Free Medical Plans Practice Questions
Oklahoma Accident & Health exam — 105 practice questions.
Subtopics: Copayment, Coinsurance, Deductible, HMO, PPO, HDHP and HSA, Out-of-pocket maximum, Preventive care, Network, Continuity of coverage, Clean claims, Defective claims, Claim refunds, Preauthorization, Verification of eligibility, Medical necessity denials, Newborn coverage, Adopted children, Mammography, Insulin cost sharing, Diabetes coverage, Maternity stays, Child immunizations, Health benefit plan defined, Prostate screening, Autism coverage, High deductible plans, Military reinstatement, Premium refund at death, Fee-for-service, Stop-loss, Major medical, POS, Gatekeeper, Utilization review, 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, 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 plan feature that requires the insured to pay a fixed dollar amount per office visit is a:
Copayment
A copayment is a fixed dollar amount the insured pays for a specific service such as an office visit.
2. Under a major medical plan, coinsurance refers to:
The percentage split of costs after the deductible
Coinsurance is the percentage split of covered expenses between the insurer and insured after the deductible is met.
3. The annual amount an insured must pay out of pocket before a major medical plan begins to pay is the:
Deductible
The deductible is the amount the insured pays each year before the plan starts paying covered expenses.
4. A Health Maintenance Organization (HMO) typically requires members to:
Select a primary care physician who coordinates care
HMOs generally require a primary care physician to coordinate care and referrals within the network.
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.
