Chapter Exam - Medical Expense

limited health insurance policy

A dread disease policy is considered to be a type of

elimination periods

All of these are characteristics of a major medical expense policy EXCEPT

Provider

Who is the individual paid on a fee-for-service basis?

upper limit of the total lifetime benefits the insurance company will pay

"Maximum benefits" refers to the

a disease

A fee for service health insurance plan will normally cover

$5,000

An insured has a stop-loss limit of $5,000, a deductible of $500, and an 80/20 coinsurance. The insured incurs $25,000 of covered losses. How much will the insured have to pay?

$200

An insured under a Major Medical expense plan with a zero deductible and 80/20 coinsurance provision files a $1,000 claim. How much of this claim is the insured responsible for?

$50.00

Kate has a Major Medical Plan with a 75/25 coinsurance and a deductible of $25. How much will she have to pay if she, not having met any of her deductible, visits the doctor and receives a bill for $125?

$700

Kim has health insurance with a deductible of $500 and an 80/20 coinsurance. How much will she pay if she incurs a loss of $1,500?

Work-related injuries

Major Medical expense plans provide coverage for each of the following EXCEPT

an injury occurring at the insured's residence

Medical Expense Insurance would cover

No deductible payment is required

When an insured has a major medical plan with first dollar coverage, how does this impact the benefits paid?

Hospital indemnity plan

Which of the following is NOT included under a health benefit plan?

Integrated deductible

Which of the following types of deductibles would apply a single deductible to both medical and dental insurance coverage?

Hospital indemnity

Which type of coverage pays an amount per day for hospitalization directly to the insured regardless of the insured's other health insurance?