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Free Medical Plans Practice Questions

Maine Accident & Health exam — 45 practice questions.

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

Read the Medical Plans study guide

Sample questions & answers

1. A key feature of a Health Maintenance Organization (HMO) is that members usually:

Select a primary care physician who coordinates care and referrals

HMO members typically choose a primary care physician who manages care and provides referrals to specialists.

2. Compared with an HMO a Preferred Provider Organization (PPO) generally:

Allows members to use out-of-network providers at a higher cost

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

3. In a 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 before the plan starts paying benefits.

4. Coinsurance in a medical plan refers to:

The percentage of covered costs the insured shares after the deductible

Coinsurance is the percentage of covered costs the insured pays after meeting the deductible.

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.