Free Medical Plans Practice Questions
Indiana Accident & Health exam — 106 practice questions.
Subtopics: Deductible, Coinsurance, Out-of-pocket maximum, HMO, PPO, Capitation, Coordination of benefits, Health savings account, Preventive care, Mammography coverage, Newborn coverage, Adopted children, Dependent age limit, Disabled dependents, CHIP, ACA metal levels, ACA catastrophic plans, Essential health benefits, Preventive services, Marketplace agent registration, Prompt payment, Grievances, External review, Fee-for-service, Stop-loss, Major medical, POS, Gatekeeper, Preauthorization, Utilization review, Copayment, Comprehensive major medical, HIPAA portability, HIPAA privacy, Dependent to age 26, Exclusive Provider Organization, High-deductible health plan, Closed-panel HMO, Open-panel HMO, Concurrent review, Second surgical opinion, Case management, Out-of-network cost sharing, 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. The amount an insured must pay out of pocket before a medical plan begins to pay is called what?
Deductible
The deductible is the initial amount the insured pays each year before the plan starts sharing covered costs.
2. After the deductible is met, the percentage of covered costs the insured continues to share is called what?
Coinsurance
Coinsurance is the percentage split of covered expenses between the insured and the plan after the deductible.
3. The provision that caps the total an insured pays in a year, after which the plan pays 100 percent, is called what?
Out-of-pocket maximum
The out-of-pocket maximum, or stop-loss, limits the insured's annual cost sharing, after which the plan pays covered expenses in full.
4. A health maintenance organization (HMO) generally requires members to do what?
Select a primary care physician and obtain referrals
HMOs emphasize coordinated care, typically requiring a primary care physician and referrals to see specialists.
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.
