Free Medical Plans Practice Questions
Maine Accident & Health exam (series 12-ME-42) — 126 practice questions.
Subtopics: HMO, PPO, Deductible, Coinsurance, Copayment, Health savings account, Out of pocket maximum, Point of service, High deductible health plan, Newborn coverage, Maternity, Home health care, Domestic partners, Dependent children, Disabled dependents, Emergency services, Preventive services, Benefit limits, Rate discrimination, Rate factors, Guaranteed issue, Residency, Continuity of coverage, Short-term medical, Rescission, HMO alternative, HMO open enrollment, HMO benefits, Primary care choice, OB/GYN access, External review, Utilization review, Preferred providers, Pharmacy benefit managers, Health discrimination, HIV questions, HIV underwriting, Cold lead advertising, Fee-for-service, Stop-loss, Major medical, POS, Gatekeeper, Preauthorization, 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, 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, Mental health parity, Children's coverage, Prescription drugs
Read the Medical Plans study guide
Sample questions & answers
1. A key feature of a Health Maintenance Organization (HMO) is that members usually:
Select a primary care physician who coordinates care and referrals
HMO members typically choose a primary care physician who manages care and provides referrals to specialists.
2. Compared with an HMO a Preferred Provider Organization (PPO) generally:
Allows members to use out-of-network providers at a higher cost
A PPO lets members use out-of-network providers but at a higher out-of-pocket cost than in-network care.
3. In a medical plan, the deductible 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 the plan starts paying benefits.
4. Coinsurance in a medical plan refers to:
The percentage of covered costs the insured shares after the deductible
Coinsurance is the percentage of covered costs the insured pays after meeting the deductible.
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.
