Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 1/5
Which expense is MOST likely to be excluded from coverage under a typical major medical expense policy?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Major medical policies routinely exclude cosmetic surgery that is not medically necessary, along with other common exclusions such as experimental treatments, self-inflicted injuries, and services not ordered by a physician. Medically necessary care for sickness and injury — including hospitalization, surgery, and physician-ordered home health — is the core of what the policy covers.
Why the other options are wrong
- B) Hospitalization for a covered sickness is a core covered benefit of major medical insurance.
- C) Surgery required after an accidental injury is covered; accidental injuries are a standard covered loss.
- D) Home health care ordered by a physician is a typical covered benefit under modern major medical plans.
Memory hook
Cosmetic = choice, not necessity. Elective and experimental are the two classic exclusions; medical necessity is the key that unlocks the policy.