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NEW QUESTION # 47
The preventive medical care benefit sometimes provided in a Medicare supplement policy covers:
Answer: A
Explanation:
Detailed Answer in Step-by-Step Solution:
* Medicare supplement (Medigap) policies may include preventive care benefits like annual physical exams (D), which original Medicare doesn't fully cover.
* Home health (A), skilled nursing (B), and hospitalization (C) are covered by Medicare Parts A and B, not typically supplemental preventive benefits.
The Virginia study guide notes that some Medigap plans offer additional preventive services, such as annual exams, beyond Medicare's scope. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Medicare Supplement Insurance."
NEW QUESTION # 48
If a patient with a preferred provider plan chooses to use a non-preferred provider, the patient usually can expect:
Answer: B
Explanation:
Detailed Answer in Step-by-Step Solution:
* In a PPO, using a non-preferred (out-of-network) provider typically results in higher out-of-pocket expenses (A) due to lower reimbursement rates (e.g., 60% vs. 80% in-network) and potential excess charges.
* Option B (full cost) may apply to HMOs, not PPOs, which still offer some coverage. Option C (100% reimbursement) is false. Option D (waiting period) is unrelated to provider choice.
The Virginia study guide explains that PPOs offer flexibility to use out-of-network providers, but at a higher cost to the insured due to reduced coinsurance or additional charges. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Managed Care Plans."
NEW QUESTION # 49
Which type of health insurance helps to pay for the cost of care in cases where hospitalization is not required but the individuals are unable to care for themselves?
Answer: C
Explanation:
Detailed Answer in Step-by-Step Solution:
* Long-term care insurance (B) is designed to cover custodial care (e.g., help with daily activities like bathing or dressing) when individuals cannot care for themselves, often outside a hospital setting.
* Medicare (A) provides limited long-term care coverage (e.g., skilled nursing for a short period), not comprehensive custodial care.
* Major medical (C) covers hospital and medical expenses, not long-term custodial care.
* Disability income (D) replaces lost income, not care costs.
The Virginia study guide defines long-term care insurance as coverage for extended care needs, such as in nursing homes or at home, when individuals cannot perform activities of daily living, distinguishing it from Medicare or major medical plans. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Types of Health Insurance."
NEW QUESTION # 50
Which policy provision allows an employee to change from group coverage to an individual life insurance policy?
Answer: A
Explanation:
Virginia Code § 38.2-3330 requires group life insurance policies to include a conversion provision,allowing an employee to convert group coverage to an individual policy without evidence of insurability, typically within 31 days after termination of employment or group eligibility. Option B (conversion) directly describes this right, ensuring continued protection. Option A (nonforfeiture) applies to cash value options (e.g., reduced paid-up insurance) in individual policies, not group-to-individual transitions. Option C (assignment) transfers policy ownership, unrelated to conversion. Option D (incontestability) limits the insurer's ability to deny claims after a period (e.g., 2 years), not a conversion mechanism. The study guide likely highlights conversion as a key group life feature, with scenarios like an employee leaving a job and converting to a whole life policy, making B the precise answer.
NEW QUESTION # 51
What type of insurance pays a lump sum benefit if an insured loses sight in both eyes?
Answer: C
Explanation:
Detailed Answer in Step-by-Step Solution:
* Accidental death and dismemberment (AD&D) insurance (B) provides a lump sum benefit for specific losses, such as loss of sight in both eyes, due to an accident.
* Hospital expense (A) covers hospital stays, not lump sums for dismemberment.
* Major medical (C) and medical expense (D) cover healthcare costs, not specific injury benefits.
The Virginia study guide describes AD&D as providing lump sum payments for accidental death or specific injuries like loss of sight, distinct from medical expense coverage. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Health Insurance Types."
NEW QUESTION # 52
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