Free West Virginia Health Insurance Practice Exam Online

Correct answer: B. Copayment

Correct. A copayment is a flat dollar amount the insured pays for a covered service, such as $30 per office visit.

• A: A deductible is the amount paid before benefits begin, not a per-service fee.
• C: Coinsurance is a percentage split of costs, not a flat dollar amount.
• D: The premium is the periodic payment to keep the policy in force, not a per-service charge.

Correct answer: B. Deductible

Correct. The deductible is the amount the insured pays before the insurer's payment obligation begins.

• A: Coinsurance is a percentage of costs shared after the deductible is met.
• C: The stop-loss limit caps total out-of-pocket spending, it is not the initial trigger amount.
• D: Vesting relates to retirement plans, not health insurance.

Correct answer: B. Coinsurance

Correct. Coinsurance is a percentage-based cost-sharing arrangement between insurer and insured after the deductible.

• A: A copayment is a flat dollar amount, not a percentage split.
• C: Premium loading refers to an add-on charge for higher-risk applicants, not cost sharing on claims.
• D: An elimination period is a waiting period before disability or long-term care benefits begin.

Correct answer: B. Health Maintenance Organization (HMO)

Correct. HMOs generally require a primary care physician gatekeeper and referrals for specialist care.

• A: PPOs typically allow members to see specialists without a referral.
• C: Traditional indemnity plans reimburse for services rendered by any provider without a referral requirement.
• D: A high-deductible health plan describes cost-sharing structure, not network/referral rules.

Correct answer: B. PPO

Correct. A PPO offers a network of preferred providers with richer benefits, while still covering out-of-network care at a reduced level.

• A: An HMO generally does not pay for out-of-network care except emergencies.
• C: An EPO generally provides no coverage at all for out-of-network care except emergencies.
• D: A POS plan without out-of-network benefits would not pay for care outside the network.