Major Medical policies typically contain which of the following features?

• A. Copayments and exclusions
• B. No deductible
• C. Deductible and coinsurance
• D. HMO network requirements

Answer: (C)

Major medical coverage is built on cost-sharing between the insurer and the insured. The hallmark is a deductible you pay before benefits kick in, followed by coinsurance where you share a percentage of the remaining costs after the deductible is met. This arrangement provides broad protection against high medical bills while keeping you responsible for a portion of costs, up to the out-of-pocket limit.

Copayments and exclusions can appear in plans, but they don’t define major medical in the same way. A plan with no deductible isn’t typical for major medical, and network requirements are characteristic of managed-care plans like HMOs, not the standard major medical structure.