Free Medical Plans Practice Questions
Arkansas Life, Accident & Health exam — 55 practice questions.
Subtopics: Point of service, Gatekeeper, Capitation, Formulary, Flexible spending account, Major medical, Exclusive provider organization, Usual customary reasonable, Newborn coverage, Newborn notice, Newborn nursery care, HMO definition, HMO evidence of coverage, HMO enrollee, Clean claims, External review, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Health reimbursement arrangement, Precertification, Basic hospital expense, ACA metal tiers, Essential health benefits, Lifetime limits, Preventive care, Special enrollment, HDHP and HSA, Managed care, Usual, reasonable and customary, Basic surgical, Short-term medical, Vision insurance
Read the Medical Plans study guide
Sample questions & answers
1. A point-of-service (POS) plan combines features of:
HMO and PPO plans, letting members choose in- or out-of-network at the time of care
A POS plan blends HMO and PPO features, letting the member choose network or out-of-network care when service is needed.
2. In a managed care plan, the primary care physician acting as a gatekeeper:
Coordinates care and authorizes referrals to specialists
The gatekeeper primary care physician coordinates care and authorizes referrals to specialists.
3. Capitation is a payment method in which a provider is paid:
A fixed amount per member per month regardless of services used
Under capitation a provider receives a fixed amount per member per month regardless of services used.
4. A prescription drug formulary is:
A list of drugs the plan covers, often by tier
A formulary is the plan's list of covered drugs, frequently organized into cost tiers.
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Practice: Medical Plans
Answer choices are shuffled every time, and every question comes with an explanation.
Practice questions are study aids generated for exam preparation and are not actual exam questions. Content is provided for educational purposes and is not legal advice. Verify current statutes, rules, and exam specifications with the Insurance Department and the exam administrator before relying on it.
