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  3. Life, Accident & Health
  4. Medical Plans

Free Medical Plans Practice Questions

North Carolina Life, Accident & Health exam — 23 practice questions.

Subtopics: HMO basics, PPO basics, Deductible and coinsurance, HDHP and HSA, Coordination of benefits, Group conversion, Utilization review, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Health reimbursement arrangement, Flexible spending account, Capitation, Precertification, Basic hospital expense, Major medical

Read the Medical Plans study guide

Sample questions & answers

1. A defining characteristic of an HMO is that it generally:

Provides care through a network and emphasizes coordinated, preventive care

HMOs deliver care through a contracted network, often using a primary care physician to coordinate services and emphasizing preventive care.

2. A PPO plan typically offers members:

The option to use out-of-network providers at higher cost

PPOs let members use both in-network and out-of-network providers, with lower cost sharing for staying in network.

3. In a major medical plan, the insured generally pays the deductible and then:

A coinsurance share of covered expenses up to an out-of-pocket maximum

After the deductible, the insured typically pays a coinsurance percentage of covered expenses until reaching the out-of-pocket maximum, after which the plan pays 100 percent.

4. To be eligible to contribute to a health savings account, an individual must be covered by:

A qualified high-deductible health plan

HSA contributions require coverage under a qualified high-deductible health plan and the absence of disqualifying coverage, under federal rules.

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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.