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  3. Life, Accident & Health
  4. Medical Plans

Free Medical Plans Practice Questions

Alabama Life, Accident & Health exam — 24 practice questions.

Subtopics: HMO prepaid care, Network discounts, Referral requirement, Capitation, HDHP, Preventive care, Utilization review, Out-of-pocket maximum, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Health reimbursement arrangement, Flexible spending account, Precertification, Basic hospital expense, Major medical

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Sample questions & answers

1. HMOs are distinguished from indemnity plans primarily by their emphasis on:

Prepaid, coordinated care delivered through a network

HMOs provide prepaid, coordinated care through a defined network, unlike open indemnity reimbursement.

2. PPO members generally pay less when they:

Use in-network preferred providers

PPOs negotiate discounts with preferred providers, so in-network care costs the member less.

3. Compared with a PPO, an HMO is more likely to require:

A primary care physician referral to see specialists

HMOs commonly require a PCP referral for specialist care, while PPOs usually do not.

4. Under capitation, an HMO pays a provider:

A fixed amount per member per period regardless of services used

Capitation pays providers a set amount per enrolled member per period, shifting some utilization risk to providers.

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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.