Question

When an insured has a major medical plan with first dollar coverage, how does this impact the benefits paid?

a) No deductible payment is required
b) Deductible specified in the contract is payable by the insured
c) Insured must pay a percentage of coverage losses
d) An initial deductible plus a percentage of the remaining covered loss is owed by the insured

Answer 1

An insured with a major medical plan that includes first dollar coverage is not required to pay a deductible before the insurer pays benefits. This type of plan is designed to provide immediate coverage and simplify the claims process for the insured.

Step-by-step explanation:

When an insured has a major medical plan with first dollar coverage, this impacts the benefits paid in such a way that no deductible payment is required. First dollar coverage plans provide immediate benefit payments from the insurer without the insured having to pay a deductible first. This is in contrast to other plans that may involve a deductible, which is the amount an insured must pay out-of-pocket before the insurer starts to pay benefits. Additionally, some plans might include copayments, which are fixed fees for services, or coinsurance, where the insured pays a percentage of the costs.