Ch. 17 - Private Insurance Plans for Seniors

Long-term care policies normally cover expenses associated with

a. drug and alcohol dependency treatment
b. halfway homes
c. nursing homes
d. intensive care units

Linda is covered with the long-term care insurance and has early-stage Alzheimer's. She is still able to reside in her home while receiving primary care, as opposed to moving into a nursing home. All of the following long-term benefits encourage home health care EXCEPT

a. custodial care
b. home health care
c. adult day care
d. respite care

Which of the following is NOT an allowable exclusion for long-term insurance policies?

a. Self-inflicted injuries
b. Acute care
c. Custodial care outside the U.S.
d. Care for incurable conditions

Under a long-term care inflation rider, the benefit levels

a. periodically increase without proof of insurability
b. periodically increase without proof of insurability
c. periodically decrease with proof of insurability
d. periodically decrease with proof of insurability

Emergency health care coverage for Medicare enrollees traveling abroad is

a. excluded from a Medicare Supplement
b. a core benefit under a Medicare Supplement
c. a Medicare Supplement additional benefit
d. a Medicare Part D benefit

Which of these statements reflects an accurate portrayal of Medicare SELECT?

a. Insured uses preferred providers in exchange for paying lower premiums
b. Evidence of insurability must always be given before enrollment
c. Medicare SELECT is normally subject to deductibles and coinsurance
d. Open enrollment periods do not apply to medicare SELECT plans

When dealing with long-term care coverage, which of the following are classified as ADLs?

a. reading, writing, learning
b. occupation, income, insurability
c. age, height, weight
d. eating, bathing, dressing, and mobility

Which of the following does a Medicare Advantage enrollee typically pay for?

a. retainer fee
b. annual deductibles
c. small co-pay per visit or per service
d. capitation

A health plan offered by private insurance companies is

a. Social Security
b. Medicaid
c. Medicare
d. a Medicare Supplement

What is a "functional assessment" for long-term care benefits?

a. an assessment of the insurer's financial solvency
b. a review of the insurer's ability to pay long-term care 
c. a review of the insured's ability to perform the activities of daily living
d. an assessment of the quality of care given in a long-term care facility

Julie is in need of assistance with one or two activities of daily living. She may be eligible for a(n)

a. respite care facility
b. hospice facility
c. assisted living facility
d. intermediate care facility

Employer-paid qualified long-term care insurance premiums are typically

a. deducted from the employee's net income
b. included on the employee's gross income
c. included as a dividend to the employee
d. excluded from the employee's gross income

Medicare Supplement insurance requires an individual to be at least how old for open enrollment?

a. 59 1/2 years old
b. 65 years old
c. 70 1/2 years old
d. No minimum age

Which individual would be best suited for Medicare Supplement insurance?

a. Medicare enrollee
b. Medicaid enrollee
c. Social Security recipient
d. HMO subscriber

Medicare Part A coinsurance payments are covered by

a. Part B Medicare
b. Part D Medicare
c. Medicare Supplement Plan A
d. Never covered

The guarantee of insurability option provides a long-term care policyowner the ability to

a. buy additional coverage at a later date
b. add the insured's spouse at a later date
c. pay the same premium for life
d. cancel the policy at anytime

Which of the following does NOT meet the requirements of "skilled nursing care"?

a. must be ordered by a doctor
b. must require daily care
c. must be provided exclusively in a hospital
d. must be provided by skilled medical practitioners

Which of the following describes coverage for the Medicare Part B coinsurance?

a. only a Long-term care policy will cover Medicare Part B coinsurance
b. a Medicare Supplement optional benefit
c. a Medicare Supplement core benefit
d. Medicare Part B does not require a coinsurance so no additional coverage is needed

Custodial care is normally covered under 

a. major medical insurance
b. Medicare Part B
c. Long-term disability insurance
d. Long-term care insurance

What type of doctor-ordered care assists an individual with performing basic daily activities such as bathing, dressing, and eating?

a. custodial care
b. respite care
c. family care
d. domestic care

Which of these is a type of private insurance that covers the cost-sharing amounts under Medicare?

a. major medical insurance
b. Medicaid
c. disability income
d. Medicare Supplement

Home health care benefits typically do NOT include coverage for

a. nursing care
b. wheelchairs
c. physical therapy
d. prescription medication

In a long-term care insurance, what s an "ADL"?

a. advocates of daily living
b. approved dollar limits
c. activities of daily living
d. accepted doctor lists

Respite Care Coverage is typically found in a(n)

a. HMO
b. PPO
c. Long Term Care policy
d. Major Medical Expense policy

Which of the following is NOT covered by a comprehensive long-term care policy?

a. custodial care
b. acute care
c. physical therapy
d. skilled nursing care

Terry receives long-term physical therapy at her residence. What type of insurance would cover this service?

a. home health care
b. long-term disability income
c. nursing home
d. respite care

In long-term care insurance, what is the length of time for which claims will be paid?

a. benefit period
b. free-look period
c. grace period
d. elimination period

Which of the following is a true statement regarding a Medicare Supplement policy purchased during the open enrollment period?

a. there will be a reduction in benefits
b. the elimination period will be longer than normal
c. the cost of premiums will be higher than normal
d. the policy will be issued regardless of health

Some standard Medicare Supplement policies include which benefit?

a. Hospice care
b. Respite care
c. Vision care
d. Custodial care

Patrick purchased a long-term care policy. He has a health condition for which medical treatment was recommend by a physician within 6 months prior to the policy's effective date. This condition is called a(n)

a. antecedent condition
b. pre-existing condition
c. hazardous condition
d. grandfathered condition

Andy is in need of health care performed by skilled medical practitioners, but only on an intermittent basis. What level of care will his doctor likely prescribe?

a. respite care
b. intermediate care
c. custodial care
d. skilled nursing care

Medicare supplement insurance that provides a preventative medical care benefit will often cover

a. respite care
b. hospitalization
c. custodial care
d. yearly physical examinations

Qualified long-term care premiums are treated for tax purposes as

a. Qualified Retirement plans
b. always non-deductible
c. 100% tax-deductible
d. tax-deductible to the extent they exceed 7 1/2% AGI

Medicare Part A does NOT provide coverage for

a. inpatient room and board
b. prescriptions administered while an inpatient
c. the first 3 pints of blood
d. skilled nursing facility care

A Medicare Supplement policy is required to do which of the following?

a. Provide a 10 day free-look period
b. Provide a 20 day free-look period
c. Provide a 30 day free-look period
d. Provide a 60 day free-look period

Medicare Part B excess charges are covered by

a. long-term care policies
b. respite care
c. Medicare Part A
d. Medicare Supplement insurance

A family counseling benefit is typically offered under which of these coverages?

a. skilled nursing care
b. respite care
c. home health care
d. hospice care

Which would NOT be a location where skilled nursing care is provided?

a. hospital
b. custodial care facility
c. nursing home
d. personal residence

Long Term Care policies will usually pay for eligible benefits using which of the following methods?

a. delayed
b. fee for service
c. expense incurred
d. respite