Health Insurance Assessment

1. Which plan type generally won't cover out-of-network care except in an emergency?
- A) PPO
- B) HMO
- C) Any plan with a low deductible
- D) None of them
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: HealthCare.gov says an HMO generally won't cover out-of-network care except in an emergency. A PPO pays toward out-of-network care at an additional cost.
Review: HMO vs. PPO vs. EPO vs. POS: Which Health Plan Type Fits You?
1. Which plan type requires a referral from your primary care doctor to see a specialist?
- A) PPO
- B) EPO
- C) POS
- D) Catastrophic
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: HealthCare.gov says POS plans require a referral from your primary care doctor to see a specialist.
Review: HMO vs. PPO vs. EPO vs. POS: Which Health Plan Type Fits You?
2. What do the Bronze, Silver, Gold and Platinum names describe?
- A) The quality of care
- B) How the plan and you split covered costs on average
- C) The size of the network
- D) How fast claims are paid
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: The categories describe cost sharing: on average Bronze pays about 60% and Platinum about 90%. They have nothing to do with quality of care.
Review: Bronze, Silver, Gold or Platinum: Which Health Plan Level Should You Choose?
2. You qualify for cost-sharing reductions. Which metal level must you choose to get them?
- A) Bronze
- B) Silver
- C) Gold
- D) Platinum
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: The extra savings on deductibles and copays apply only on Silver plans.
Review: Bronze, Silver, Gold or Platinum: Which Health Plan Level Should You Choose?
3. To have a Marketplace plan start January 1, what's the last day to enroll?
- A) November 1
- B) December 15
- C) December 31
- D) January 15
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: HealthCare.gov lists December 15 as the last day to enroll for coverage starting January 1. Open Enrollment itself ends January 15.
Review: When Can You Get Health Insurance? Open Enrollment and Special Enrollment Periods
3. After losing job-based coverage, how long do you generally have to enroll in a Marketplace plan through a Special Enrollment Period?
- A) 7 days
- B) 60 days
- C) 6 months
- D) Until next Open Enrollment only
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: Losing qualifying coverage in the past 60 days can qualify you for a Special Enrollment Period.
Review: When Can You Get Health Insurance? Open Enrollment and Special Enrollment Periods
4. Under federal COBRA, how much can a former employee be required to pay?
- A) Nothing; the employer pays
- B) The same share they paid while working
- C) Up to 102% of the cost to the plan
- D) Half the premium
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: The Department of Labor says qualified individuals may be required to pay the entire premium, up to 102% of the cost to the plan.
Review: Lost Your Job: Should You Choose COBRA or a Marketplace Plan?
4. You choose COBRA and later cancel it voluntarily. Does that open a Special Enrollment Period for a Marketplace plan?
- A) Yes, automatically
- B) Generally no
- C) Only in December
- D) Only if you're under 26
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: HealthCare.gov says voluntarily dropping COBRA doesn't count as a qualifying event.
Review: Lost Your Job: Should You Choose COBRA or a Marketplace Plan?
5. Generally, how long can you stay on a parent's health plan that covers dependents?
- A) Until 18
- B) Until 21, if a student
- C) Until 26
- D) Until you marry
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: HealthCare.gov says you usually can be added to a parent's plan and stay on it until you turn 26.
Review: Can You Stay on Your Parent's Health Insurance Until 26?
5. You're 24, married and offered your own job-based plan. Can you generally stay on a parent's job-based plan?
- A) No, marriage ends it
- B) Yes, generally until 26
- C) Only if you live with them
- D) Only if you decline to work
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: Generally you can stay on a parent's job-based plan until 26 even if you're married or turn down your own job-based coverage.
Review: Can You Stay on Your Parent's Health Insurance Until 26?
6. How long do you generally have to file an internal appeal after a health insurance claim denial?
- A) 10 days
- B) 30 days
- C) 180 days (6 months)
- D) 2 years
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: HealthCare.gov says you must file your internal appeal within 180 days of receiving notice of the denial.
Review: How to Appeal a Health Insurance Claim Denial: Internal Appeal and External Review
6. An independent external reviewer decides in your favor. What must your insurer do?
- A) Nothing; it's advice only
- B) Accept the reviewer's decision
- C) Start a new appeal
- D) Cancel your plan
Practice: you’ve seen the answer to both versions of this question, so it won’t change your Insurance IQ.
Explanation: HealthCare.gov says your insurer is required by law to accept the external reviewer's decision.
Review: How to Appeal a Health Insurance Claim Denial: Internal Appeal and External Review

Educational only: this assessment measures what the course teaches. It says nothing about whether your own insurance is adequate, and it isn’t a professional evaluation of your policy.

Health Insurance: Final Assessment

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