Medical expense policies commonly exclude care for conditions caused by...
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A standard exclusion in medical expense policies is treatment for injuries that are covered by workers' compensation, because the employer's comp policy is the primary payer for occupational injuries and the health plan should not duplicate that benefit. Emergency ambulance transport, office visits for acute illness, and prescription drugs are ordinary covered services under most medical expense contracts. This exclusion is one of the common exclusions and limitations tested under individual medical expense insurance, alongside experimental treatment and cosmetic surgery, which appear in the already-validated question bank.
Why the other options are wrong
- B) Emergency ambulance services are typically covered medical expenses, not excluded.
- C) Physician office visits for acute illness are routine covered benefits.
- D) Prescription drugs are a standard covered service, not a common exclusion.
Memory hook
Workers' comp pays for the job injury, so the health plan stays home.