WISCONSIN ACCIDENT AND HEALTH
INSURANCE CORE CONCEPTS AND
APPLICATION QUESTIONS FINAL REVIEW
GRADED A+ 2026.
⫸ After joining a health maintenance organization (HMO), a
subscriber will typically select a
capitation level.
primary care physician.
closed panel.
deductible level. Answer: primary care physician.
⫸ The grouping of two or more small employers in order to obtain
group health insurance at a favorable rate is called a multiple
employer
Grouping.
Trust.
Alliance.
Corporation. Answer: Trust.
⫸ Medicare Part A does NOT provide coverage for
,Inpatient room and board.
Inpatient prescription medication.
First 3 pints of blood.
Skilled nursing facility care. Answer: First 3 pints of blood.
⫸ Which of the following is NOT true of a preferred provider plan?
If service is obtained outside the preferred provider plan, benefits are
reduced and costs increase.
Members of the preferred provider plan select from among the
preferred providers for needed services.
Hospitals can only initiate preferred provider plans.
Preferred provider plans can include dental care. Answer: Hospitals
can only initiate preferred provider plans.
⫸ Which of the following does TRI-CARE provide accident and
health coverage to?
Military families.
Social Security recipients.
Permanently disabled individuals.
Children. Answer: Military families.
,⫸ Medicare will cover a maximum of how many days per benefit
period in a skilled nursing facility?
10 days.
30 days.
60 days.
100 days. Answer: 100 days.
⫸ An individual may receive Medicare Part A Hospital benefits,
regardless of age, as long as the person has
received which of the following benefits for at least 24 months?
Unemployment.
Workers compensation.
Medicaid.
Social Security Disability. Answer: Social Security Disability.
⫸ Inpatient psychiatric care is covered under Part A Medicare
Insurance for 190 days per
billing period.
hospital visit.
year.
lifetime. Answer: lifetime.
, ⫸ All parts of the Medicare program (except for public information
and enrollment) are administered by which federal agency?
The ACA.
The Social Security Administration.
The Department of Homeland Security.
The Centers for Medicare and Medicaid Services. Answer: The
Centers for Medicare and Medicaid Services.
⫸ At what age do most people become eligible for Medicare?
59 1/2.
62.
65.
72. Answer: 65.
⫸ Terry suffers an injury at his workplace which is covered by
workers compensation. Terry also has a medical expense insurance
policy. Under medical expense insurance policies, losses that are
covered by workers compensation are typically
Excluded from coverage.
Partially covered.
Covered, but requiring a higher deductible and copay.
INSURANCE CORE CONCEPTS AND
APPLICATION QUESTIONS FINAL REVIEW
GRADED A+ 2026.
⫸ After joining a health maintenance organization (HMO), a
subscriber will typically select a
capitation level.
primary care physician.
closed panel.
deductible level. Answer: primary care physician.
⫸ The grouping of two or more small employers in order to obtain
group health insurance at a favorable rate is called a multiple
employer
Grouping.
Trust.
Alliance.
Corporation. Answer: Trust.
⫸ Medicare Part A does NOT provide coverage for
,Inpatient room and board.
Inpatient prescription medication.
First 3 pints of blood.
Skilled nursing facility care. Answer: First 3 pints of blood.
⫸ Which of the following is NOT true of a preferred provider plan?
If service is obtained outside the preferred provider plan, benefits are
reduced and costs increase.
Members of the preferred provider plan select from among the
preferred providers for needed services.
Hospitals can only initiate preferred provider plans.
Preferred provider plans can include dental care. Answer: Hospitals
can only initiate preferred provider plans.
⫸ Which of the following does TRI-CARE provide accident and
health coverage to?
Military families.
Social Security recipients.
Permanently disabled individuals.
Children. Answer: Military families.
,⫸ Medicare will cover a maximum of how many days per benefit
period in a skilled nursing facility?
10 days.
30 days.
60 days.
100 days. Answer: 100 days.
⫸ An individual may receive Medicare Part A Hospital benefits,
regardless of age, as long as the person has
received which of the following benefits for at least 24 months?
Unemployment.
Workers compensation.
Medicaid.
Social Security Disability. Answer: Social Security Disability.
⫸ Inpatient psychiatric care is covered under Part A Medicare
Insurance for 190 days per
billing period.
hospital visit.
year.
lifetime. Answer: lifetime.
, ⫸ All parts of the Medicare program (except for public information
and enrollment) are administered by which federal agency?
The ACA.
The Social Security Administration.
The Department of Homeland Security.
The Centers for Medicare and Medicaid Services. Answer: The
Centers for Medicare and Medicaid Services.
⫸ At what age do most people become eligible for Medicare?
59 1/2.
62.
65.
72. Answer: 65.
⫸ Terry suffers an injury at his workplace which is covered by
workers compensation. Terry also has a medical expense insurance
policy. Under medical expense insurance policies, losses that are
covered by workers compensation are typically
Excluded from coverage.
Partially covered.
Covered, but requiring a higher deductible and copay.
