed, minus any applicable copays and deductibles. 4. The entire amount billed on a 50/50 coinsurance basis. Answer: The amount that would have been paid to a participating provider Q: Contracts that are prepared by one party and submitted to the other party on a take-it-orleave-it basis are classified as 1. Contracts of adhesion. 2. Unilateral contracts. 3. Aleatory contracts. 4. Binding contracts. Answer: Contracts of adhesion Q: Fred and Jody are covered under a group health insurance plan at his place of employment. When Jody gave birth to their first child, what must he do in order to have coverage for their child? 1. Notify the insurer within 31 days in order for coverage to continue without any evidence of insurability 2. Notify the insurer on the anniversary date of the plan 3. Notify the employer within 10 days 4. Notify the insurer immediately and provide proof of insurability Answer: Notify the insurer within 31 days in order for coverage to continue without any evidence of insurability Q: An applicant for an adjuster's license who meets all the requirements except the experience, special education, or training requirements may be issued 1. A license with limited authority. 2. A regular adjuster's license. 3. A temporary license as an apprentice adjuster. 4. A learner's permit. Answer: A temporary license as an apprentice adjuster. Q: policies cover only those injuries and illnesses that occur outside of one's job. 1. Workers compensation 2. Full coverage 3. Limited 4. Nonoccupational Answer: Nonoccupational Q: All of the following statements concerning Medicaid are correct EXCEPT 1. Individuals claiming benefits must prove they do not have the ability or means to pay for their own medical care. 2. Persons, at least 65 years of age, who are blind or disabled and financially unable to pay, may qualify for Medicaid Nursing Home Benefits. 3. Medicaid is a state funded program that provides health care to persons over age 65, only. 4. Individual states design and administer the Medicaid program under broad guidelines established by the federal government. Answer: Medicaid is a state funded program that provides health care to persons over age 65, only. Q: Hospital indemnity/hospital confinement indemnity policy will provide pay- ment based on 1. The type of illness. 2. The premiums paid into the policy. 3. The medical expense incurred. 4. The number of days confined in a hospital. Answer: The number of days confined in a hospital. Q: What is the period of coverage for events such as death or divorce under COBRA? 1. 60 days 2. 31 days 3. 12 months 4. 36 months Answer: 36 months Q: Can an individual who belongs to a POS plan use an out-of-network physician? 1. No