Free Medical Plans Practice Questions
Mississippi Accident & Health exam — 91 practice questions.
Subtopics: HMO, PPO, Deductible, Coinsurance, Out-of-pocket maximum, HSA, Copayment, Preexisting conditions, Coordination of benefits, Newborn coverage, Newborn notice, Newborn transport, Newborn immunizations, Immunization cost sharing, Medicaid eligibility, Assignment of benefits, COB disclosure, Essential health benefits, Fee-for-service, Stop-loss, Major medical, POS, Gatekeeper, 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, 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, Prescription drugs
Read the Medical Plans study guide
Sample questions & answers
1. A health maintenance organization (HMO) typically requires members to:
Use network providers, often through a primary care doctor
HMOs generally deliver care through a network and often coordinate services through a primary care physician.
2. Compared with an HMO, a preferred provider organization (PPO) generally:
Allows out-of-network care at a higher cost to the member
A PPO allows members to use out-of-network providers but at a higher out-of-pocket cost than network providers.
3. In a major 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 covered expenses.
4. An 80/20 coinsurance provision in a medical plan means that after the deductible the insurer pays:
80 percent while the insured pays 20 percent up to the out-of-pocket limit
Under 80/20 coinsurance, the insurer pays 80 percent and the insured pays 20 percent of covered costs after the deductible, up to the out-of-pocket limit.
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.
