Free Medical Plans Practice Questions
Tennessee Life, Accident & Health exam — 55 practice questions.
Subtopics: Point of service, Referrals, Capitation, Preventive care, Usual customary reasonable, Flexible spending account, Health reimbursement arrangement, Limited benefit coverage, Newborn coverage, Prompt pay, External review, Mental health parity, Telehealth, 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, 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 managed-care plan combining HMO-style network care with the option to go out of network at higher cost is a:
Point-of-service (POS) plan
A POS plan blends HMO features with the option to use out-of-network providers at higher cost sharing.
2. In a traditional HMO, access to a specialist usually requires:
A referral from the PCP
Traditional HMOs use the primary care physician as a gatekeeper who must refer members to specialists.
3. Paying a provider a fixed amount per member per month regardless of services used is called:
Capitation
Capitation pays providers a set amount per member per month regardless of the volume of services delivered.
4. Many ACA-compliant plans cover certain preventive services:
With no cost sharing in network
ACA-compliant plans generally cover designated preventive services in network with no cost sharing to the member.
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.
