Which Following Statements Explained for Students (Easy Guide)
Understanding this question requires applying core subject principles.
What This Question Is About
This question relates to which following statements and requires a structured academic response.
How to Approach This Question
Break the problem into smaller parts and analyze each logically.
Key Explanation
This topic involves which following statements. A strong answer should include explanation, application, and examples.
Original Question
Which of the following statements is TRUE? You cannot choose the Economy Plan if you have a family. You can choose to opt out of any health care, vision coverage, and/or dental coverage included in the Standard Plan described in the Medical Plan documents. Neither plan covers visits to Urgent Care Facilities. Because both plans are a “grandfathered health plan” there is a $0 office copay Simon is a single individual and wants to sign up for the Standard Plan being offered by his employer. He plans to use in-network physicians. Which of the statements below is TRUE? The cost of his annual physical will be 50% after deductible The maximum amount that he can expect to pay out-of-pocket is $6,000. His annual deductible will be $800. Once he hits his annual deductible of $800, he will incur no additional costs for health care services for the rest of the calendar year. Select the answer that best completes the following sentence: Samantha is looking to buy a health plan for herself and her family and will only use in-network doctors. The maximum out-of-pocket cost she would have to pay for herself and her family using the Standard Plan is __________, while the maximum out-of-pocket cost she would to pay for herself and her family using the Economy Plan is ___________. $3,300 // $12,000 $7,000 // $6,000 $6,600 // $14,000 $3,300 // $7,000 At what point does the health insurance company cover all of the out-of-pocket costs for an insured individual on the economy plan? Above $1,200 in-network or $2,400 out-of-network Above $3,300 in-network or $6,000 out-of-network Above $7,000 in-network or $12,000 out-of-network Above $14,000 in-network or $24,000 out-of-network Francis has the Standard Plan offered by his employer and is making an Office Visit to an in-network doctor to treat his flu-like symptoms. How much would Francis be asked to pay by the office manager in the doctor’s office? $0 $15 $25 $40 On the first day of the year, while covered as an individual under the Standard Plan and using in-network doctors, Jackie broke her leg while skiing. She incurred the following bills: ambulance ride to hospital, emergency room services, X-Ray of her broken leg ($530) and outpatient surgery to repair the broken leg ($10,000). How much would Jackie pay out-of-pocket for her surgery? $270 $800 $2,000 $10,000 Review the table on page 3 comparing in-network and out-of-network costs under the Standard Plan. Which statement is TRUE? Insurance plans encourage the use of out-of-network doctors by offering lower costs on most services they perform. Insurance plans encourage the use of in-network doctors by offering lower costs on most services they perform. The costs for in-network and out-of-network doctors are the same for ALL services they offer. Office visits, immunizations and annual physicals have the same costs for both in-network and out-of-network doctors. Refer to the Prescription Drug table on page 4 in the sample Health Benefits Form. John is covered under the Standard Plan and plans to purchase his prescription drugs from an in-network pharmacy. All of the following are true, EXCEPT… For a 30-day supply purchased at retail, the generic version of the prescription drug is $40 cheaper than the preferred brand. If John is looking for the lowest cost for his prescription drugs, he should purchase from mail order. The cost of a three month supply of generic prescription drugs purchased at retail would be $50. If John chose the Economy Plan, there would be no difference in the price of the generic version of prescription drugs. Refer to the Quest Diagnostics Lab table at the bottom of page 4 in the sample Health Benefits Form provided to you. Which of the following is TRUE? The cost of doing lab tests in an out-network-lab is 10 times the cost of doing the lab tests in an in-network lab. The patient’s copay is $30 if they used an in-network lab When using an in-network hospital lab, the patient would have to pay $60 until they hit their deductible. The cheapest option for the patient is to always use the in-network hospital lab. All of the following are important factors to consider when choosing a healthcare plan, EXCEPT… The healthcare plan you had last year Your anticipated medical expenses for the year you are purchasing the plan How much you will have to pay toward expenses in deductibles, copayments, and employee contributions How much you can afford to pay out-of-pocket Part II: What Did You Learn? Directions: Use what you learned from analyzing the health benefits form to answer this question. What is/are the benefit(s) of having a health plan?
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