Chapt. 17 Medical Expense Ins.

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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
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
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.
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
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
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
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
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
All of the following are types of deductible provisions associated with major medical policies except
A. corridor
B. integrated
C. flat
D. stop-loss
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
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