Medical Expense 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?

$1,600

An insured covered by a group Major Medical plan is hospitalized after sustaining injuries that resulted from an automobile accident. Assuming the plan had a $1,000 deductible and an 80/20 Coinsurance clause, how much will the INSURED be responsible to pay with $11,000 in covered medical expenses?

$3,000

Which of the following BEST describes a Hospital Indemnity policy?

Coverage that pays a stated amount per day of a covered hospitalization

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

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

Limits an insured's out-of-pocket medical expenses

Which of the following types of health coverage frequently uses a deductible?

Major Medical policy

Which of the following statements BEST describes dental care indemnity coverage?

Services are reimbursed after insurer receives the invoice

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

Which of the following medical expenses does Cancer insurance NOT cover?

arthritis

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

hospital room and board

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

hospital room and board

Which of the following health insurance coverages is BEST suited for meeting the expenses of catastrophic illness?

major medical