Surgical Expenses Now Generally Are Reimbursed on the Basis Of:
Surgical expenses now generally are reimbursed on the basis of:
A) actual surgical expense.
B) listed benefit schedules.
C) specific percentage of actual surgical expense.
D) average national cost of the surgery.
E) usual,reasonable and customary expenses.
Suppose a person has a health insurance policy with a $500 calendar year deductible,a $2,000 out-of-pocket cap,and an 80% co-insurance provision.If this person suffers a $600 covered loss,how much will the insurance company pay? (Assume no previous losses have occurred.)
A) $ 80
E) some other amount
Nick has a comprehensive health care policy with a $250 per calendar year deductible and 80%-20% with a maximum $1,000 co-payment cap per calendar year.In January,Nick had a $600 claim which the insurance company paid $280.Nick experiences another unrelated claim in October resulting in total bills of $5,000.How much will Nick have to pay for the second claim?
D) $ 930
E) none of the above
Major medical plans are characterized by deductibles,internal limits,and:
A) benefit levels.
B) participation or co-insurance.
C) illness or injury frequency limits.
D) maximum surgical medical benefits.
E) sliding or decreasing premiums.