Free Medical Plans Practice Questions
Connecticut Life, Accident & Health exam (series 12-CT-03) — 57 practice questions.
Subtopics: HMO gatekeeper, PPO, Indemnity plan, Copayment, Deductible, Out-of-pocket maximum, HDHP, Preventive care, Newborn coverage, Newborn notice, Adopted children, Dependent age, Disabled dependent, Chiropractic, Mammograms, Infertility, Mental health, Specified disease, Specified disease Medicaid, Health care centers, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Health reimbursement arrangement, Flexible spending account, Capitation, Precertification, Basic hospital expense, Major medical, ACA metal tiers, Essential health benefits, Lifetime limits, 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. In many HMO plans, the primary care physician acts as a gatekeeper, meaning the PCP:
Coordinates care and provides referrals to specialists
The HMO gatekeeper coordinates the member's care and provides referrals to specialists.
2. A PPO encourages members to use network providers by:
Offering lower cost sharing for in-network care
A PPO offers lower cost sharing when members use network providers but still covers out-of-network care at higher cost.
3. A traditional indemnity (fee-for-service) health plan generally allows the insured to:
Use any provider, subject to deductible and coinsurance
A traditional indemnity plan lets the insured choose providers freely, paying a deductible and coinsurance.
4. A copayment is best described as:
A fixed dollar amount paid for a covered service
A copayment is a set dollar amount the member pays for a covered service such as an office visit.
All Life, Accident & Health topics
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.
