Free Medical Plans Practice Questions
Idaho Life, Accident & Health exam — 52 practice questions.
Subtopics: Point-of-service plan, Basic vs major medical, Usual customary reasonable, Formulary, Exclusive provider organization, Fee-for-service, Network provider, Comprehensive major medical, Enhanced short-term plans, External review, External review deadline, External review decision, Expedited external review, External review cost, External review binding, Types, Cost sharing, Cost containment, Health savings account, Health reimbursement arrangement, Flexible spending account, Capitation, Precertification, Basic hospital expense, Major medical, ACA metal tiers, Essential health benefits, Lifetime limits, Preventive care, 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. A point-of-service (POS) plan combines features of:
An HMO and a PPO
A POS plan blends HMO and PPO features, letting members use a gatekeeper network or go out of network at higher cost.
2. Basic hospital and surgical expense coverage differs from major medical because it:
Provides first-dollar benefits up to limited amounts with little or no deductible
Basic coverage pays first-dollar benefits up to modest limits, while major medical adds broad coverage subject to a deductible and coinsurance.
3. The usual, customary, and reasonable (UCR) standard is used to:
Determine the allowable amount payable for a medical service in an area
UCR is used to determine a reasonable allowable charge for a service based on prevailing fees in the geographic area.
4. A formulary in a prescription drug plan is:
The list of drugs the plan covers
A formulary is the list of prescription drugs the plan covers, often arranged in cost tiers.
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.
