New Mexico Life & Health Insurance Exam — All Questions
AllGeneral Insurance ConceptsLife Insurance BasicsLife Insurance PoliciesLife Policy Provisions, Riders, Options & ExclusionsAnnuitiesLife & Annuity Taxation and UsesHealth Insurance BasicsHealth PoliciesHealth Policy Provisions, Clauses & RidersGroup Insurance, Social Insurance & Senior ProductsNew Mexico Producer LicensingNew Mexico Insurance LawNew Mexico Ethics & Marketing
53 questions
Health Policies
In a PPO, using an out-of-network provider generally results in:
- a.Coverage at a higher out-of-pocket cost to the insured✓
- b.A cash bonus to the insured
- c.No coverage whatsoever
- d.The same cost as staying in-network
A PPO still covers out-of-network care but at a higher cost to the insured, preserving flexibility. It neither denies out-of-network care nor charges the same as in-network.
Health Policies
A Point-of-Service (POS) plan:
- a.Covers only emergency and urgent care services and provides no coverage at all for routine visits, whether they are in-network or out-of-network
- b.Never uses a primary care physician
- c.Blends HMO and PPO features, letting the member choose in-network (gatekeeper) or out-of-network care at the time of service✓
- d.Is identical to traditional indemnity coverage
A POS plan combines HMO gatekeeping for the lowest cost with the option to go out-of-network at higher cost, deciding at the point of service. It is not the same as indemnity coverage.
Health Policies
To contribute to a Health Savings Account (HSA), an individual must be covered by a:
- a.Stand-alone dental plan
- b.Qualified high-deductible health plan (HDHP)✓
- c.Low-deductible HMO plan
- d.Medicare plan
HSA contributions require enrollment in a qualified high-deductible health plan and no disqualifying coverage. Low-deductible HMOs, Medicare, and dental plans do not qualify a person to fund an HSA.