Special Types Of Medical Expense Polocies

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Comprehensive dental policies:

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work much the same way as comprehensive medical expense coverage

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What is not considered non routine dental care:

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annual checkups and cleaning of teeth, including x-rays to check the health of the teeth

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For non routine treatments, a comprehensive dental policy generally pays

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a percentage of the reasonable and customary charges after a deductible

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The main difference between a prepaid dental plan and a comprehensive dental plan is that:

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comprehensive dental plans pay based on reasonable and customary charges, and prepaid dental plans pay on a capitation (based on a payment per person, rather than a payment per service provided) basis.

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Hospital indemnity insurance pays:

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an income for each day the insured is confined to the hospital

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vision care insurance is generally needed to cover all of the following except:

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injury to the eye

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Prescription drug policies generally exclude:

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experimental drugs

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Credit Health insurance covers:

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a debtor

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The amount of coverage available under a credit insurance policy is generally limited to:

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the total amount of indebtedness at any given point

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The creditor must notify the debtor that he or she may be covered by the group insurance plan:

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Even if the creditor pays the full cost of the coverage

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Dental Plan that is a Scheduled Policy means:

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Benefits are limited to specified maximums per procedure, with first dollar coverage.

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Comprehensive policy means:

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work much the same way as comprehensive medical expense coverage - usually providing routine dental care services without deductibles or coinsurance.

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Non routine Dental care includes:

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Restorative, Oral Surgery, Endodontics, Periodontics, Prosthodontics, Pediatric dentristy, Oral pathology, Orthodontics

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Exclusions and limitations in dental policies:

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Cosmetic exclusion, missing tooth, five year replacement, vertical dimension, splinting and restoring occlusion, oral hygiene instructions, plaque control programs

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Can a dental plan be converted later into an individual plan:

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No! Because dental coverage is usually available only on a group basis, most plans do not include a conversion privilege. Members cannot convert when their membership in the group ends or the group plan is terminated.

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Dread Disease Policy is:

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can be purchased to cover specific diseases such as heart or cancer. Generally these policies cover illness that do not occur frequently. They can be fairly inexpensive.

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Travel Accident Insurance

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may be offered as a benefit of either an individual or a group AD&D policy. Benefits are limited to losses caused by accidents while traveling.

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Hosptial Income (Indemnity) Insurance:

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Pays an indemnity directly to the insured not to the hospital. They are not intended to cover expenses for hospitals but to provide a flow of income when you are confined in a hospital.

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Vision Care Insurance

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Usually cover, eye exams, lenses and frames, contact lenses, other corrective items.

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Limitations on vision insurance:

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replacement frames or lenses because of loss or breakage, sunglasses and safety glasses, medical and surgical costs of the type covered by basic and major medical policies

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Prescription Drug Policies

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Also known as discount plans. Operate with a network of pharmacies that member must use.

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Credit Insurance:

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Covers a debtor, with the creditor receiving the benefits to pay off the debt if the debtor is disabled or dies accidentally. The most common is group coverage such as through a car dealership, a credit card company, etc. Generally a creditor must have a minimum number, often 100, to qualify.

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Credit Health insurance differs from Credit Life insurance:

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Credit health covers death only when it is accidental. If a debtor dies a natural death, the policy does not apply.

Credit Life pays death benefits whether the death occurs accidentally or by natural causes.