QUESTIONS AND ANSWERS
Which of the following services is NOT covered under a hospitalization expense
policy?
surgeon's fees
What services are covered under a hospitalization expense policy
daily room and board, intensive care, miscellaneous expenses
A comprehensive major medical health insurance policy contains an Eligible
Expenses provision which identifies the types of health care services that are
covered. All of the following health care services are typically covered EXCEPT
for
experimental and investigative services
Basic Medical Expense insurance
has lower benefit limits than Major Medical Insurance
M has a Major Medical insurance policy with a $200 flat deductible and an 80%
Coinsurance clause. If M incurs a $2,200 claim for an eligible medical expense,
how much will M receive in payment for this claim?
In this situation, $2,200 - $200 deductible x 80% = $1,600.
Which of the following BEST desscribes a Hospital Indemnity policy?
Coverage that pays a stated amount per day of a covered hospitalization
Deductibles are used in health policies to lower
One of the primary reasons for using deductibles in health policies is to reduce the
overuse of medical services.
C was injured while deep sea diving 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?
The correct answer is "$720". In this situation, $400 deductible + 20% of the remaining
medical bill = $720.
A major medical policy typically
A major medical policy provides benefits for reasonable and necessary medical
expenses, subject to policy limits.