Free Medical Plans Practice Questions
Nevada Accident & Health exam — 104 practice questions.
Subtopics: HMO, PPO, POS, Deductible, Coinsurance, Copayment, Out-of-pocket maximum, Health savings account, Coordination of benefits, Prompt claim payment, Late payment interest, Additional information, Newborn coverage, Adopted children, Preventive services, Mental health parity, Substance use disorder, Reconstructive surgery, Hospice care, Home health care, Telehealth, Silver State Exchange, HMO certificate of authority, Fee-for-service, Stop-loss, Major medical, 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, 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 health plan that emphasizes preventive care and generally requires members to use network providers through a primary care gatekeeper is a(n):
Health maintenance organization
An HMO emphasizes preventive care and usually requires members to use network providers coordinated by a primary care physician.
2. A plan that allows members to use out-of-network providers at higher cost while offering savings for network providers is a:
Preferred provider organization
A PPO offers reduced costs for using preferred network providers while still allowing out-of-network care at a higher cost.
3. A plan that blends HMO features with the option to use out-of-network providers at the point of service is a:
Point-of-service plan
A point-of-service plan combines HMO-style network care with the option to go out of network at the time service is needed.
4. The amount an insured must pay out of pocket before a medical plan begins to pay benefits is the:
Deductible
The deductible is the amount the insured pays before the plan starts paying covered expenses.
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.
