PEARSON VUE NATIONAL HEALTH INSURANCE
PRACTICE TEST 2026 ACTUAL EXAMINATION
TEST COMPLETE QUESTIONS AND SOLUTIONS
GRADED A+
◉ Individual disability income policy. Answer: Usually60% to 70%
of the insured's current net earnings at time of disablement.
Requires continuance of claim every 6 months.
◉ Business overhead expense policy. Answer: Covers office rent,
utilities, employee labor. However, the owner cannot collect for loss
of income under this policy. Taxable!
◉ Business disability buyout policy. Answer: The Corporation or
business partners can benefit from this policy.
◉ Group disability income policy. Answer: Offered on a
nonoccupational basis.
◉ Key employee policy. Answer: High level executives and vice
presidents are key employees.
,◉ Accidental Death and Dismemberment(AD&D. Answer: Hybrid
policy combines Health and Life policies into 1 policy to rule them
all.
Principal sum (100%) = 2 limbs or death within 90 days of an
accident.
Capital sum (50%) = 1 limb or eyesight within 90 days of an
accident.
◉ Medical expense insurance. Answer: Medical expenses are any
costs incurred in the prevention or treatment of injury or disease.
Medical expenses include doctor and hospital visits, co-payments,
co-insurance, deductibles, prescriptions, and glasses.
◉ Basic hospital, medical, and surgical policies. Answer: Not
designed to provide coverage for catastrophic losses. No deductible
"First Dollar" coverage. No network -choose any provider. Benefit
limits are based on a surgical fee schedule, or a percentage of
expenses incurred. Benefits will be less than the total cost of
services.
◉ Major medical policies. Answer: Cover catastrophic and prolonged
injury or illness. High maximum limit, generally up to a million
dollars. The limit does not include out of pocket expenses including
deductibles and coinsurance.
, ◉ Family Deductible. Answer: If a family is insured, a maximum of 2
-3 deductibles will satisfy the deductible requirement for the entire
family per calendar year.
◉ Common Accident Deductible. Answer: Only one deductible is
paid if several family members are injured in the same accident.
◉ Carryover Provision. Answer: Expenses that did not satisfy the
previous year's deductible and happened in the last 3 months of the
year count towards satisfying the next year's deductible
◉ Health Maintenance Organizations (HMOs). Answer: Subscribers
must live within the service area(in-network).Primary care
physicians (PCPs) act as gatekeepers to specialists and stress
preventative care. Prepaid because of the capitation fee. An HMO
will never pay for services out of network unless it is a bona fide
emergency.
◉ Preferred Provider Organizations (PPOs). Answer: Will cover
services out of network, but at a much lower percentage.
◉ Point of Service (POS) plans. Answer: Combine PPO and HMO
benefits into the same plan.
PRACTICE TEST 2026 ACTUAL EXAMINATION
TEST COMPLETE QUESTIONS AND SOLUTIONS
GRADED A+
◉ Individual disability income policy. Answer: Usually60% to 70%
of the insured's current net earnings at time of disablement.
Requires continuance of claim every 6 months.
◉ Business overhead expense policy. Answer: Covers office rent,
utilities, employee labor. However, the owner cannot collect for loss
of income under this policy. Taxable!
◉ Business disability buyout policy. Answer: The Corporation or
business partners can benefit from this policy.
◉ Group disability income policy. Answer: Offered on a
nonoccupational basis.
◉ Key employee policy. Answer: High level executives and vice
presidents are key employees.
,◉ Accidental Death and Dismemberment(AD&D. Answer: Hybrid
policy combines Health and Life policies into 1 policy to rule them
all.
Principal sum (100%) = 2 limbs or death within 90 days of an
accident.
Capital sum (50%) = 1 limb or eyesight within 90 days of an
accident.
◉ Medical expense insurance. Answer: Medical expenses are any
costs incurred in the prevention or treatment of injury or disease.
Medical expenses include doctor and hospital visits, co-payments,
co-insurance, deductibles, prescriptions, and glasses.
◉ Basic hospital, medical, and surgical policies. Answer: Not
designed to provide coverage for catastrophic losses. No deductible
"First Dollar" coverage. No network -choose any provider. Benefit
limits are based on a surgical fee schedule, or a percentage of
expenses incurred. Benefits will be less than the total cost of
services.
◉ Major medical policies. Answer: Cover catastrophic and prolonged
injury or illness. High maximum limit, generally up to a million
dollars. The limit does not include out of pocket expenses including
deductibles and coinsurance.
, ◉ Family Deductible. Answer: If a family is insured, a maximum of 2
-3 deductibles will satisfy the deductible requirement for the entire
family per calendar year.
◉ Common Accident Deductible. Answer: Only one deductible is
paid if several family members are injured in the same accident.
◉ Carryover Provision. Answer: Expenses that did not satisfy the
previous year's deductible and happened in the last 3 months of the
year count towards satisfying the next year's deductible
◉ Health Maintenance Organizations (HMOs). Answer: Subscribers
must live within the service area(in-network).Primary care
physicians (PCPs) act as gatekeepers to specialists and stress
preventative care. Prepaid because of the capitation fee. An HMO
will never pay for services out of network unless it is a bona fide
emergency.
◉ Preferred Provider Organizations (PPOs). Answer: Will cover
services out of network, but at a much lower percentage.
◉ Point of Service (POS) plans. Answer: Combine PPO and HMO
benefits into the same plan.
