Medical Expense Insurance

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What type of policy would only provide coverage for specific types of illnesses (cancer, stroke, etc)?

Dread disease insurance. ( Dread disease insurance provides benefits for ONLY specific types of illnesses such as cancer or stroke.)

Which of the following is NOT a limited benefit plan? cancer policies life insurance policies dental policies critical illness policies

life insurance policies

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?

$2,100 In this situation, $10,000 x 20% coinsurance + $100 deductible = $2,100.

Which of the following medical expenses does Cancer insurance NOT cover? Chemotherapy Radiation treatment Physician visit Arthritis

Arthritis

All of the following statements about Major Medical benefits are true EXCEPT 1) The deductible can be expressed as a fixed dollar amount 2) The benefit period begins only after a specified amount of expenses have accrued 3) Benefits are generally expressed as a percentage of eligible expenses 4) Benefits have no maximum limit

Benefits have no maximum limit

A characteristic of Preferred Provider Organizations (PPOs) would be

Discounted fees for the patient

Which of these is NOT a characteristic of a Health Reimbursement Arrangement (HRA)?

Employee funds the HRA entirely (HRA plans are employer-funded medical reimbursement plans.)

Basic Medical Expense insurance?

Has lower benefit limits than Major Medical insurance.

With a Basic Medical Expense policy, what does the hospitalization expense cover?

Hospital Room and Board

Which of the following situations does a Critical Illness plan cover?

Leukemia

In Major Medical Expense policies, what is the intent of a Stop Loss provision?

Limits an insured's out-of-pocket medical expenses. (The purpose of a Stop Loss provision in Major Medical Expense policies is to limit the amount of an insured's out-of-pocket medical expenses.)

Generally, how long is a benefit period for a Major Medical Expense Plan?

One year

In order to establish a Health Reimbursement Arrangement (HRA), it MUST

be established by the employer

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 deductible?

carryover provision

Deductibles are used in health policies to lower

overuse of medical services


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