2 C3

Comprehensive major medical policies usually combine

Major Medical with Basic Hospital/Surgical coverage

The individual health insurance policy that offers the broadest protection is a

major medical

M has a major medical insurance policy with a $200 flat deductible and an 80% coinsurance clause. If M incurs a $2200 claim for an eligible medical expense how much will M receive in payment for this claim?

$1600 (2200-200 x 80% = 1600)

J's major medical policy has a $2000 deductible & an 80/20 coinsurance clause. If J is hospitalized and receives A bill for $10,000 J would pay

$3600 (2000 + 20% of remaining bill = 3600)

This type of deductible provision states that should more than one family member be involved in a common accident, or suffer the same illness, only one individual deductible amount shall be applied

Common accident deductible

Which of the following BEST Describes a hospital indemnity policy

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

Which of the following statements best describes the intent of a coinsurance clause in a major medical policy

Discourages overutilization of the insurance coverage

The first portion of a covered major medical insurance expense at the insured is required to pay is called the

Initial deductible

J was reviewing her health insurance policy and noticed the phrase "this policy will only pay for a semi private room". this phrase is considered to be a

Internal limit (limit place on the dollar amount of certain services or type of service)

Which provision allows a portion of any used medical benefits to be restored following a particular amount of benefit has been used, or after the policy has been in effect for a particular period of time

Restoration of used benefit

Which of the following situations does a critical illness plan cover

leukemia

A health reimbursement arrangement must be established

by the employer

Basic Medical Expense Insurance

has lower benefit limits than Major Medical insurance

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

one year

Deductibles are used in health policies to lower

overuse of medical services