Free Medical Plans Practice Questions
Louisiana Accident & Health exam — 85 practice questions.
Subtopics: HMO, PPO, Coinsurance, Deductible, Copayment, Out-of-pocket maximum, Gatekeeper, Coordination of benefits, Health savings account, Prompt payment, Mandated benefits, HMO definition, 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 key characteristic of a Health Maintenance Organization (HMO) is that it:
Stresses prevention and uses a gatekeeper PCP
HMOs stress preventive care and typically require members to use network providers coordinated by a primary care physician.
2. A Preferred Provider Organization (PPO) typically:
Offers lower costs for in-network providers but allows out-of-network care at higher cost
A PPO gives the insured cost savings for using network providers while still allowing out-of-network care at a higher cost.
3. Coinsurance in a major medical plan refers to:
The insured's percentage share after the deductible
Coinsurance is the percentage split of covered costs between the insured and the insurer after the deductible is met.
4. The deductible in a health plan 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 plan benefits begin.
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.
