Free Medical Plans Practice Questions
Georgia Accident & Health exam (series 12-GA-02) — 86 practice questions.
Subtopics: HMO, PPO, Deductible, Coinsurance, Health savings account, Out-of-pocket maximum, Disabled dependents, Newborn coverage, Adopted children, Prompt payment, Fee-for-service, Stop-loss, Major medical, POS, Gatekeeper, Preauthorization, Utilization review, Preventive care, Copayment, 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, Plan concepts, Consumer-driven plans, HDHP and HSA, Cost containment, Grievances and appeals, ACA, Emergency services, Mental health parity, Children's coverage, Prescription drugs
Read the Medical Plans study guide
Sample questions & answers
1. Which feature best describes a health maintenance organization (HMO) plan?
uses a network and a primary care gatekeeper
HMOs deliver care through a contracted network, stress preventive services, and often route care through a primary care gatekeeper.
2. A preferred provider organization (PPO) generally:
lets insureds use out-of-network providers at a higher cost
PPOs allow members to use out-of-network providers, but in-network providers carry lower cost sharing.
3. In a medical expense plan, the deductible is:
what the insured pays before the plan pays
The deductible is the amount the insured must pay out of pocket before the plan begins paying covered expenses.
4. An 80/20 coinsurance arrangement means that, after the deductible:
the insurer pays 80% and the insured pays 20%
With 80/20 coinsurance the plan pays 80 percent and the insured pays 20 percent of covered charges until the out-of-pocket maximum is met.
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.
