Medical Expense Insurance Exam Questions with Complete Solutions

Medical Expense Insurance Exam Questions with Complete Solutions Which of the following policy features allows an insured to defer current health charges to the following year's deductible instead of the current year's deducitble? - ANSWER Carryover provision A Health Reimbursement Arrangement MUST be established - ANSWER by the employer M is insured under a basic Hospital/Surgical Expense policy. A physician performs surgery on M. What determines the claim M is eligible for? - ANSWER determined by terms of the policy Which of these is NOT a characteristic of a Health Reimbursement Arrangement (HRA)? Employee funds the HRA entirely Employer funds the HRA entirely HRA's can be offered with other health plans HRA's allow reimbursement for eligible medical expenses - ANSWER Employee funds the HRA entirely Q is hospitalized for 3 days and receives a bill for $10,100. Q has a Major Medical policy with a $100 deductible and 80/20 coinsurance. How much will Q be responsible for paying on this claim? - ANSWER $2,100 A prospective insured completes and signs an application for health insurance but intentionally conceals information about a pre-existing heart condition. The company issues the policy. Two months later, the insured suffers a heart attack and submits a claim. While processing the claim, the company discovers the pre-existing condition. In this situation, the company will - ANSWER continue coverage but exclude the heart condition