The primary purpose of a major medical expense insurance policy is to protect the insured against:

Why B is correct

A major medical expense policy is designed to provide catastrophic protection against large, extraordinary, and largely unpredictable medical expenses resulting from a serious illness or injury. It typically carries high policy limits, a deductible, and coinsurance, and it is structured so that routine, small claims are not what the coverage is built around. This places major medical at the top of the individual medical expense plan types covered under the examination outline for AH-III.A.1a. The policy protects the insured from the financial devastation of a major health event, such as a prolonged hospitalization, cancer treatment, or major surgery, which can generate five- or six-figure bills. Understanding that its function is catastrophic loss protection, not routine-bill reimbursement, is a foundational distinction tested on the A&H examination.

Why the other options are wrong

• A) Small, frequent routine bills are not the target of major medical coverage, which is built around high limits and catastrophic losses. Routine expenses such as office visits are more typical of first-dollar coverage or limited benefit policies, and major medical is deliberately designed to focus on the large, unpredictable claim.
• C) Replacing lost income when a worker cannot perform their job is the function of disability income insurance, not medical expense insurance. Major medical reimburses health care costs; income replacement is a separate product with its own elimination periods and benefit periods.
• D) Major medical covers expenses from both illness and injury, so restricting coverage to accident-related injuries would describe an accident-only limited policy rather than the broad protection a major medical plan provides.

Memory hook

Major medical means major bills: it is the big-ticket safety net for catastrophic care.