Health Insurance Deductibles and Coverage Quiz

Study Notes

Private or semi-private room covered at 100%
Intensive Care Unit expenses covered at 100%
Comprehensive coverage for medical treatment, medications, and diagnostic tests
Inpatient consultations, medical, and nursing fees are fully covered
Rehabilitation services covered if confined immediately after hospitalization
Private duty nursing covered with an annual maximum of $6,000
Accommodation for a companion of a hospitalized child covered up to $100 per day for a maximum of 10 days

Ground ambulance costs fully covered
Air ambulance service requires pre-authorization with a per event maximum of $50,000
Repatriation of mortal remains covered up to $10,000 per insured

Emergency room and emergency medical services fully covered
Outpatient physician visits covered up to 24 visits per policy year
Comprehensive coverage for various diagnostic imaging and laboratory tests at 100%
Cancer treatment (chemotherapy/radiotherapy) fully covered
Outpatient surgery and related services covered
Outpatient dialysis fully funded
Physical therapy and rehabilitation services offered, along with several complementary therapies
Home health care services available with pre-authorization, maximum of 60 visits per policy year

Failure to disclose pre-existing conditions may result in claim denial, policy termination, or rescission of coverage
Underwriters may waive preexisting limitations for specific conditions upon declaration

Available for Plans 2 and 3, including prenatal, postnatal care, and complications of pregnancy
Excludes fertility/infertility services and related treatments, including pregnancy care

Some medical services require pre-authorization, which must be obtained in writing
Penalties of 40% may apply for failure to obtain pre-authorization for the entire episode of care