Free Medical Plans Practice Questions
North Carolina Life, Accident & Health exam — 55 practice questions.
Subtopics: HMO basics, PPO basics, Deductible and coinsurance, HDHP and HSA, Coordination of benefits, Group conversion, Utilization review, Disabled dependent children, Newborn coverage, Adopted children, Child enrollment, Direct OB-GYN access, Mammogram coverage, PSA coverage, Diabetes coverage, Preferred provider plans, External review, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Health reimbursement arrangement, Flexible spending account, Capitation, Precertification, Basic hospital expense, Major medical, ACA metal tiers, Essential health benefits, Lifetime limits, Preventive care, Special enrollment, Managed care, Usual, reasonable and customary, Basic surgical, Short-term medical, Vision insurance
Read the Medical Plans study guide
Sample questions & answers
1. A defining characteristic of an HMO is that it generally:
Delivers care through a network of providers
HMOs deliver care through a contracted network, often using a primary care physician to coordinate services and emphasizing preventive care.
2. A PPO plan typically offers members:
Out-of-network care at a higher cost
PPOs let members use both in-network and out-of-network providers, with lower cost sharing for staying in network.
3. In a major medical plan, the insured generally pays the deductible and then:
Coinsurance on covered costs up to an out-of-pocket cap
After the deductible, the insured typically pays a coinsurance percentage of covered expenses until reaching the out-of-pocket maximum, after which the plan pays 100 percent.
4. To be eligible to contribute to a health savings account, an individual must be covered by:
A qualified high-deductible health plan
HSA contributions require coverage under a qualified high-deductible health plan and the absence of disqualifying coverage, under federal rules.
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.
