Certified Revenue Cycle Representative (CRCR) Practice Exam

What is first dollar coverage in healthcare insurance?

1. Coverage that applies after a deductible is met

2. Insurance coverage starting from the first dollar of expenses without a deductible

3. Coverage focused on preventive services only

4. Insurance that pays for emergencies only

The correct answer is: Insurance coverage starting from the first dollar of expenses without a deductible

First dollar coverage in healthcare insurance refers to a type of policy that starts paying for medical expenses right from the very first dollar spent, without requiring the insured to meet a deductible. This means that individuals do not have to pay out-of-pocket for a certain amount of expenses before the insurance coverage kicks in. This feature is particularly beneficial because it can make healthcare services more accessible to patients from the onset of their medical expenses, easing the financial burden immediately. In the context of health insurance, first dollar coverage can be advantageous for patients who might avoid seeking necessary medical care due to costs. By eliminating deductibles, individuals can receive immediate assistance for their healthcare needs. This type of coverage may be seen in various plans, including some HMO, PPO, or specialized policies that emphasize access to care without upfront costs. The other options emphasize aspects of healthcare coverage that are not related to first dollar coverage. For instance, coverage that applies after a deductible has been met refers to more traditional insurance structures where the policyholder must first incur a set amount of costs before gaining benefits. Coverage focused only on preventive services or insurance that pays solely for emergencies illustrates limitations that do not pertain to the essence of first dollar coverage, which addresses general medical expenses regardless of the type of service