Massachusetts Health & Accident Insurance Practice Exam

What does All-Cause deductible mean?

1. It needs to be met for each specific condition

2. Only needs to be met once during a specified benefit period

3. It is generally higher than other deductibles

4. All expenses are covered without any deductible

The correct answer is: Only needs to be met once during a specified benefit period

An All-Cause deductible refers to a single deductible that, once met, applies to all claims within a specified benefit period, rather than resetting for each separate condition or incident. This means that after an individual reaches the threshold of the All-Cause deductible during that term, they can claim benefits for various health expenses without having to meet another deductible for different conditions or treatments. For instance, if a policy has a $1,000 All-Cause deductible and the policyholder incurs several medical expenses throughout the year, once they have paid a total of $1,000 for those expenses, they would be covered for any future eligible medical treatment for the rest of that benefit period, regardless of the number or types of medical conditions involved. This type of deductible can simplify the claims process for policyholders, allowing them to receive coverage for various conditions without the burden of multiple deductibles. The other choices don't accurately reflect the mechanics of an All-Cause deductible, as they imply differing rules around deductibles and coverage.