test 17

  1. 1. The miscellaneous expense benefit in a basic hospital expense policy normally will cover

    A.  drugs and medicine administered in the hospital
  2. 2. All of the following are types of deductible provisions associated with major medical policies EXCEPT

    A.  stop-loss
  3. 3. Which of the following statements about deductible provisions in medical insurance policies is NOTcorrect?

    A) c. They are most common in basic medical expense policies.
  4. 4. When a medical expense policy pays benefits on a fixed-rate basis, it pays

    C) c. a flat amount per day for hospital room and board
  5. 5. If the coinsurance feature in a major medical insurance policy is 75/25 with a $100 deductible, how much of a $2,100 bill would the insured pay?

    C.  $600
  6. 6. Which of the following examples pertaining to major medical policy deductibles is CORRECT?

    B. Valerie incurs a hospital bill of $8,300. Her basic medical expense insurance pays $2400. Valerie pays a $200 deductible and her major medical plan takes care of the balance of covered expenses. Her deductible would be classified as a corridor deductible.
  7. 7. Wilbur's basic medical expense policy limits the miscellaneous expense benefit to 20 times the $90 daily room and board benefit. During his recent hospital stay, miscellaneous expenses totaled $2,100. How much, if any, of this amount will Wilbur have to pay?

    B.  $300
  8. 8. Clarence is to enter the hospital for a thyroidectomy. His basic medical expense policy includes a relative value schedule for surgical expense. The schedule lists 55 units for a thyroidectomy and a conversion factor of $8. How much will the policy pay?

    A.  $440
  9. 9. Arthur incurs total hospital expenses of $9,500, all of which are covered by his major medical policy. The policy includes a $500 deductible and a 75/25 coinsurance feature. Of the total expense, how much will Arthur have to pay?

    B.  $2,750
  10. 10. An insured has a basic hospital/surgical expense policy, which provides benefits of $50 per day for upto 30 days of hospitalization and $750 for miscellaneous charges. It bases its surgical benefits on aschedule approach. The insured is hospitalized for a severely broken leg that requires surgery. The surgicalprocedure has been assigned $500 by the policy, though the customary charge in the area is $600. The insured incurs the following covered expenses: $80 per day for seven days hospital charge $675 for the surgical procedure $800 for miscellaneous expenses The insured's policy will pay

    C.  $1,600
Card Set
test 17
test chapter 17