Question 6020 of 287 · Texas Life, Accident and Health Agent Exam

A preexisting condition is generally defined as

Exactly one answer is correct.

Aany condition that the insured discovers in the first year, based on the company's internal procedures, as agreed between the agent and the insurer
Ba condition for which the insured received medical advice or treatment before the policy's effective date
Ca condition that is caused by an accident
Da condition that exists only in a family member

Show solution

Correct answer to question 6020

B: a condition for which the insured received medical advice or treatment before the policy's effective date

Explanation

Preexisting condition clauses limit coverage for conditions that existed before the coverage began. Under the ACA, individual and group major medical plans cannot exclude preexisting conditions.

6021Coinsurance in a major medical policy means that
6022Under an 80/20 coinsurance policy with a $500 deductible, the insured has a covered loss of $5,500. How much will the insurer pay?
6023A deductible differs from a copayment in that a deductible is
6024A pre-authorization (prior approval) requirement means that
6025Usual, reasonable and customary (URC) charges refer to
6026A policy that pays 80 percent of a lifetime maximum of $1 million per person has

A preexisting condition is generally defined as

Correct answer to question 6020

Explanation

More questions: Accident and Health: Policy Provisions, Clauses and Riders