State RegulationsNY specificDifficulty 1/5
What does N.Y. Ins. Law §4303(j) require of an accident and health policy delivered in New York with respect to preventive care services?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under N.Y. Ins. Law §4303(j), accident and health policies delivered in New York may not treat preventive care as an excluded category; the policy must provide coverage for preventive care services. New York deliberately steers coverage toward early detection and routine preventive services instead of paying only after illness develops. An agent should never describe preventive services as an optional rider the insured can waive away.
Why the other options are wrong
- A) Preventive care coverage is not waivable; a written waiver cannot strip a benefit New York law requires the policy to contain.
- B) The statute does not split preventive coverage between adults and children; the required coverage applies across the board.
- C) Nothing limits preventive care coverage to hospital settings; the requirement concerns the category of services, not the place of delivery.
Memory hook
§4303(j): prevention is mandatory coverage, not an optional add-on.