Free Medical Plans Practice Questions

South Carolina Life, Accident & Health exam — 24 practice questions.

Subtopics: Gatekeeper, Capitation, Point of service, Preventive care, Network discounts, Basic hospital expense, Surgical schedule, Comprehensive major medical, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Health reimbursement arrangement, Flexible spending account, Precertification, Major medical

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Sample questions & answers

1. In a managed care plan that uses a gatekeeper, the primary care physician:

Coordinates care and authorizes referrals to specialists

In a gatekeeper model, the primary care physician coordinates care and must authorize referrals to specialists.

2. Under a capitation arrangement, a provider is paid:

A fixed amount per member per period regardless of services used

Capitation pays the provider a set amount per enrolled member per period, regardless of the volume of services used.

3. A point-of-service (POS) plan combines features of:

An HMO and a PPO, with the choice made at the time of service

A POS plan blends HMO and PPO features, letting the member decide in-network or out-of-network care at the point of service.

4. Many medical plans cover preventive services such as immunizations:

Often with little or no cost sharing

Preventive services such as immunizations and screenings are commonly covered with little or no cost sharing; specifics vary by plan.

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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.