Free Medical Plans Practice Questions
Idaho Accident & Health exam — 88 practice questions.
Subtopics: HMO, PPO, Deductible, Coinsurance, Copayment, Out-of-pocket maximum, Health savings account, Gatekeeper, Coordination of benefits, Enhanced short-term plans, External review, External review deadline, External review decision, Expedited external review, External review cost, External review binding, Fee-for-service, Stop-loss, Major medical, POS, Preauthorization, Utilization review, Preventive care, 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 maintenance organization (HMO) generally provides care:
Through a network of providers with an emphasis on preventive care
An HMO delivers care through a contracted network and emphasizes preventive services to control costs.
2. How does a preferred provider organization (PPO) differ from an HMO? A PPO:
Allows out-of-network care at a higher cost to the insured
A PPO lets members use out-of-network providers, though usually at a higher out-of-pocket cost than in-network care.
3. In a medical expense 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 before the plan starts paying covered expenses.
4. An 80/20 coinsurance arrangement means that after the deductible the plan pays:
80 percent and the insured pays 20 percent of covered charges
Under 80/20 coinsurance, the plan pays 80 percent of covered charges and the insured pays the remaining 20 percent.
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.
