Chapter 3 - Medical Expense Insurance Exam Updated Questions and Answers Solved

C was injured while deep sea driving and requires a hospital stay. C has a Major Medical policy with a 80/20 coinsurance clause and a $400 deductible. What is the MAXIMUM C will pay if the covered medical expenses are $2000? - $720 Which of the following statements BEST defines usual, customary, and reasonable (UCR) charges? - The maximum amount considered eligible for reimbursement by an insurance company under a health plan J's Major Medical policy has a $2,000 deductible and an 80/20 Coinsurance clause. If J is hospitalized and receives a bill for $10,000, J would pay - $3,600 Which of these options can an individual use their medical flexible spending account to pay for? - Prescription drugs All of the following are limited benefit plans, EXCEPT: - life insurance policies This type of deductible provision waives the deductible for all family members after some of them have satisfied individual deductibles within the same year: - Family maximum deductible An insured covered by a group Major Medical plan is hospitalized after sustaining injuries that resulted from an automobile accident. Assuming the plan had a $1,000 deductible and an 80/20 Coinsurance clause, how much will the INSURED be responsible to pay with $11,000 in covered medical expenses? - $3,000 In Major Medical Expense policies, what is the intent of a Stop Loss provision? -Limits an insured's out-of-pocket medical expenses. The first portion of a covered Major Medical insurance expense that the insured is required to pay is called the: - initial deductibleWhich of the following is NOT a limited benefit plan? - life insurance policies