Free Medical Plans Practice Questions
Colorado Accident & Health exam — 111 practice questions.
Subtopics: HMO, PPO, Deductible, Coinsurance, Out-of-pocket maximum, Copayment, Health savings account, Preventive care, Point-of-service plan, Newborn coverage, Maternity length of stay, Maternity coverage, Complications of pregnancy, Adopted children, Dependent children, Prostate screening, Hospice and home health, Diabetes coverage, Insulin cost sharing, Essential health benefits, Guaranteed renewability, Market withdrawal, Utilization review, External review, Grace period - subsidized, Grace period - unsubsidized, Termination, Health-status rating, Special enrollment, Child-only plans, Health exchange, Plan description, Claim practices, Fee-for-service, Stop-loss, Major medical, POS, Gatekeeper, Preauthorization, Coordination of benefits, Comprehensive major medical, HIPAA portability, HIPAA privacy, Dependent to age 26, Exclusive Provider Organization, High-deductible health plan, Capitation, Closed-panel HMO, Open-panel HMO, Concurrent review, Second surgical opinion, Case management, Out-of-network cost sharing, Metal tier levels, Guaranteed issue, Medical loss ratio, Annual and lifetime limit prohibition, Health insurance marketplace, Premium tax credit, Prescription drug formulary, Major medical cost-sharing, Plan concepts, Consumer-driven plans, HDHP and HSA, Cost containment, Grievances and appeals, ACA, Emergency services, Mental health parity, Children's coverage, Prescription drugs
Read the Medical Plans study guide
Sample questions & answers
1. A health maintenance organization (HMO) typically requires members to:
Use network providers and a primary care physician
An HMO emphasizes network care and a primary care physician who coordinates services and referrals, generally with low cost-sharing in network.
2. Compared with an HMO, a preferred provider organization (PPO) generally:
Allows out-of-network care at higher cost
A PPO lets members use out-of-network providers but at higher out-of-pocket cost than using preferred in-network providers.
3. In a major medical plan, the deductible is:
The amount the insured pays before the plan begins to pay
The deductible is the amount the insured must pay out of pocket each period before the plan starts paying covered expenses.
4. An 80/20 coinsurance provision means that after the deductible, the plan pays:
80 percent of covered costs, the insured 20 percent
With 80/20 coinsurance, the plan pays 80 percent and the insured pays 20 percent of covered costs until the out-of-pocket maximum is reached.
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.
