Free Medical Plans Practice Questions
Kansas Life, Accident & Health exam (series 12-KS-05) — 54 practice questions.
Subtopics: Point of service, Fee-for-service, Capitation, UCR charges, Formulary, Flexible spending account, Preventive care, Referral, Mental illness coverage, Substance use coverage, Outpatient mental health, Maternity stays, ACA navigators, Essential health benefits, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Health reimbursement arrangement, Precertification, Basic hospital expense, Major medical, ACA metal tiers, Lifetime limits, 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:
HMO and PPO plans, letting members choose at the time care is needed
A POS plan blends HMO and PPO features, letting members decide in or out of network when care is needed.
2. A traditional indemnity (fee-for-service) plan generally:
Reimburses covered charges and lets the insured choose providers
A fee-for-service indemnity plan reimburses covered charges and lets the insured choose providers freely.
3. Under capitation, an HMO pays a provider:
A fixed amount per member per period
Capitation pays the provider a set amount per member per period regardless of the services actually used.
4. Usual, customary, and reasonable (UCR) charges are used to:
Determine the allowable amount a plan will pay for a service
UCR figures help determine the allowable amount a plan will pay for a given service in an area.
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.
