Maryland Health Insurance Practice Exam Free - 2026

• A. 10 days after the loss
• B. 31 days after the loss
• C. 20 days after the occurrence or commencement of the loss, or as soon thereafter as reasonably possible
• D. 90 days after the loss

Correct answer: C. 20 days after the occurrence or commencement of the loss, or as soon thereafter as reasonably possible

Explanation: Maryland's required health policy provision states that written notice of claim must be given within twenty (20) days after the occurrence or commencement of any covered loss, or as soon thereafter as is reasonably possible. Option A is too short. Option B is the grace period for most policies, not the notice period. Option D is the proof-of-loss period, not the notice period. See Md. Code, Ins. § 15-211.

• A. 20 days after the loss
• B. 60 days after the loss
• C. 180 days after the loss
• D. 90 days after the loss, unless it was not reasonably possible, and in any event within 1 year

Correct answer: D. 90 days after the loss, unless it was not reasonably possible, and in any event within 1 year

Explanation: Maryland requires written proof of loss within ninety (90) days after the loss (or after the end of the period for which the insurer is liable for continuing loss); a late filing does not invalidate the claim if proof was not reasonably possible to give in time and is furnished as soon as reasonably possible, but not later than 1 year after the deadline, absent legal incapacity. Option A is the notice-of-claim period. Option B is the waiting period before legal action. Option C is not a statutory health-claim period. See Md. Code, Ins. § 15-213.

• A. 10 days
• B. 7 days
• C. 31 days
• D. 45 days

Correct answer: A. 10 days

Explanation: Maryland's required Grace Period provision sets 7 days for weekly-premium policies, 10 days for monthly-premium policies, and 31 days for all other policies (a uniform 31 days applies where the policyholder may freely switch payment modes). Option B applies to weekly premiums. Option C applies to quarterly, semiannual and annual premiums. Option D is not a statutory grace period. See Md. Code, Ins. § 15-209.

• A. Immediately, and within 1 year of the denial
• B. Not before 60 days after proof of loss was furnished, and not after 3 years from when proof was required
• C. Not before 30 days after proof of loss, and not after 2 years
• D. Not before 90 days after proof of loss, and not after 5 years

Correct answer: B. Not before 60 days after proof of loss was furnished, and not after 3 years from when proof was required

Explanation: Maryland's required provision bars any action at law or in equity before the expiration of 60 days after written proof of loss has been furnished and after the expiration of 3 years after proof of loss is required to be furnished. Options A, C and D each misstate one or both statutory periods. See Md. Code, Ins. § 15-217.

• A. It must sell her the policy and cannot use her answers to medical questions to deny coverage or change the price
• B. It must sell her the policy but may triple the premium based on her health
• C. It may decline her but must refund her application fee
• D. It must give her a free policy for one year

Correct answer: A. It must sell her the policy and cannot use her answers to medical questions to deny coverage or change the price

Explanation: Guaranteed issue rights, also called Medigap protections, arise in situations such as losing other coverage through no fault of your own. When one applies, the insurer cannot deny the Medigap policy, cannot use medical underwriting to raise the price, and generally cannot impose waiting periods beyond limited pre-existing condition rules. See medicare.gov.

• A. Nothing; Medigap policies must always be issued on request
• B. It may only adjust the deductible, not the premium
• C. It may use medical underwriting to charge more or decline the application
• D. It must issue the policy but may exclude all claims permanently

Correct answer: C. It may use medical underwriting to charge more or decline the application

Explanation: Outside the Medigap open enrollment period, and without a guaranteed issue right, insurers are not required to sell a Medigap policy: they may apply medical underwriting, charge a higher premium based on health, or refuse the application altogether. This is why timing a Medigap purchase matters. See medicare.gov.

• A. The Medigap open enrollment period repeats every fall
• B. The Medigap open enrollment period is a one-time 6-month window that begins the first month the person has Part B and is 65 or older, and it does not repeat annually
• C. The Medigap period lasts 7 months and recurs each birthday
• D. There is no separate Medigap enrollment period

Correct answer: B. The Medigap open enrollment period is a one-time 6-month window that begins the first month the person has Part B and is 65 or older, and it does not repeat annually

Explanation: Medigap open enrollment starts the first month a person is both enrolled in Part B and age 65 or older, lasts 6 months, and is a one-time opportunity that does not repeat each year. Medicare's annual open enrollment, by contrast, recurs every year for changing Medicare health and drug plan choices. See medicare.gov.

• A. It is administered entirely by the federal government with no state role
• B. It is a private insurance program subsidized through tax credits
• C. Each state funds its program alone, with no federal money
• D. States administer their own programs within federal requirements, with funding shared by the states and the federal government

Correct answer: D. States administer their own programs within federal requirements, with funding shared by the states and the federal government

Explanation: Medicaid is a joint federal-state program: each state administers its own program within federal guidelines, and costs are shared between the state and federal governments. Federal law requires states to cover certain mandatory groups, such as low-income families, qualified pregnant women and children, and SSI recipients. See medicaid.gov.

• A. By spending down: once her incurred medical expenses exceed the gap between her income and the state's medically needy income standard, she can become eligible
• B. By transferring her income to a relative the month before applying
• C. By paying a one-time enrollment fee to the state
• D. She cannot qualify under any circumstances once income exceeds the limit

Correct answer: A. By spending down: once her incurred medical expenses exceed the gap between her income and the state's medically needy income standard, she can become eligible

Explanation: States may operate a medically needy program for people with significant health needs whose income is too high for other eligibility groups. Such individuals spend down by incurring medical expenses; when those expenses exceed the difference between their income and the state's medically needy income level, Medicaid eligibility can begin. This contrasts with the categorically needy groups, who qualify by category and income alone. See medicaid.gov.

• A. Medicaid pays first and then bills the other insurers
• B. By law, all other available third parties must meet their legal obligation to pay claims before Medicaid pays
• C. Medicaid splits every claim 50/50 with any other insurer
• D. Medicaid only pays claims submitted in the last month of the year

Correct answer: B. By law, all other available third parties must meet their legal obligation to pay claims before Medicaid pays

Explanation: Medicaid generally pays only after other liable third parties, such as health insurers, liability insurers, and Medicare, have met their legal obligation to pay. States are required to take reasonable measures to identify such third-party liability. This is the opposite of primary coverage. See medicaid.gov.

• A. It must prevent any substantial gainful activity and be expected to last at least 12 continuous months or result in death
• B. It must prevent the worker's own occupation for at least 6 months
• C. It must prevent any work for at least 90 days
• D. Any doctor-certified illness qualifies regardless of duration

Correct answer: A. It must prevent any substantial gainful activity and be expected to last at least 12 continuous months or result in death

Explanation: Social Security defines disability as the inability to engage in any substantial gainful activity because of a medically determinable physical or mental impairment expected to result in death or to last for a continuous period of at least 12 months. Partial and short-term disabilities are not covered. See 42 U.S.C. 423(d) and ssa.gov.

• A. Payments begin the day after the disability onset date
• B. Payments begin after a 12-month waiting period
• C. Payments cannot begin until a waiting period of 5 consecutive calendar months of disability has passed
• D. Payments are retroactive to the date the disability began, with no waiting period

Correct answer: C. Payments cannot begin until a waiting period of 5 consecutive calendar months of disability has passed

Explanation: SSDI has a waiting period defined as the earliest period of 5 consecutive calendar months during which the worker has been under a disability, so cash benefits begin with the sixth full month. This waiting period serves a role similar to an elimination period in private disability income insurance. See 42 U.S.C. 423(c).