Free Medical Plans Practice Questions
Illinois Accident & Health exam — 91 practice questions.
Subtopics: Mandated benefits, External review, HMO, PPO, Deductible, Coinsurance, Copayment, HSA, HMO evidence of coverage, HMO complaints, HMO medical necessity, HMO ambulance, HMO adopted children, HMO and Medicaid, Dependent coverage, Mammography mandate, Form filing, Fee-for-service, Stop-loss, Major medical, POS, Gatekeeper, 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, Out-of-pocket maximum, 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. Illinois law requires health plans that provide the coverage to include benefits for:
Mammography screening
Illinois mandates coverage of certain services such as mammography screening in plans that provide medical benefits.
2. An Illinois insured whose claim is denied as not medically necessary may request:
An independent external review
Illinois law gives insureds the right to an independent external review of adverse medical-necessity determinations.
3. In a traditional HMO the member usually selects a:
Primary care physician who coordinates care
HMO members typically choose a primary care physician who serves as a gatekeeper coordinating care.
4. A PPO encourages members to use network providers by:
Offering lower cost-sharing in network
A PPO offers lower out-of-pocket costs for using preferred network providers.
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.
