Free Medical Plans Practice Questions
Iowa Accident & Health exam (series 12-IA-02) — 104 practice questions.
Subtopics: HMO, PPO, Deductible, Coinsurance, Health savings account, Out-of-pocket maximum, Copayment, Point of service, Gatekeeper, Newborn coverage, Adopted children, Mammography, Diabetes coverage, Maternity stays, Continuity of care, External review, Individual market eligibility, Individual market definitions, Credit disability, ACA essential benefits, ACA preexisting conditions, ACA dependents, ACA cost-sharing reductions, ACA premium tax credit, ACA individual mandate, ACA employer notice, No Surprises Act, 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, Prescription drugs
Read the Medical Plans study guide
Sample questions & answers
1. Which description best fits a health maintenance organization (HMO)?
Stresses preventive care with a gatekeeper network
HMOs emphasize preventive care and generally require members to use network providers coordinated by a primary care physician.
2. Compared with an HMO, a preferred provider organization (PPO) generally:
Covers out-of-network care at a higher cost
A PPO lets members use out-of-network providers but at a higher out-of-pocket cost than network providers.
3. In a major medical plan, the amount the insured pays before the insurer begins to pay is the:
Deductible
The deductible is the amount the insured must pay out of pocket before the plan begins paying covered costs.
4. After the deductible is met, the percentage of covered costs the insured continues to share with the insurer is:
Coinsurance
Coinsurance is the percentage of covered costs shared by the insured 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.
