Medical Expense Plans

Question 1

Which of the following items is NOT typically covered under a medical expense policy’s miscellaneous expense benefit?

• X-rays
• Surgeon’s fees
• Laboratory fees
• Use of the operating room

Answer 1

• Surgeon’s fees

Question 2

Basic hospital expense insurance provides coverage for all of the following EXCEPT

• anesthesia & use of the operating room & supplies
• physician services
• hospital room & board
• drugs & x-rays

Answer 2

• physician services

Question 3

Major medical policies that pay 100% of covered expenses above a specifies amount after the insured’s deductible contain what kind of a provision?

• Umbrella
• Blue Sky
• Stop-loss
• Maximum benefit

Answer 3

• Stop-loss

Question 4

Which of the following organizations reiburses its insureds for covered medical expenses?

• Blue Cross/ Blue Shield organizations*
• Commercial insurers
• HMO’s
• PPO’s

Answer 4

• Commercial insurers

Question 5

A basic medical expense policy is usually written with first-dollar coverage, which means it does not have

• a stop-loss provision
• a deductible
• a coinsurance clause
• a corridor deductible

Answer 5

• a deductible