Free Medical Plans Practice Questions
Wyoming Accident & Health exam — 100 practice questions.
Subtopics: Health maintenance organization, Preferred provider organization, Deductible, Coinsurance, Copayment, Out-of-pocket maximum, Health savings account, Capitation, Gatekeeper, Basic hospital expense, Major medical, Usual customary reasonable, Diabetes coverage, Discretionary clauses, Child health insurance program, Wyoming Health Insurance Pool, HMOs, Fee-for-service, Stop-loss, HMO, PPO, POS, Preauthorization, Utilization review, Preventive care, Coordination of benefits, Comprehensive major medical, HIPAA portability, HIPAA privacy, Dependent to age 26, Exclusive Provider Organization, High-deductible health plan, 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, Mental health parity, Children's coverage, Newborn coverage, Prescription drugs
Read the Medical Plans study guide
Sample questions & answers
1. A health maintenance organization (HMO) typically emphasizes:
Preventive care delivered through network providers, often via a primary care physician
HMOs stress preventive care and the use of network providers, frequently coordinated through a primary care physician.
2. A preferred provider organization (PPO) generally allows members to:
Use out-of-network providers, though at a higher cost
A PPO lets members see out-of-network providers but pays a larger share when in-network providers are used.
3. The amount an insured must pay out of pocket before the health plan begins paying covered expenses is the:
Deductible
The deductible is the initial amount the insured must pay before the plan starts paying covered expenses.
4. Under an 80/20 coinsurance arrangement, after the deductible is met the insured generally pays:
20 percent of covered charges up to the out-of-pocket maximum
With 80/20 coinsurance the plan pays 80 percent and the insured pays 20 percent of covered charges until the out-of-pocket limit is reached.
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.
