PROFESSIONAL TEST PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
COMPREHENSIVE REVIEW GRADED A+
⩥ 80%.
Answer: Medicare Part B only covers what percent?
⩥ Yes.
Answer: Does Medicare Part B cover oxygen?
⩥ Physicians Services
Outpatient hospital services
Medical equipment and supplies.
Answer: Medicare Part B covers:
⩥ Medicare Part C.
Answer: Also known as the Medicare Advantage plan operated by
private companies. Covers medications transportation exxtra
⩥ Medicaid eligibility.
Answer: Based on income and financial resources.
,If you've already been receiving government Social Security
If a child less than 21 years old and has a disability severe enough to
meet disability standards under Social Security disability. Parental
income is disregarded
⩥ Skilled home health care and long-term care.
Answer: Medicaid covers
⩥ SCHIP.
Answer: State children's health insurance program
⩥ SCHIP.
Answer: administered by the center for Medicare and Medicaid.
Government gives money to 2 approved State programs up to the age of
19
⩥ subsidy.
Answer: financial assistance that you do not have to pay back
⩥ premium.
Answer: amount that you pay monthly for insurance
⩥ cost sharing.
,Answer: amount of money paid out of pocket, includes copays,
deductible. Does not include premiums.
⩥ tricare prime.
Answer: for active duty military members to help them be "fit for duty"
⩥ tricare standard.
Answer: fee-for-service insurance option. You can see any tricare
authorized provider inside or outside of network.
⩥ tricare extra.
Answer: insurance option, you don't have to pain an annual fee but you
have an annual deductible. outpatient discounts on cost-sharing.
⩥ deductible.
Answer: amount of money that you must pay before the insurance will
pay a claim.
⩥ health maintenance organization (HMO).
Answer: a health insurance provider for a group of people in a
geographical area that delivers agreed to set of services and products to
an enrolled group for a predetermined periodic payment (usually
monthly). Patients have to see in network providers. Your PCP has to
, give you a referral for outside specialists except: internists, OB/GYN
and pediatrics. Requires preauthorization for outside providers.
⩥ preferred provider organization (PPO).
Answer: pooled group of providers who are able to pool their resources.
Have a stronger negotiating power with health maintenance
organizations.
⩥ point of service providers (POS).
Answer: insurance benefit for HMOs or PPOs to see any provider in or
out of network for an additional premium. gate keeper = requires a PCP
referral.
⩥ self insured.
Answer: large companies use this. They need a third party administer to
handle claims. Case managers report to the third party administer.
⩥ fee for service.
Answer: type of payment where providers are paid for each service.
⩥ capitation.
Answer: type of payment to a provider for a group of people assigned to
them where there is a fixed cost per person, per time period , not