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Free Medical Plans Practice Questions

Wisconsin Accident & Health exam — 45 practice questions.

Subtopics: HMO, PPO, Deductible, Coinsurance, Copayment, Out-of-pocket maximum, HSA, POS plan, Network provider, 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

Read the Medical Plans study guide

Sample questions & answers

1. A Health Maintenance Organization (HMO) generally:

Provides care through a network and emphasizes a primary care gatekeeper

HMOs deliver care through contracted networks and often require a primary care physician to coordinate services.

2. A Preferred Provider Organization (PPO) typically:

Offers lower costs for using network providers but allows out-of-network care

PPOs encourage use of network providers through lower cost sharing while still allowing out-of-network care at higher cost.

3. A deductible in a medical plan is:

The amount the insured pays before the plan begins paying

The deductible is the amount an insured must pay out of pocket before the plan starts paying benefits.

4. Coinsurance in a health plan refers to:

The percentage of covered costs shared between insurer and insured

Coinsurance is the percentage split of covered expenses between the plan and the insured after the deductible.

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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.