Free Medical Plans Practice Questions
Maine Life, Accident & Health exam (series 12-ME-01) — 90 practice questions.
Subtopics: Flexible spending account, Capitation, Fee-for-service, Precertification, Usual customary and reasonable, Health reimbursement arrangement, Stop-loss feature, Exclusive provider organization, 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, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Basic hospital expense, Major medical, ACA metal tiers, Essential health benefits, Lifetime limits, Preventive care, Special enrollment, HDHP and HSA, Managed care, Usual, reasonable and customary, Basic surgical, Vision insurance
Read the Medical Plans study guide
Sample questions & answers
1. A flexible spending account (FSA) generally allows an employee to:
Set aside pretax dollars for eligible medical expenses
An FSA lets employees fund eligible out-of-pocket medical costs with pretax dollars, subject to use-it-or-lose-it rules.
2. Under a capitation arrangement, an HMO pays a contracted provider:
A fixed amount per member per month regardless of services used
Capitation pays the provider a set fee per enrolled member each month, shifting some utilization risk to the provider.
3. A traditional fee-for-service (indemnity) medical plan generally:
Reimburses covered services with broad freedom to choose providers
A fee-for-service plan reimburses for covered services and lets the insured choose providers fairly freely.
4. Precertification (prior authorization) in a managed care plan is used to:
Review the medical necessity of a service before it is provided
Precertification reviews whether a proposed service is medically necessary before it is rendered to control costs.
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.
