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HEALTH INSURANCE EXAM QUESTIONS & ANSWERS – COMPLETE EXAM PREP (2026 A+ GUIDE)

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Prepare for your Health Insurance Licensing Exam with this comprehensive collection of practice questions and verified answers. Designed to help you master key insurance concepts, regulations, policy provisions, underwriting principles, and claims processing topics commonly tested on certification and licensing exams. This resource is ideal for students, insurance agents, and professionals seeking efficient revision and exam success

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HEALTH INSURANCE EXAM QUESTIONS & ANSWERS –
COMPLETE EXAM PREP (2026 A+ GUIDE)
Which of the following statements is CORRECT about coinsurance?
A: It applies to deductibles as well as to claim payments.

B: It helps control overutilization of benefits.

C: It if effective for the first claim payment and waived for future claims.

D: Insurance companies may adjust the coinsurance ratio after issuing this policy.

B: It helps control overutilization of benefits.




Which of the following health policies requires a beneficiary designation?

A: Travel Accident

B: Medicare Supplement

C: Blanket

D: Long Term Care

A: Travel Accident




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?



A: Cancel the policy and refund one year's premiums

B: Settle the claim according to what the premiums would have purchase under the more
hazardous occupation

,C: Pay the claim in full and then cancel the policy

D: Pay the claim after deducting an extra one-year premium payment

B: Settle the claim according to what the premiums would have purchase under the more
hazardous occupation




The purpose of the Medical Information Bureau (MIB) is to:

A: recommend the premium rates for health policies issued to substandard risks

B: share medical data among member companies

C: provide background data for large group health plans

D: provide actuarial data on dread diseases

B: share medical data among member companies




An applicant for insurance submits an application to an insurer for underwriting but does
not forward any premium payment with the application. Legally, the applicant is making:

A: an inquiry for an offer

B: an offer

C: a counteroffer

D: an acceptance

A: an inquiry for an offer




An insured becomes disabled three years after his Disability Income policy is issued. The
disability is caused by a condition that existed prior to the policy issue date but was not
specifically excluded from the coverage. In this situation, the insurer will most likely take
which of the following actions?

, A: Pay the full claim

B: Pay the claim for a maximum of six months only

C: Deny the claim on the basis of misrepresentation

D: Deny the claim because it involves a pre-existing condition

A: Pay the full claim




A precertification review prior to a nonemergency hospitalization is an example of:



A: managed care

B: Medicaid

C: Medicare

D: Disability Income

A: managed care




Which of the following provisions designates to whom claim payments are made?

A: Time of Payment of Claims

B: Claim Forms

C: Notice of Claim

D: Payment of Claims

D: Payment of Claims




Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to:

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Institución
HEALTH INSURANCE
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HEALTH INSURANCE

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Subido en
9 de junio de 2026
Número de páginas
18
Escrito en
2025/2026
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