Free Medical Plans Practice Questions
Hawaii Accident & Health exam — 93 practice questions.
Subtopics: HMO, PPO, Deductible, Coinsurance, Copayment, Out-of-pocket maximum, HSA, POS plan, Gatekeeper, Child health supervision, Child health visits, Mammography, Mammogram referrals, Optometric services, In vitro fertilization, Adopted newborns, Genetic information, Medical foods, Diabetes coverage, Autism coverage, Autism ABA limit, Fee-for-service, Stop-loss, Major medical, POS, Preauthorization, Utilization review, Preventive care, 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, Essential health benefits, 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, Newborn coverage, Prescription drugs
Read the Medical Plans study guide
Sample questions & answers
1. A health plan that emphasizes preventive care and generally requires members to use a network of providers for a prepaid fee is a(n):
Health maintenance organization (HMO)
An HMO provides care through a network for a prepaid fee and emphasizes preventive care, usually requiring in-network use.
2. A plan that offers lower out-of-pocket costs for using preferred network providers but still covers out-of-network care at a higher cost is a(n):
Preferred provider organization (PPO)
A PPO gives lower costs for preferred providers but still covers out-of-network care at higher cost sharing.
3. The amount an insured must pay out of pocket before a medical plan begins to pay benefits is the:
Deductible
The deductible is the amount the insured pays before the plan begins to share covered costs.
4. After the deductible is met, the percentage of covered costs the insured continues to share with the insurer is called:
Coinsurance
Coinsurance is the percentage of covered costs the insured shares after the deductible is satisfied.
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.
