Illinois Health Insurance Practice Exam

What term is defined as usual, reasonable, and customary eligible expenses in the context of insurance coverage?

1. Rehabilitative and habilitative therapy

2. Major Medical covers

3. Daily hospital benefits

4. Prescription drugs

The correct answer is: Major Medical covers

The term that refers to usual, reasonable, and customary eligible expenses in the context of insurance coverage is typically associated with Major Medical policies. These policies are designed to cover a broad range of health care services and expenses, including hospital stays, surgeries, and other significant medical treatments. Major Medical insurance assesses claims based on what is considered standard for a given service in a specific geographical area. This ensures that the amounts charged for care are not only reasonable but align with common practices within the healthcare industry. The other options, such as rehabilitative and habilitative therapy, daily hospital benefits, and prescription drugs, represent specific types of services or coverage but do not encompass the broader concept of usual, reasonable, and customary expenses as defined by a Major Medical plan. These options may be covered under a Major Medical policy but do not define the overarching term itself.