Full Answer
What is a medical expense policy?
Gravity Created by jackson_edelmann5 Terms in this set (68) A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as
What is a typical customary and reasonable medical expense?
Terms in this set (68) A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as Usual, customary and reasonable.
What are eligible expenses for health care services?
A comprehensive major medical health insurance policy contains an Eligible Expenses provision which identifies the types of health care services that are covered. All of the following health care services are typically covered EXCEPT for
What is Dan’s major medical expense policy deductible?
Dan has a major medical expense policy with a $200 deductible and an 80/20 coinsurance provision. He incurs covered medical expenses of $100 in November and $400 in January. Under the carryover provision, what will the insurer pay?
What are medical expense policies?
Basic Medical Expense policies offer coverage for standard hospital, surgical, and physician expenses. It works to insure certain types of hospital visits/stays, surgery for specific types of procedures, and common physician fees.
What type of policy is a hospital expense policy?
Hospital expense insurance is insurance coverage that protects policyholders against losses associated with being treated in a hospital for a medical issue. Medical expense insurance is commonly purchased to supplement a regular health insurance policy.
What is a basic medical expense plan referred to as?
Regular Medical Expense Benefits sometimes called physicians' nonsurgical expense. Remember that some states refer to this particular category as basic medical expense. Coverage is for nonsurgical services a physician provides.
What are the benefits in medical expense insurance?
Medical expense insurance pays benefits for nonsurgical doctors' fees commonly rendered in a hospital, and sometimes pays for home and office calls as well. Basically, medical expense insurance can pay for all medical treatment and services (always dependent upon the policy).
What is a DI policy?
The term disability income (DI) insurance refers to an insurance policy that provides income to individuals who can no longer work because of a disability. Disability income insurance helps protect people from financial losses if an accident or illness renders them incapable of working and receiving regular income.
What is basic hospital expense insurance?
Basic Hospital and Medical Surgical Expense Coverage means policies designed to provide coverage for hospital and medical surgical expenses only incurred as a result of a covered accident or sickness.
Which type of insurance policy combines basic medical expense coverage with major medical coverage?
A comprehensive major medical policy is an insurance policy with a low deductible and high maximum coverage limits, as well as a coinsurance provision, which combines basic coverage with major medical coverage.
What is a premium in insurance?
The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance. If you have a Marketplace health plan, you may be able to lower your costs with a premium tax credit.
What does basic medical expense cover quizlet?
-Basic coverage provided by an individual medical expense policy include hospital expense, surgical expense, and medical expense.
What is medical expense?
Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and for the purpose of affecting any part or function of the body. These expenses include payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners.
Which medical expense policies generally provide first dollar coverage?
First dollar coverage plans are available on health insurance, homeowner's insurance, and car insurance policies, among others.
What is the primary purpose of medical expense insurance?
What is the primary purpose of medical expense insurance? Pay actual medical costs for illness or injury. Combining the benefits of two insurance policies issued for a married couple.
What are the three basic coverages?
The three basic coverages are hospital, surgical and medical , and may be purchased separately or as a package. a. The provision which prevents the insured from bringing any legal action against the company for at least 60 days after proof of loss is known as. a) Time limit on certain defenses.
What is an insurance agent?
An insurance agent proposed an individual health insurance policy that is guaranteed renewable. If the applicant accepts this policy, the insurer agrees that. a) The company will change the premium rate based upon the insured's health only. b) The premium rate cannot be changed for any reason.
Which section of a health policy states the causes of eligible loss under which an insured is assumed to be disabled?
the section of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the. insuring clause. the provision which prevents the insured from bringing any legal action against the company for at least 60 days after proof of loss is known as. legal actions.
What is a copayment in insurance?
copayment. under the mandatory uniform provision notice of claim, the first notice of injury or sickness covered under an accident and health policy must contain. a statement that is sufficiently clear to identify the insured and the nature of the claim.
What is mutual insurance?
in the forming of an insurance contract, this is referred to as. utmost good faith.
What is a 75% comprehensive plan?
75%. a health insurance plan that covers all accidents and sicknesses that are not specifically excluded from the policy is referred to as a. comprehensive plan. a policy which covers medical costs related to a specific condition is called a. dread disease policy.
What is a health maintenance organization plan?
health maintenance organization plan. a medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as.
Is disability insurance deductible?
group disability income insurance premiums paid by the employer are. deductible by the employer as an ordinary business expense. as it pertains to group health insurance, COBRA stipulates that. group coverage must be extended for terminated employees up to a certain period of time at the former employees expense.
Is dividend paid on mutual insurance taxable?
on a participating insurance policy issued by a mutual insurance company, dividends paid to policyholders are. not taxable since the IRS treats them as a return of a portion of the premium paid.
How much is Dan's medical insurance?
Dan has a major medical expense policy with a $200 deductible and an 80/20 coinsurance provision. He incurs covered medical expenses of $100 in November and $400 in January.
When does a policyowner submit proof of loss?
A policyowner suffers a covered accident and health insurance loss on June 30, and submits the proof of loss to the insurer July 10. If the policyowner cancelled the coverage on July 2, how will the insurance company handle the claim?
How long does a termination employee have to change to an individual health insurance policy?
c) By law, the new, individual policy must provide the same benefits as the group insurance policy. Terminated employees have 31 days to convert to an individual health insurance policy, without having to provide proof of insurability. The insurer can adjust the new, individual. health policy's premium as it sees fit, ...
Why do variable life policies fluctuate?
Because variable life policies invest in the insurer's separate accounts and allow the policyowner to choose specific investment strategies, the interest rates will fluctuate depending upon the performance of the investments. The policy value, therefore, should reflect the effects of inflation up the economy.
How long does it take to recover a claim against an insurance company?
A claiment wants to bring a recovery action against an insurance company for a loss claimed under a policy. The action must be brought#N#a) Within 2 years. #N#b) Within 3 years .#N#c) Immediately.#N#d) Only within 60 days.
Does Carol have a deductible?
provide first-dollar coverage for basic medical benefits, but a deductible may be applied to. the major medical benefits. Carol is insured under her employer's group life insurance plan at her place of. employment.