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Free Medical Plans Practice Questions

Alabama Accident & Health exam — 45 practice questions.

Subtopics: HMO, PPO, Gatekeeper, Copayment, POS, HSA, Basic medical, Major medical, Coordination of benefits, Fee-for-service, Deductible, Stop-loss, 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, Out-of-pocket maximum

Read the Medical Plans study guide

Sample questions & answers

1. A defining feature of a Health Maintenance Organization (HMO) is:

Emphasis on prepaid care through a network with a primary care physician

HMOs emphasize prepaid, coordinated care within a network, typically requiring a primary care physician.

2. A Preferred Provider Organization (PPO) generally allows members to:

Use out-of-network providers at higher cost

PPOs let members use out-of-network providers but at higher out-of-pocket cost than in-network care.

3. In an HMO, the primary care physician often acts as a 'gatekeeper' by:

Coordinating care and referring to specialists

The gatekeeper PCP coordinates care and provides referrals to specialists within the HMO.

4. A copayment in a medical plan is:

A flat dollar amount paid at the time of service

A copayment is a fixed dollar amount the member pays for a covered service at the time of care.

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Practice: Medical Plans

Take a randomized, timed-style practice test. Answer choices are shuffled and your results are scored instantly with an explanation for every question.

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.