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Free Medical Plans Practice Questions

Maryland Accident & Health exam — 45 practice questions.

Subtopics: HMO, PPO, Deductible, Coinsurance, Copayment, Stop-loss / out-of-pocket max, HSA, Preexisting condition, Coordination of benefits, Fee-for-service, Stop-loss, Major medical, POS, Gatekeeper, 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 characteristic of a Health Maintenance Organization (HMO) is:

Care coordinated through a primary care physician and network

HMOs emphasize coordinated, in-network care, often requiring a primary care physician and referrals, with a focus on prevention.

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

Use out-of-network providers at higher cost

PPOs offer a network of preferred providers but allow out-of-network care, usually at higher out-of-pocket cost.

3. A deductible in a medical plan is:

The amount the insured pays before the plan pays

The deductible is the amount the insured must pay out of pocket before the insurer begins paying covered expenses.

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

80% and the insured pays 20% of covered costs

With 80/20 coinsurance, the plan pays 80% of covered expenses and the insured pays the remaining 20% until any out-of-pocket maximum is met.

All Accident & Health topics

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.