Florida Life and Health Insurance Exam Prep
1. Basic Medical Expense policies
Answer: Provide coverage for Hospital, Surgical andPhysicians Medical Expense.
-Purchased as a individual or group policy.
-provide first dollar coverage (no deductibles).
-limited benefit periods and low coverage limits.
2. Major Medical Expense Policy
Answer:
-A supplement (in addition) to Basic Medical oras a stand-alone policy.
-individual or group policy.
-Take over when the Basic Policy runs out
3. Hospital Expenses
Answer: -Pay for covered expenses incurred during a hospital stay.
1. Daily hospital benefit - Room and Board
2. Miscellaneous expenses - Other Medical Expenses (X-Rays, MRI, Prescriptions,Doctor
Visits)
4. Daily HospitalBenefit
Answer: -Cost of a hospital room, up to a daily $ limit.The limit maybe expressed either as a
dollar amount, e.g. $500 per day, or it may be expressedas the Usual, Customary and
Reasonable (UCR) and Charge
5. Usual, Customary and Reasonable (UCR)
Answer: Insurance company will pay an amount for a given procedure based upon the
average charge for that procedure in that specific geographic area.The coverage is subject to a
maximum amount ornumber of days.
6. Benefit Schedule
Answer: -Specifically states what is covered in the plan and for howmuch.The coverage is
subject to a maximum amount or number of days.
7. Indemnity
Answer: Insured pays the bill and is reimbursed by the insurance company upto a specified
limit amount. Medical expense policies that pay a fixed rate provide the insured with a stated
benefit amount for each day of hospital confinement.
8. Reimbursement
Answer: Policyowners obtain medical treatment from whatever sourcethey want and submit
their charges to their insurer for reimbursement (actual amount).