Alabama Health Insurance Practice Exam Free 2026

• A. To accumulate savings
• B. To pay for or reimburse medical expenses
• C. To replace lost income
• D. To provide a death benefit

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 monthly premium amount
• B. The amount deducted from a claim
• C. The amount the insured must pay before insurance begins covering expenses
• D. The maximum amount the insurer will pay

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 premium sharing between employer and employee
• B. The percentage of costs the insured pays after the deductible is met
• C. Insurance from two companies
• D. Insurance that covers coins and valuables

Correct answer: B. 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 payment shared with another insurer
• B. A fixed amount paid for a covered service at the time of service
• C. A payment for multiple services
• D. The premium payment

Correct answer: B. 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 maximum deductible allowed
• B. The most you have to pay for covered services in a year before insurance pays 100%
• C. The maximum you can pay for premiums
• D. The maximum the insurance company will pay

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 prerequisite for insurance application
• B. A condition for policy renewal
• C. A health condition that existed before coverage began
• D. A condition required for coverage

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

Explanation: A pre-existing condition is a health problem that existed before the start date of new health coverage. Under the ACA, insurers cannot deny coverage or charge more based on pre-existing conditions.

• A. The insurance company's computer system
• B. The facilities, providers, and suppliers a health plan contracts with
• C. A group of insurance agents
• D. Multiple insurance policies working together

Correct answer: B. 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. Previous insurance coverage history
• B. Authorization given before becoming insured
• C. Authorization for premium payments
• D. Approval from the insurer before receiving certain services or medications

Correct answer: D. 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.

• A. Hospital maintenance coverage
• B. A type of Medicare plan
• C. A managed care plan requiring members to use network providers and select a PCP
• D. A government health program

Correct answer: C. A managed care plan requiring members to use network providers and select a PCP

Explanation: An HMO is a type of managed care plan that requires members to use network providers, select a primary care physician (PCP), and get referrals from the PCP to see specialists.

• A. A plan that offers more flexibility to see in-network or out-of-network providers
• B. A policy for preferred customers only
• C. A government-sponsored insurance
• D. A provider who offers premium services

Correct answer: A. A plan that offers more flexibility to see in-network or out-of-network providers

Explanation: A PPO offers more flexibility than an HMO. Members can see any provider but pay less when using in-network providers. Referrals are typically not required to see specialists.

• A. A plan that only covers in-network care except in emergencies
• B. An extended payment option
• C. A plan for executives only
• D. An employee purchase option

Correct answer: A. A plan that only covers in-network care except in emergencies

Explanation: An EPO is a hybrid plan that requires members to use network providers (like an HMO) but typically doesn't require referrals to see specialists (like a PPO). Out-of-network care is only covered in emergencies.

• A. A hospital-focused deductible plan
• B. A high-dollar health plan
• C. A plan with high premiums and low deductibles
• D. A plan with higher deductibles and lower premiums, often paired with an HSA

Correct answer: D. A plan with higher deductibles and lower premiums, often paired with an HSA

Explanation: An HDHP has higher deductibles and lower monthly premiums than traditional plans. HDHPs can be paired with Health Savings Accounts (HSAs) for tax-advantaged savings for medical expenses.