Alabama Health Insurance Practice Exam Free - 2026

• A. Within 10 days of the loss
• B. Within 30 days of the loss
• C. Within 90 days of the loss
• D. Within 20 days after the loss, or as soon thereafter as reasonably possible

Correct answer: D. Within 20 days after the loss, or as soon thereafter as reasonably possible

Explanation: Ala. Code § 27-19-8 requires written notice of claim within 20 days after the occurrence or commencement of any covered loss, or as soon thereafter as reasonably possible; notice to an authorized agent is notice to the insurer. Option C (90 days) is the proof-of-loss deadline under § 27-19-10, not notice. Options A and B are not statutory periods. See Ala. Code § 27-19-8.

• A. 15 days
• B. 20 days
• C. 30 days
• D. 45 days

Correct answer: A. 15 days

Explanation: Ala. Code § 27-19-9 (Claim Forms) provides that if the insurer does not furnish claim forms within 15 days after notice of claim, the claimant is deemed to have complied with proof-of-loss requirements by submitting written proof of the occurrence, character and extent of loss within the policy's proof-of-loss time. Option B is the notice-of-claim period; option D is the conditional-receipt reinstatement period; option C is not in this provision. See Ala. Code § 27-19-9.

• A. Proof must always be filed within 90 days; no exceptions.
• B. Within 90 days, but if not reasonably possible, as soon as possible and no later than one year (absent legal incapacity).
• C. Within 180 days in all cases.
• D. Within three years of the loss.

Correct answer: B. Within 90 days, but if not reasonably possible, as soon as possible and no later than one year (absent legal incapacity).

Explanation: Ala. Code § 27-19-10 requires written proof of loss within 90 days, but failure to do so does not invalidate the claim if it was not reasonably possible, provided proof is furnished as soon as reasonably possible and, except in the absence of legal capacity, no later than one year from the time proof is otherwise required. Option A ignores the exception; option C is not a statutory period; option D is the legal-actions limit under § 27-19-14. See Ala. Code § 27-19-10.

• A. Immediately, and within one year of the loss
• B. After 30 days, and within two years of the loss
• C. Not before 60 days after proof of loss, and not after three years from when proof was required
• D. After 90 days, and within five years

Correct answer: C. Not before 60 days after proof of loss, and not after three years from when proof was required

Explanation: Ala. Code § 27-19-14 requires the provision that no action may be brought before 60 days after written proof of loss is furnished, nor after three years from the time written proof of loss is required. Options A, B and D misstate both the waiting period and the limitation period. See Ala. Code § 27-19-14.

• A. To build tax-deferred cash value for retirement
• B. To pay for or reimburse medical expenses
• C. To indemnify the insured for damage to property
• D. To provide a death benefit to named beneficiaries

Correct answer: B. To pay for or reimburse medical expenses

Explanation: The primary purpose of health insurance is to pay for or reimburse medical expenses including hospitalization, doctor visits, medications, and other healthcare services.

• A. The maximum amount the insurer will pay for covered expenses in a policy year
• B. The percentage of covered expenses the insured shares with the insurer after the deductible
• C. The amount the insured must pay before insurance begins covering expenses
• D. The fixed dollar amount the insured pays each time a covered service is received

Correct answer: C. The amount the insured must pay before insurance begins covering expenses

Explanation: A deductible is the amount the insured must pay out-of-pocket for covered healthcare services before the insurance company begins to pay. Higher deductibles generally mean lower premiums.

• A. The fixed dollar amount the insured pays at the time a covered service is received
• B. The amount the insured must pay each year before the plan begins paying benefits
• C. The rule deciding which plan pays first when the insured is covered by two plans
• D. The percentage of costs the insured pays after the deductible is met

Correct answer: D. The percentage of costs the insured pays after the deductible is met

Explanation: Coinsurance is the percentage of covered healthcare costs that the insured pays after the deductible has been met. For example, with 80/20 coinsurance, the insurer pays 80% and the insured pays 20%.

• A. A fixed amount paid for a covered service at the time of service
• B. A percentage of the bill the insured pays after the deductible is met
• C. The amount the insured pays each year before the plan starts to pay
• D. The periodic amount paid to the insurer to keep the policy in force

Correct answer: A. A fixed amount paid for a covered service at the time of service

Explanation: A copayment is a fixed dollar amount that the insured pays for a covered healthcare service at the time of service. For example, a $30 copay for a doctor visit or $10 copay for a generic prescription.

• A. The highest deductible a plan may charge before it must begin sharing your costs
• B. The most you have to pay for covered services in a year before insurance pays 100%
• C. The most the insurance company will pay for your covered services during the year
• D. The total premium you can be charged for coverage during a single policy year

Correct answer: B. The most you have to pay for covered services in a year before insurance pays 100%

Explanation: The out-of-pocket maximum is the most you'll pay during a policy period for covered services through deductibles, copays, and coinsurance. After reaching this limit, the insurance company pays 100% of covered expenses.

• A. A condition that first appears during the probationary period
• B. A chronic condition that is not covered under any health plan
• C. A health condition that existed before coverage began
• D. A medical exam the insurer requires before issuing a policy

Correct answer: C. A health condition that existed before coverage began

Explanation: A pre-existing condition is generally a condition for which the insured received diagnosis, care, or treatment before the coverage began. For ACA-compliant individual and group major medical coverage, insurers may not deny coverage, exclude the condition, or charge more because of it. Excepted benefits such as disability income, long-term care, and hospital indemnity coverage may still underwrite and apply pre-existing condition limits, as may short-term limited-duration insurance, which is not treated as individual health insurance coverage.

• A. The group of insurers that share a large risk under a reinsurance treaty
• B. The list of prescription drugs a health plan agrees to cover
• C. The producers and agencies appointed to sell a health plan's policies
• D. The facilities, providers, and suppliers a health plan contracts with

Correct answer: D. The facilities, providers, and suppliers a health plan contracts with

Explanation: A network is the group of doctors, hospitals, pharmacies, and other healthcare providers that have contracted with a health insurance plan to provide services at negotiated rates.

• A. Approval from the insurer before receiving certain services or medications
• B. An insurer review conducted after treatment to decide whether it was medically necessary
• C. The insured's written consent allowing the insurer to obtain medical records
• D. Evidence of prior creditable coverage submitted when applying for a new policy

Correct answer: A. Approval from the insurer before receiving certain services or medications

Explanation: Prior authorization (also called pre-authorization) is approval from the insurance company required before the insured can get a specific service or medication. Without it, the insurer may not pay for the service.