Types Of Health Policies Flashcards
In health insurance, what is considered a sickness?
An illness that first arises while the policy is in force
Who are the parties in a group health contract?
The employer and the insurer
What are the three types of basic medical expense insurance?
Hospital, surgical and medical
What is a fee-for-service health plan?
Under a fee-for-service plan, providers receive payments for each service provided
What types of injuries and services will be excluded from major medical coverage?
Injuries caused by war, intentionally self-inflicted injuries, injuries covered by workers compensation, regular dental/vision/hearing care, custodial care, and elective cosmetic surgery
In what type of health plans are providers paid for services in advance, regardless of the services provided?
Prepaid plans
What type of hospital policy pays a fixed amount each day that the insured is in the hospital?
Hospital indemnity
What are the two types of Flexible Spending Accounts?
Health care accounts and dependent care accounts
A client has a new individual disability income policy with a 20-day probationary period and a 30-day elimination period. Ten days later, the client breaks their leg and is off work for 45 days. How many days of disability benefits will the policy pay?
A)10 days
B)15 days
C)20 days
D)45 days
B) 15 days
An insured is covered by a disability income policy that contains an accidental means clause. The insured exits a bus by jumping down the steps and breaks an ankle. What coverage will apply?
A) Coverage will apply, but will be reduced by 50%.
B) no coverage will apply, since the injury could have been foreseen.
C) No coverage will apply, since disability income policies cover sickness only.
D) Coverage will apply since the break was accidental.
B) no coverage will apply, since the injury could have been foreseen.
