Free Health Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Health practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A self-employed consultant wants insurance that replaces part of her earnings if illness prevents her from working. Which coverage best addresses that need?

   1. A. Hospital indemnity insurance
   2. B. Disability income insurance
   3. C. Major medical insurance
   4. D. Accidental death insurance

   Answer: B

   Explanation: NAIC defines disability income as compensation for "a portion of the income they lose because of a disabling injury or illness." The consultant needs income replacement. Major medical addresses medical expenses, hospital indemnity pays a hospital-related fixed benefit, and accidental death insurance requires an accidental death rather than inability to work.

   Reference: NAIC Glossary of Insurance Terms — Disability Income

2. 2A D.C. accident-and-sickness policy uses the prescribed entire-contract provision. A producer orally promises to remove an exclusion. What approval and documentation would make a policy change valid under that provision?

   1. A. The producer's approval, documented in the agency's client file
   2. B. The insured's approval, documented in a letter to the producer
   3. C. An executive officer's approval, endorsed on or attached to the policy
   4. D. A claim examiner's approval, documented in the insurer's claim file

   Answer: C

   Explanation: "No change in this policy shall be valid until approved by an executive officer of the insurer and unless such approval be endorsed hereon or attached hereto. No agent has authority to change this policy or to waive any of its provisions." Only executive-officer approval endorsed on or attached to the policy satisfies the change provision. The producer, insured's letter, and claim examiner do not supply that combination of authority and policy documentation.

   Reference: D.C. Code § 31-4712, Accident and Sickness Policies — § 31–4712(c)(1)(A); archived text, flow line 57

3. 3A beneficiary with Original Medicare receives a covered outpatient physician service. Which Medicare part provides the medical-insurance coverage for that service?

   1. A. Part A
   2. B. Part B
   3. C. Part C
   4. D. Part D

   Answer: B

   Explanation: Medicare.gov states that Part B covers "Services from doctors and other health care providers" and outpatient care. Part A is principally hospital insurance, Part C is the Medicare Advantage alternative, and Part D concerns prescription drugs. The question concerns an Original Medicare outpatient physician service, so Part B is the applicable part.

   Reference: Medicare.gov Parts of Medicare — Part B (Medical Insurance)

4. 4A surgeon's policy uses an own-occupation disability definition. Illness prevents her from performing surgery, though she could do a suitable teaching job and is not currently working in it. How does that other-work capacity affect the own-occupation assessment?

   1. A. Capacity for other work does not by itself defeat the own-occupation assessment.
   2. B. Inability to perform every suitable occupation must also be established for the assessment.
   3. C. Loss of a specified bodily function must also be established for the assessment.
   4. D. Reduced earnings from a job currently being performed must also be established for the assessment.

   Answer: A

   Explanation: NAIC distinguishes policies paying when the insured cannot perform "the duties of your occupation" from policies requiring inability to do any qualified gainful work. Capacity for another job does not alone defeat the stated own-occupation test. Any-occupation incapacity, presumptive bodily loss, and residual earnings tests are different disability concepts; other actual policy conditions still apply.

   Reference: NAIC Simplifying the Complications of Disability Insurance — Comparing Disability Policies, Definition of Disability

5. 5An insurer requests a consumer report containing medical information to evaluate a disability application. Under the FCRA rule described by the FTC, whose permission must be obtained before the consumer reporting agency can issue the report?

   1. A. The applicant's employer
   2. B. The insurance producer
   3. C. The insurance company
   4. D. The insurance applicant

   Answer: D

   Explanation: "If you need a consumer report that has medical information, you must get the applicant’s permission before the CRA can issue the report." The applicant must authorize acquisition of the medical-information report. The employer, producer and insurer are real participants in insurance or report transactions, but permission from one of them does not substitute for the applicant permission required here.

   Reference: FTC Consumer Reports: What Insurers Need to Know — Medical-information permission paragraph, archived flow lines 519–520

6. 6Who appoints the District of Columbia Commissioner of Insurance, Securities, and Banking?

   1. A. The Mayor, with the advice and consent of the Council
   2. B. The Council, with the advice and consent of the Mayor
   3. C. The Chief Judge of the Superior Court
   4. D. The Attorney General of the District

   Answer: A

   Explanation: D.C. Code § 31-104 provides that the Commissioner is appointed by the Mayor with the advice and consent of the Council. The controlling text states: "The Commissioner shall be appointed by the Mayor, with the advice and consent of the Council".

   Reference: § 31–104. Commissioner of the Department of Insurance, Securities, and Banking. | D.C. Law Library — § 31-104(a)

7. 7What minimum inpatient stay must covered D.C. maternity and newborn care include after a vaginal delivery?

   1. A. 48 hours
   2. B. 24 hours
   3. C. 72 hours
   4. D. 96 hours

   Answer: A

   Explanation: D.C. Code § 31-3802.01(a) requires a minimum in-hospital stay of 48 hours after a vaginal delivery. The controlling text states: "minimum of 48 hours after a vaginal delivery".

   Reference: Chapter 38. Newborn Health Insurance. | D.C. Law Library — § 31-3802.01(a)

8. 8An architect's personal disability policy replaces part of her salary. She also wants money to pay office rent, utilities, and employee payroll while she recovers from a disabling illness. Which additional protection fits these expenses?

   1. A. Business disability buyout insurance
   2. B. Group disability income insurance
   3. C. Individual disability income insurance
   4. D. Business overhead expense insurance

   Answer: D

   Explanation: NAIC explains that overhead coverage pays "standard business expenses such as payroll, utilities, rent, etc., while the business owner recovers from a disability." These operating costs differ from individual or group income benefits replacing personal earnings, and from a disability buyout funding a transfer of ownership.

   Reference: NAIC Small Business Insurance — Disability Insurance, business overhead insurance paragraph

9. 9A D.C. policy contains the prescribed Time Limit on Certain Defenses clause, including its fraudulent-misstatement exception. For a loss beginning after the protected period, what is the minimum elapsed period after issue beyond which an ordinary nonfraudulent application misstatement cannot be used to void the policy or deny that loss?

   1. A. 1 year
   2. B. 2 years
   3. C. 3 years
   4. D. 5 years

   Answer: C

   Explanation: "After 3 years from the date of issue of this policy no misstatements, except fraudulent misstatements, made by the applicant in the application for such policy shall be used to void the policy or to deny a claim for loss incurred or disability (as defined in the policy) commencing after the expiration of such 3-year period." The ordinary nonfraudulent-misstatement period is three years for a loss beginning afterward. The fraudulent-misstatement exception remains; one, two, and five years are not this prescribed period.

   Reference: D.C. Code § 31-4712, Accident and Sickness Policies — § 31–4712(c)(1)(B)(i); archived text, flow line 61

10. 10A family seeks public medical coverage based on qualifying low income rather than Medicare age or disability entitlement. Which program should the producer identify as the relevant medical-assistance program?

    1. A. Medicaid
    2. B. Medicare
    3. C. Social Security Disability Insurance
    4. D. COBRA continuation coverage

    Answer: A

    Explanation: HealthCare.gov describes Medicaid as "free or low-cost health coverage to some low-income people, families and children" and other eligible groups. Medicaid is therefore the relevant program to investigate. Medicare and SSDI use different eligibility foundations, while COBRA continues qualifying group coverage rather than providing means-related public medical assistance.

    Reference: HealthCare.gov Medicaid Glossary — Medicaid, definition