Chapter Exam - 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

T was treated for an ailment 2 months prior to applying for a health insurance policy. This condition was noted on the application and the policy was issued shortly afterwards. How will the insurer likely consider this condition?

Insurer will likely treat as a pre-existing condition which may not be covered for one year

Basic Hospital and Surgical policy benefits are:

lower than the actual expenses incurred

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

For which of the following expenses does a Basic Hospital policy pay?

Hospital room and board

The first portion of a covered Major Medical insurance expense that the insured is required to pay is called the:

Initial deductible

Which of the following is NOT a limited benefit plan?

Life insurance policy

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

One year

Which of these options can an individual use their medical flexible spending account to pay for?

Prescription drugs

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

Which of the following phrases refers to the fees charged by a healthcare professional?

Usual, customary, and reasonable expenses

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

be established by the employer

Under a Basic Medical policy, what does the hospitalization expense portion cover?

hospital room and board

A major medical policy typically:

provides benefits for reasonable and necessary medical expenses, subject to policy limits


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