Question 1

What type of health insurance plan pays a fixed dollar amount per day of hospitalization, regardless of actual expenses incurred?

Accepted Answer

A hospital indemnity (or hospital confinement indemnity) plan pays a set daily benefit for each day the insured is hospitalized, with no coordination to actual medical costs.

Question 2

What is the primary characteristic that distinguishes a basic medical expense plan from a major medical plan?

Accepted Answer

A basic medical expense plan covers specific, first-dollar benefits (like hospital room and board) with defined limits and usually no deductible, while major medical covers broad, catastrophic expenses with deductibles and coinsurance.

Question 3

What is a 'comprehensive major medical' plan?

Accepted Answer

A comprehensive major medical plan combines basic medical expense coverage and major medical coverage into a single policy, providing broad protection from the first dollar (after the deductible) without separate base plan limits.

Question 4

In a major medical policy, what is the 'corridor deductible'?

Accepted Answer

A corridor deductible is the amount the insured must pay out-of-pocket between the benefits paid by a basic plan and the point at which the major medical plan begins to pay, effectively 'bridging' the two coverages.

Question 5

What does the coinsurance provision in a major medical policy require the insured to do?

Accepted Answer

Coinsurance requires the insured to share a percentage of covered expenses with the insurer after the deductible is met—typically the insured pays 20% and the insurer pays 80%—until the out-of-pocket maximum is reached.

Health Insurance Types – Life & Health License Exam

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