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Free Medical Plans Practice Questions

Illinois Accident & Health exam — 34 practice questions.

Subtopics: Fee-for-service, Deductible, Stop-loss, Major medical, HMO, PPO, 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

Read the Medical Plans study guide

Sample questions & answers

1. A fee-for-service (indemnity) medical plan generally:

Lets the insured choose providers and reimburses covered charges

Fee-for-service plans reimburse covered expenses and typically allow the insured to choose providers freely.

2. A deductible in a medical plan is the amount the insured must pay:

Out of pocket before the plan begins to pay

The deductible is the initial amount the insured pays before the plan starts paying covered expenses.

3. A stop-loss (out-of-pocket maximum) provision protects the insured by:

Capping the insured's total out-of-pocket cost, after which the plan pays 100 percent

The stop-loss limits the insured's annual out-of-pocket costs; beyond it the plan pays 100 percent of covered expenses.

4. Major medical insurance is characterized by:

High maximum limits, deductibles, and coinsurance for a broad range of services

Major medical provides broad coverage with high limits, using deductibles and coinsurance to share costs.

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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 Pennsylvania Insurance Department and the exam administrator before relying on it.