Answers26-27 Ignite Financial Literacy Personal Finance - EL3403Health Insurance

Health Insurance Answers

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1
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Which of the following is not a way health insurance helps to save you money?

A
In many cases, your employer will pay a certain portion of your health insurance premium.
B
Some health care plans have made arrangements with health care providers to offer their services at a lower rate.
C
Many times, you only have to pay a deductible to receive goods or services. The remaining balances are paid by your insurer.
D
Most health care plans set a portion of your premium aside in an escrow account so that you have money available in case of a medical emergency.
2
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Which of the following is something that should not be a consideration when choosing a health care plan?

A
annual premiums to be paid by the insured individual and family
B
deductible or co-pay to be paid by the insured individual and family
C
total coverage received by insured individual and family
D
the coverage the insured individual and family already receive in auto insurance
3

What is the difference between a co-payment and co-insurance?

A
Co-payment refers to two spouses paying for the same coverage, and co-insurance refers to two spouses receiving the same benefits.
B
A co-payment is a flat fee for each service, and co-insurance is based on a percentage of the costs incurred.
C
Co-payment is when a group of individuals work to cover each other’s medical expenses, and co-insurance is when an individual has multiple insurance policies from different companies.
D
A co-payment is when an employer helps an employee pay for insurance premiums, and co-insurance is when an employer helps an employee find better insurance than they could alone.
4

Bob’s employer covers 23% of his family’s annual health insurance premium. The balance of the premium is deducted in equal amounts from Bob’s paycheck 26 times over the calendar year. If $185.30 is withheld from each of Bob’s paychecks, what is his family’s annual health insurance premium?

A
$805.65
B
$4,817.80
C
$6,256.88
D
$20,946.96
5

The health benefits Tom receives from his employer cover 43% of the total monthly premium of $345.00. How much does Tom have to pay each month?

A
$148.35
B
$196.65
C
$302.00
D
$288.00
6

Gerald would like to add a dental and vision option to the health insurance plan he purchased through his employer. In addition to the 65% of Gerald’s $345 monthly health insurance premium, his employer has offered to pay 50% of a $38 monthly dental premium and 75% of a $23 monthly vision premium. If Gerald adds both the dental and vision options to his insurance plan, how much will he pay each month towards health insurance?Soopergood InsuranceOptionMonthly PremiumEmployer ContributionHealth Insurance$345 65%Dental$38 50%Vision$23 75%

A
$141.75
B
$145.50
C
$149.50
D
$260.50
7

Leroux Health Insurance is considering changing the options in one of their health care plans (Plan A) based on customer feedback that prescriptions and regular visits to the doctor are too expensive for the insured individual. How can Leroux reduce the costs of regular health care without driving up the price of their health care plan?Leroux Health InsurancePlan A Cost: Monthly Premium: $248.00 Annual Deductible: $5,500.00 Co-pays: Brand-name Prescriptions $35.00 Generic Prescriptions $15.00 Visits: Primary Care Physician: $40.00 Specialist: $60.00 Urgent Care: $125.00 Emergency Room: $325.00

A
Reduce the monthly premium but increase the co-pay amounts to compensate for the lower premium.
B
Reduce the annual deductible, but increase the co-pay amounts so that the monthly premium can stay the same.
C
Reduce the co-pay amounts but increase the annual deductible so that the monthly premium can stay the same.
D
Reduce the co-pay amounts but increase the monthly premium to compensate for the lower deductible.
8

Jim and Stephanie just got married and are thinking about changing their health care insurance plans to be more affordable. Currently, both Jim and Stephanie are insured through their own employers. Jim’s employer pays 42% of his $378 monthly premium. His insurance plan will also pay for 23% of the $345 premium for additional beneficiaries. Stephanie’s employer pays 35% of her $298 monthly premium but offers to pay an extra 10% of her premium for each beneficiary Stephanie adds to her plan. Her employer would then pay 30% of the $349 premium for each additional beneficiary.Insurance Jim's Employer BeneficiaryMonthly PremiumEmployer ContributionJim$378 42%Additional (each)$345 23% Stephanie's EmployerBeneficiaryMonthly PremiumEmployer ContributionStephanie$298 35% (+10% for each additional beneficiary)Additional (each)$349 30%Which would be the most economical way for the couple to purchase health insurance?

A
They should both add each other to their plans.
B
Stephanie should add Jim to her health care plan.
C
Jim should add Stephanie to his health care plan.
D
They should each purchase a plan from their own employer.
9

Mr. Henderson’s annual premium of $4,668 is covered entirely by his employer along with 25% of the $9,264 premium for his wife and kids. How much of the Henderson family’s annual premium is being paid for by Mr. Henderson’s employer?

A
$2,316
B
$3,483
C
$6,984
D
$10,431
10

In a fee-for-service health insurance plan with a $6,500 annual deductible, _____.

A
the insurance company will not pay more than $6,500 for any hospital visit.
B
the insurance company will pay at most $6,500 in health care in a calendar year.
C
the insured individual must pay $6,500 in health care before the insurance company will begin to pay for his health care needs.
D
the insured individual must pay $6,500 in equal monthly installments in order for the insurance company to pay for his health care needs.
11

Why are the premiums for a PPO health insurance plan generally more expensive than those for an HMO Health Insurance Plan?

A
PPO insurance plans offer a wider choice of primary care doctors and specialists.
B
HMO insurance plans have higher deductibles and copays.
C
PPO insurance plans have higher deductibles and copays.
D
HMO insurance plans require a referral for a patient to visit a specialist.
12

Sally’s employer pays for 38% of her annual health insurance premium of $4,350.00. Sally pays the remaining balance by having it deducted in equal amounts from her 26 paychecks throughout the calendar year. How much will Sally have deducted from each paycheck?

A
$63.58
B
$103.73
C
$137.75
D
$207.46
13

Liam has purchased a fee-for-service health insurance plan from Leroux Health Insurance. Plan A includes a $248.00 monthly premium and an annual deductible of $5,500.00 (not including co-pays). Liam is a fairly healthy young man. He visits his primary care physician three times a year on scheduled visits. He sees a chiropractic specialist every week to help with lower back pain. He has no current prescriptions that need refilling regularly.Assuming Liam maintains his regular visits with his primary care physician and his chiropractor, and avoids any trips to the emergency room or urgent care, how much will Liam pay in health care related fees this year?Leroux Health InsurancePlan A Cost: Monthly Premium: $248.00 Annual Deductible: $5,500.00 Co-pays: Brand-name Prescriptions $35.00 Generic Prescriptions $15.00 Visits: Primary Care Physician: $40.00 Specialist: $60.00 Urgent Care: $125.00 Emergency Room: $325.00

A
$716.00
B
$3,816.00
C
$5,500.00
D
$6,216.00
14

Which of the following statements best describes the difference between a health maintenance organization (HMO) and a preferred provider organization (PPO)?

A
An HMO is paid a monthly premium for ongoing services while a PPO collects no money until after services are rendered.
B
An HMO allows the insured individual to choose from a list of providers while a PPO assigns the insured individual the provider nearest his or her residence.
C
An HMO requires the insured individual to go to a provider within their organization while a PPO allows the insured individual the option to receive care from a non-preferred provider at a higher cost.
D
An HMO is usually paid for by the insured individual’s employer while a PPO usually requires the insured individual to pay a co-pay or deductible for services.

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