A major medical expense policy typically does NOT:
contain a deductible
have a high limit of coverage
contain a coinsurance provision
pay surgeon fees on a first-dollar basis
The correct answer and explanation is :
The correct answer is: pay surgeon fees on a first-dollar basis.
Explanation:
A major medical expense policy is a type of health insurance designed to help cover high medical costs. It typically includes several features aimed at providing extensive coverage for a variety of medical expenses. Here’s an overview of the elements mentioned in the question:
- Contain a deductible: Most major medical expense policies do contain a deductible. The deductible is the amount the policyholder must pay out-of-pocket for covered services before the insurance starts to pay. It helps reduce premiums and prevent small claims. This is a typical feature of major medical insurance.
- Have a high limit of coverage: Major medical policies generally offer high limits of coverage to protect the insured from catastrophic health expenses. This can include large hospital bills, surgeries, and long-term care. The limits vary by policy, but they are usually high enough to protect individuals from the financial burden of severe health conditions.
- Contain a coinsurance provision: Coinsurance is a common provision in major medical insurance policies. After the deductible is met, the insurance company and the insured share the remaining costs. For example, an insured might pay 20%, while the insurer pays 80%. This helps manage the cost burden and prevent insurers from bearing the entire risk.
- Pay surgeon fees on a first-dollar basis: First-dollar coverage means that the insurance will pay the entire cost of a service from the first dollar, with no deductible or coinsurance requirement. This is not typical of major medical expense policies. Major medical insurance usually involves deductibles and coinsurance, meaning the insured will have to pay part of the cost before the insurer covers the remaining amount. Surgeons’ fees, like other medical services, would typically be subject to these provisions.
In summary, major medical expense policies typically require the insured to pay a deductible and coinsurance, and they provide coverage with high limits, but they do not typically cover expenses like surgeon fees on a first-dollar basis.