State RegulationsNY specificDifficulty 2/5
A Rochester family's medical expense policy covers physician services. During an annual physical, the physician performs routine preventive services. Which statement is correct?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under N.Y. Ins. Law §4303(j), a New York medical expense policy that covers physician services must include coverage for preventive health care services. The routine preventive care delivered at the annual physical is therefore covered; it cannot be excluded merely because no illness or injury was being treated at the time.
Why the other options are wrong
- A) Hospitalization is not a condition for covering preventive services.
- B) A deductible cannot be used to defeat the preventive care mandate.
- C) The absence of a treated illness or injury is exactly what prevention means; the mandate closes that gap.
Memory hook
Annual physical? Covered - prevention rides along with physician care.