1. Exam Prep
  2. New Mexico
  3. Accident & Health
  4. Health Insurance Fundamentals

Free Health Insurance Fundamentals Practice Questions

New Mexico Accident & Health exam — 48 practice questions.

Subtopics: Deductible math, Out-of-pocket maximum, Copayment, HMO, PPO, Indemnity, Group eligibility, Premium math, Insurable interest, Reinstatement, Conditional receipt, Producer responsibility, Fee-for-service, Deductible, 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

Sample questions & answers

1. A New Mexico health plan has a $1,500 deductible and 80/20 coinsurance. After meeting the deductible the insured incurs an additional $2,000 in covered charges. How much of that $2,000 does the insured pay in coinsurance?

$400

After the deductible, the insured pays the 20% coinsurance share: 20% of $2,000 equals $400.

2. The out-of-pocket maximum in a New Mexico health plan represents the point after which the plan generally pays:

100% of covered essential benefits for the rest of the year

Once the out-of-pocket maximum is reached the plan pays 100% of covered essential benefits for the remainder of the plan year.

3. A copayment in a New Mexico health plan is:

A fixed dollar amount the insured pays for a covered service

A copayment is a set dollar amount the insured pays for a specific covered service at the time of care.

4. A key feature of an HMO offered in New Mexico is that members generally:

Receive care through a network and often a primary care physician

HMOs deliver care through a contracted network and commonly require a primary care physician to coordinate services.

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Practice: Health Insurance Fundamentals

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.