Pearson Vue Health Insurance Practice Test
Exam Questions with Revised Answers (2025
/ 2026) 100% Guarantee Pass.
Charges for which of the following items is NOT considered a covered expense under a Medicare
Supplement policy (Part B)? - CORRECT ANSWERS Dental services
Health insurance policies are offered on a "take it or leave it" basis and referred to as which of the
following types of contracts? - CORRECT ANSWERS Contracts of Adhesion
Under the Claims Forms provision of a health policy, if the insurance company fails to send claim forms
within the time period required, the insured should: - CORRECT ANSWERS Submit the claim in
any form, which must be accepted by the company as adequate proof of loss
In an Accidental Death and Dismemberment (AD&D) policy, capital sum refers to: - CORRECT ANSWERS
A lump sum payment made for an accidental dismemberment
The Coordination of Benefits clause found in group health master contracts is used to: - CORRECT
ANSWERS Avoid double payment of benefits to an insured who has duplicate group coverages
Which of the following definitions MOST accurately describes the Probationary Period? - CORRECT
ANSWERS The waiting period a new hire must satisfy prior to becoming eligible for group
health coverage
A Health Maintenance Organization (HMO) differs from a traditional insurer in that an HMO: - CORRECT
ANSWERS Emphasizes preventive medicine
A married insured has an Accidental Death and Dismemberment (AD&D) policy that names their sibling
as the primary beneficiary and their child as the contingent beneficiary. If the insured and their sibling
,are both killed instantly in a train accident, the policy proceeds would be paid to which of the following?
- CORRECT ANSWERS The insured's child
The Social Security program provides all of the following benefits EXCEPT: - CORRECT ANSWERS
Workers compensation
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to: - CORRECT
ANSWERS Increase the premium rate for an entire class of insureds
A Disability Income policy may provide benefits for which of the following losses? - CORRECT ANSWERS
Residual Disability
Which of the following statements about the Medicare program is CORRECT? - CORRECT ANSWERS
It is a federally sponsored program.
A child has a physical impairment, attends school, and is incapable of self-sustaining employment and/or
self care. Which of the following statements is CORRECT about the child's medical coverage under their
parent's group plan? - CORRECT ANSWERS The child's coverage continues as long as they are
continually incapacitated and financially dependent on their parent.
Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which of the following policy
features? - CORRECT ANSWERS Exclusions
The PRIMARY purpose of Medicaid is to: - CORRECT ANSWERS Provide Medical Expense
coverage to persons below certain minimum income requirements
Which of the following provisions designates to whom claim payments are made? - CORRECT ANSWERS
Payment of Claims
, Under an Accidental Death and Dismemberment (AD&D) policy, insurable interest must exist at which of
the following times? - CORRECT ANSWERS At the inception of the policy
When periodic claim payments are required under a long-term disability income policy, an insurer MUST
make payments to an insured at least once every: - CORRECT ANSWERS Month
A 68 year-old employee that is covered by a group medical insurance plan has medical expenses. The
employee's company health plan is the: - CORRECT ANSWERS Secondary payor
An insured whose Disability Income policy contains a Change of Occupation clause takes a new job in a
more hazardous occupation and fails to notify the insurer of the change. One year later, the insured
becomes disabled. The insurer will most likely take which of the following actions? - CORRECT ANSWERS
Settle the claim according to what the premiums would have purchased under the more hazardous
occupation
The purpose of the Medical Information Bureau (MIB) is to: - CORRECT ANSWERS Share
medical data among member companies
Which of the following laws requires an insurer to notify an applicant in writing that an investigative
consumer report may be made on the applicant? - CORRECT ANSWERS D. Fair Credit Reporting
Act (Insurance Information and Privacy Protection Act)
Which of the following statements is CORRECT about a Waiver of Premium provision in a Disability
Income policy? - CORRECT ANSWERS D. It allows the insured to maintain a policy in force while
disabled and unable to pay premiums.
The Internal Revenue Service (IRS) considers Disability Income benefits paid under an employer-paid
group Disability Income to be: - CORRECT ANSWERS C. fully taxable
Two people own a small interior design studio that employs six people. The owners are concerned about
the financial continuation of the business if either of them should become permanently disabled. In this
Exam Questions with Revised Answers (2025
/ 2026) 100% Guarantee Pass.
