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Free Medical Plans Practice Questions

Colorado Accident & Health exam — 45 practice questions.

Subtopics: HMO, PPO, Deductible, Coinsurance, Out-of-pocket maximum, Copayment, Health savings account, Preventive care, Point-of-service plan, Fee-for-service, Stop-loss, Major medical, POS, Gatekeeper, Preauthorization, 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

Read the Medical Plans study guide

Sample questions & answers

1. A health maintenance organization (HMO) typically requires members to:

Receive care from network providers and often select a primary care physician

An HMO emphasizes network care and a primary care physician who coordinates services and referrals, generally with low cost-sharing in network.

2. Compared with an HMO, a preferred provider organization (PPO) generally:

Allows out-of-network care at a higher cost to the insured

A PPO lets members use out-of-network providers but at higher out-of-pocket cost than using preferred in-network providers.

3. In a major medical plan, the deductible is:

The amount the insured pays before the plan begins to pay

The deductible is the amount the insured must pay out of pocket each period before the plan starts paying covered expenses.

4. An 80/20 coinsurance provision means that after the deductible, the plan pays:

80 percent and the insured pays 20 percent of covered costs up to the out-of-pocket limit

With 80/20 coinsurance, the plan pays 80 percent and the insured pays 20 percent of covered costs until the out-of-pocket maximum is reached.

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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.