Free Medical Plans Practice Questions
South Carolina Life, Accident & Health exam — 51 practice questions.
Subtopics: Gatekeeper, Capitation, Point of service, Preventive care, Network discounts, Basic hospital expense, Surgical schedule, Comprehensive major medical, Newborn coverage, Adopted children, Postpartum stay, Mammography mandate, Clean claim payment, Prompt pay enforcement, Types, Cost sharing, Cost containment, Point-of-service plan, Health savings account, Health reimbursement arrangement, Flexible spending account, Precertification, Major medical, ACA metal tiers, Essential health benefits, Lifetime limits, Special enrollment, HDHP and HSA, Managed care, Usual, reasonable and customary, Basic surgical, Short-term medical, Vision insurance
Read the Medical Plans study guide
Sample questions & answers
1. In a managed care plan that uses a gatekeeper, the primary care physician:
Authorizes referrals
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
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
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 at no cost
Preventive services such as immunizations and screenings are commonly covered with little or no cost sharing; specifics vary by plan.
All Life, Accident & Health topics
Practice: Medical Plans
Answer choices are shuffled every time, and every question comes with an explanation.
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.
