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State RegulationsFL specificDifficulty 1/5

Which type of service must a non-grandfathered health plan in Florida cover without imposing cost-sharing on the enrollee?

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Answer & full 3-part explanation (select an option above, or peek)

Why A is correct

Non-grandfathered health plans must cover recommended preventive care services without cost-sharing, meaning no copayment, coinsurance, or deductible may be charged to the enrollee for those services. This minimum benefit standard is reflected in Chapter 627, Florida Statutes, and is administered in Florida by the Office of Insurance Regulation. Elective cosmetic surgery, unproven experimental treatments, and ordinary over-the-counter purchases are not among the mandated preventive services.

Why the other options are wrong

  • B) Elective cosmetic surgery is not a mandated preventive service and may be excluded entirely.
  • C) Experimental treatments not approved for general use are not required preventive benefits under the minimum benefit standards.
  • D) Ordinary over-the-counter purchases without a prescription are not required to be covered without cost-sharing.

Memory hook

Prevention is free; vanity is not.

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