Chapt. 17 Medical Expense Ins.

Chapt. 17 Medical Expense Ins. Chapt. 17 Medical Expense Ins.
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The miscellaneous expense benefit is a basic hospital expense policy normally will cover
A. physicians' bedside visits
B. the administering of anesthesia
C. drugs and medicine administered in the hospital
D. hospital room and board
 
c
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. $400
B. $440
C. $540
D. $550
 
b
Which of the following statements about deductible provisions in medical insurance policies is not correct?
A. They help to eliminate small claims
B. They provide that initial expenses up to a specified amount are to be paid by the insured.
C. They are most common in basic medical expense policies
D. They help to hold down premium rates.
 
c
An insured has a basic hospital/surgical expense policy, which provides benefits of $50 per day for up to 30 days of hospitalization and $750 for miscellaneous charges. It bases its surgical benefits on a schedule approach. The insured is hospitalized for a severely broken leg that requires surgery. The surgical procedure 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
A. $1,600
B. $1,700
C. $1,800
D. $2,035
 
a
When a medical expense policy pays benefits on a fixed-rate basis, it pays
A. a certain percentage of whatever the hospital room charges are
B. for total hospital expenses, less a deductible
C. a flat amount per day for hospital room and board
D. only for surgery and miscellaneous hospital expenses
 
c
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?
A. $0
B. $210
C. $300
D. $2,100
 
c
Which of the following examples pertaining to major medical policy deductibles is correct?
A. Eric's major medical policy has a $500 flat deductible provision. He incurs covered expenses totaling $350. He will pay nothing and his major medical policy will pay $350
B. Sarah has a major medical policy with a $500 flat deductible and an 80/20 coinsurance provision. Her covered expenses total $1,800. Of that amount, she will pay $500 and her insurance will pay $1,300
C. Valerie incurs a hospital bill of $8,300. Her basic medical expense insurance pays $2,400. 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.
D. An integrated deductible amount is $2,000. With this deductible, after the basic policy benefits are exhausted, the insured pays the full $2,000 deductible and then the major medical benefits are payable
 
c
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?
A. $2,375
B. $2,750
C. $2,875
D. $6,675
 
b
All of the following are types of deductible provisions associated with major medical policies except
A. corridor
B. integrated
C. flat
D. stop-loss
 
d
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?
A. $100
B. $500
C. $600
D. $1,500
 
c
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