Free Medical Plans Practice Questions
Missouri Accident & Health exam — 121 practice questions.
Subtopics: Health maintenance organization, Preferred provider organization, Deductible, Coinsurance, Copayment, Out-of-pocket maximum, Health savings account, Major medical, Gatekeeper, Newborn coverage, Adopted children, Handicapped dependents, Dependent children, Mental health parity, Mammography, Immunizations, Formulary changes, Clinical trials, PKU formula, Autism coverage, Cancer screenings, Chiropractic, Physical therapy cost sharing, Telehealth, Speech and hearing, Diabetes, Oral chemotherapy, Breast cancer transplants, Maternity stays, Grievances, Expedited review, Grievance appeals, Grievance procedures, Claims processing, Fee-for-service, Stop-loss, HMO, PPO, POS, Preauthorization, Utilization review, 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, 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, Children's coverage, Prescription drugs
Read the Medical Plans study guide
Sample questions & answers
1. A managed care plan that emphasizes prepaid care through a network and a primary care physician is a(n):
Health maintenance organization
An HMO provides prepaid comprehensive care through a defined network, usually coordinated by a primary care physician.
2. A plan that lets members use out-of-network providers at higher cost is a:
Preferred provider organization
A PPO allows care outside the preferred network but with higher out-of-pocket costs.
3. The amount an insured must pay out of pocket before the health plan begins paying is the:
Deductible
The deductible is the initial amount the insured pays before the plan starts to pay benefits.
4. Under an 80/20 medical plan, the insured's 20 percent share of covered expenses is called:
Coinsurance
Coinsurance is the percentage of covered costs the insured shares with the insurer after 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.
