Medical Expense Insurance - Chapter 15 Quiz

A policyholder has a major medical plan with a 80%/20% coinsurance and a deductible of $75. If the insured has previously met her deductible and receives a bill for $175, how much will the insurer pay?

$140

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?

$5,000

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?

$50.00

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

Dread disease insurance

All of the following are qualifications for establishing a health savings account (HSA) EXCEPT

Enrolled in a health plan with a prescription drug benefit

Low frequency diseases can be exclusively covered by what kind of health insurance policies?

Limited policies

What is the tax liability for employer contributions in Health Savings Accounts (HSA's)?

No tax payment needed

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

Work-related injuries

An insured has a health plan that pays established amounts in accordance with a list of injuries, surgical procedures, or other losses. This list is called a

benefit schedule

Jennifer is required to pay a specific sum out of pocket before any benefits are paid in a year. Her health policy most likely contains a(n)

deductible

A payment system for health care in which the provider is paid for each service given is called

fee-for-service

A dread disease policy is considered to be a type of

limited health insurance policy

The focus of major medical insurance is providing coverage for

medical and hospitalization expenses

Distributions from a Health Savings Account (HSA) for qualified medical expenses are

tax-free

Maximum benefits refers to the

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