Fundamentos de Accidente y SaludPregunta 469 de 716
Basic medical expense coverage differs from major medical coverage mainly because basic coverage typically:
a.Provides first-dollar benefits with no deductible but has relatively low limits
b.Is designed to absorb catastrophic medical costs across a broad range of services and providers
c.Carries very high lifetime limits
d.Requires a large annual deductible
Explicación
Basic medical expense plans historically paid 'first dollar' benefits, meaning they began paying with little or no deductible, but they had relatively low benefit limits for specific services. Major medical, by contrast, provides broad, high-limit protection after a deductible and coinsurance, and is meant to handle large or catastrophic costs. So basic coverage is characterized by low limits and first-dollar payment, not high limits or a large deductible. The two are often combined so basic pays first and major medical covers the excess.
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Preguntas relacionadas de este tema
- A key difference between a Health Maintenance Organization (HMO) and a Preferred Provider Organization (PPO) is that an HMO typically:
- Once an insured's covered out-of-pocket expenses reach the plan's 'stop-loss' (out-of-pocket maximum) for the year, the plan generally:
- The two broad categories of health insurance are:
- A 'calendar-year' deductible in a medical plan means the insured must satisfy the deductible:
- A 'family deductible' provision in a medical plan generally:
- The 'coordination of benefits' (COB) provision in group health insurance is designed to prevent:
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Revisado por John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — verificar)