Charges for which of the following items is NOT considered a covered expense under a Medicare
Supplement policy (Part B)? - CORRECT ANSWERS Dental services
Health insurance policies are offered on a "take it or leave it" basis and referred to as which of the
following types of contracts? - CORRECT ANSWERS Contracts of Adhesion
Under the Claims Forms provision of a health policy, if the insurance company fails to send claim forms
within the time period required, the insured should: - CORRECT ANSWERS Submit the claim in
any form, which must be accepted by the company as adequate proof of loss
In an Accidental Death and Dismemberment (AD&D) policy, capital sum refers to: - CORRECT ANSWERS
A lump sum payment made for an accidental dismemberment
The Coordination of Benefits clause found in group health master contracts is used to: - CORRECT
ANSWERS Avoid double payment of benefits to an insured who has duplicate group coverages
Which of the following definitions MOST accurately describes the Probationary Period? - CORRECT
ANSWERS The waiting period a new hire must satisfy prior to becoming eligible for group
health coverage
A Health Maintenance Organization (HMO) differs from a traditional insurer in that an HMO: - CORRECT
ANSWERS Emphasizes preventive medicine
A married insured has an Accidental Death and Dismemberment (AD&D) policy that names their sibling
as the primary beneficiary and their child as the contingent beneficiary. If the insured and their sibling
,are both killed instantly in a train accident, the policy proceeds would be paid to which of the following?
- CORRECT ANSWERS The insured's child
The Social Security program provides all of the following benefits EXCEPT: - CORRECT ANSWERS
Workers compensation
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to: - CORRECT
ANSWERS Increase the premium rate for an entire class of insureds
A Disability Income policy may provide benefits for which of the following losses? - CORRECT ANSWERS
Residual Disability
Which of the following statements about the Medicare program is CORRECT? - CORRECT ANSWERS
It is a federally sponsored program.
A child has a physical impairment, attends school, and is incapable of self-sustaining employment and/or
self care. Which of the following statements is CORRECT about the child's medical coverage under their
parent's group plan? - CORRECT ANSWERS The child's coverage continues as long as they are
continually incapacitated and financially dependent on their parent.
Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which of the following policy
features? - CORRECT ANSWERS Exclusions
The PRIMARY purpose of Medicaid is to: - CORRECT ANSWERS Provide Medical Expense
coverage to persons below certain minimum income requirements
Which of the following provisions designates to whom claim payments are made? - CORRECT ANSWERS
Payment of Claims
, Under an Accidental Death and Dismemberment (AD&D) policy, insurable interest must exist at which of
the following times? - CORRECT ANSWERS At the inception of the policy
When periodic claim payments are required under a long-term disability income policy, an insurer MUST
make payments to an insured at least once every: - CORRECT ANSWERS Month
A 68 year-old employee that is covered by a group medical insurance plan has medical expenses. The
employee's company health plan is the: - CORRECT ANSWERS Secondary payor
An insured whose Disability Income policy contains a Change of Occupation clause takes a new job in a
more hazardous occupation and fails to notify the insurer of the change. One year later, the insured
becomes disabled. The insurer will most likely take which of the following actions? - CORRECT ANSWERS
Settle the claim according to what the premiums would have purchased under the more hazardous
occupation
The purpose of the Medical Information Bureau (MIB) is to: - CORRECT ANSWERS Share
medical data among member companies
Which of the following laws requires an insurer to notify an applicant in writing that an investigative
consumer report may be made on the applicant? - CORRECT ANSWERS D. Fair Credit Reporting
Act (Insurance Information and Privacy Protection Act)
Which of the following statements is CORRECT about a Waiver of Premium provision in a Disability
Income policy? - CORRECT ANSWERS D. It allows the insured to maintain a policy in force while
disabled and unable to pay premiums.
The Internal Revenue Service (IRS) considers Disability Income benefits paid under an employer-paid
group Disability Income to be: - CORRECT ANSWERS C. fully taxable
Two people own a small interior design studio that employs six people. The owners are concerned about
the financial continuation of the business if either of them should become permanently disabled. In this
