Free Medical Plans Practice Questions
North Dakota Life, Accident & Health exam — 55 practice questions.
Subtopics: Point of service, Exclusive provider organization, Usual customary reasonable, Capitation, Basic surgical expense, Comprehensive major medical, Flexible spending account, Health reimbursement arrangement, Self-inflicted injury, Newborn coverage, Disabled dependents, Children's coverage, Renewability, Short-term plans, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Precertification, 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, Short-term medical, Vision insurance
Read the Medical Plans study guide
Sample questions & answers
1. A point-of-service (POS) managed care plan is best described as one that:
Allows out-of-network care at higher cost
A POS plan blends HMO features with the option to use out-of-network providers at greater cost.
2. A managed care plan that covers services only from in-network providers, except in emergencies, and pays nothing out of network is typically a(n):
Exclusive provider organization
An EPO generally covers only in-network care except emergencies, with no benefits for out-of-network services.
3. The usual, customary, and reasonable (UCR) standard is used by health plans to:
Set allowable charges by area
UCR establishes the allowable amount for a service based on customary charges in the area.
4. Under a capitation arrangement, a provider is paid:
A set fee per member per month
Capitation pays the provider a fixed amount per enrolled member per period regardless of the services actually rendered.
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.
