LOMA 281 Module 2 Lesson 4 Exam
Questions and Answers 100% Solved
medical expense coverage - ✔✔A type of health insurance coverage that
provides benefits to pay for the treatment of an insured's illnesses and
injuries.
long-term care (LTC) coverage - ✔✔Health insurance that provides
benefits for medical and other services to insureds who need care for an
extended period in their own homes or in a qualified facility.
disability income coverage - ✔✔Health insurance coverage that provides
income replacement benefits to an insured who is unable to work because
of sickness or injury.
major medical coverage - ✔✔Medical expense insurance coverage that
provides substantial benefits for (1) basic hospital, surgical, and physician
expenses, (2) additional medical services related to illness or injuries, and
(3) preventive care. Most common type.
1
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
, exclusions of medical expense coverage - ✔✔Cosmetic surgery (other than
required corrective surgery), Illness or injury during military service or acts
of war,
Intentionally self-inflicted injuries, Routine dental treatments, eye exams,
and corrective lenses
coinsurance - ✔✔An expense participation requirement imposed by many
medical expense plans; the requirement generally is a specified percentage
of all allowable expenses that remain after the insured has paid the
deductible and that must be paid by the insured.
maximum out-of-pocket provision - ✔✔A major medical expense insurance
policy provision which states that the policy will cover 100 percent of
allowable medical expenses after the insured has paid a specified amount
out of pocket to satisfy deductible and coinsurance requirements. Also
known as stop-loss provision.
Affordable Care Act (ACA) - ✔✔In the U.S., a law that requires insurance
companies to accept all applicants for medical expense coverage and
restricts insurers from basing premium rates on preexisting conditions.
dread disease coverage - ✔✔Supplemental medical expense insurance
coverage that provides benefits in a lump-sum or installments for medical
2
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
Questions and Answers 100% Solved
medical expense coverage - ✔✔A type of health insurance coverage that
provides benefits to pay for the treatment of an insured's illnesses and
injuries.
long-term care (LTC) coverage - ✔✔Health insurance that provides
benefits for medical and other services to insureds who need care for an
extended period in their own homes or in a qualified facility.
disability income coverage - ✔✔Health insurance coverage that provides
income replacement benefits to an insured who is unable to work because
of sickness or injury.
major medical coverage - ✔✔Medical expense insurance coverage that
provides substantial benefits for (1) basic hospital, surgical, and physician
expenses, (2) additional medical services related to illness or injuries, and
(3) preventive care. Most common type.
1
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
, exclusions of medical expense coverage - ✔✔Cosmetic surgery (other than
required corrective surgery), Illness or injury during military service or acts
of war,
Intentionally self-inflicted injuries, Routine dental treatments, eye exams,
and corrective lenses
coinsurance - ✔✔An expense participation requirement imposed by many
medical expense plans; the requirement generally is a specified percentage
of all allowable expenses that remain after the insured has paid the
deductible and that must be paid by the insured.
maximum out-of-pocket provision - ✔✔A major medical expense insurance
policy provision which states that the policy will cover 100 percent of
allowable medical expenses after the insured has paid a specified amount
out of pocket to satisfy deductible and coinsurance requirements. Also
known as stop-loss provision.
Affordable Care Act (ACA) - ✔✔In the U.S., a law that requires insurance
companies to accept all applicants for medical expense coverage and
restricts insurers from basing premium rates on preexisting conditions.
dread disease coverage - ✔✔Supplemental medical expense insurance
coverage that provides benefits in a lump-sum or installments for medical
2
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
