Free Medical Plans Practice Questions
Wisconsin Accident & Health exam (series 22-03) — 109 practice questions.
Subtopics: HMO, PPO, Deductible, Coinsurance, Copayment, Out-of-pocket maximum, HSA, POS plan, Network provider, Dependent coverage, Handicapped children, Newborn coverage, Grandchildren, Adopted children, Mandated benefits, Provider coverage, Emergency services, Grievance, Independent review, Out-of-state providers, 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, Plan concepts, Consumer-driven plans, HDHP and HSA, Cost containment, Grievances and appeals, ACA, Mental health parity, Children's coverage, Prescription drugs
Read the Medical Plans study guide
Sample questions & answers
1. A Health Maintenance Organization (HMO) generally:
Uses a network and 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:
Costs less in network 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:
A percentage of covered costs the insured pays
Coinsurance is the percentage split of covered expenses between the plan and the insured after the deductible.
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.
