Dennis has a cavity. His insurer covers his claim up to a predetermined amount, which is indicated by a fee schedule. Which type of plan does he have?

Get more with Examzify Plus

Remove ads, unlock favorites, save progress, and access premium tools across devices.

FavoritesSave progressAd-free
From $9.99Learn more

Prepare for the Oregon Life and Health Insurance Exam with flashcards and multiple choice questions, complete with hints and explanations. Boost your confidence and ace your exam!

Dennis has a scheduled plan, which is evidenced by the fact that his insurer covers claims up to a predetermined amount as indicated by a fee schedule. In a scheduled plan, specific dental procedures are assigned set dollar amounts that the insurance will pay. This structure means that for each procedure, there is a clear cap on the insurer's responsibility, making it transparent for both the provider and the insured.

This system provides predictability for both parties, as it allows Dennis to understand upfront what financial assistance he can expect for particular dental treatments. Scheduled plans are commonly used in dental insurance, where various procedures like cleanings, fillings, and extractions are outlined in the plan documentation with their corresponding coverage limits.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy