Florida 2-15 Life, Health and Variable Annuity AgentFlorida Laws and Regulations Specific to Health InsuranceMedium

A Florida resident is reviewing their individual medical expense policy and sees a clause that states if they suffer a covered injury or illness, the insurer will pay for all reasonable and necessary medical expenses up to a very high limit, with no specific dollar amount listed per procedure. This policy structure is characteristic of which type of medical expense policy?

  1. AComprehensive Major Medical
  2. BScheduled Benefit
  3. CBasic Medical Expense
  4. DLimited Benefit
Show answer & explanation

Correct answer: A. Comprehensive Major Medical

Comprehensive Major Medical policies cover a broad range of medical expenses, often with high overall limits and a deductible, providing extensive coverage rather than specific dollar amounts per procedure.

Why the other options are wrong

  • B. Scheduled Benefit policies list specific dollar amounts for each medical procedure, which is contrary to the scenario.
  • C. Basic Medical Expense policies typically cover specific services with lower limits and may not cover all expenses.
  • D. Limited Benefit policies only cover specific illnesses or services, not a broad range of medical expenses.

Comprehensive Major Medical

A type of medical expense insurance that provides broad coverage for most medical expenses, typically with a single deductible, coinsurance, and high overall limits.

  • Covers a wide range of medical services (hospital, surgical, medical).
  • High maximum benefit limits.
  • Often includes a deductible and coinsurance.
  • No specific dollar amounts per procedure.

Memory trick: Comprehensive major medical covers all your major needs.

More Florida Laws and Regulations Specific to Health Insurance questions