Massachusetts Health Insurance Practice Exam Free - 2026

• A. Age 19, or age 23 if a full-time student; disabled children are covered only to age 23
• B. Age 21; disabled children are covered to age 26
• C. Age 25; disabled children are covered without regard to age
• D. Under 26 years of age; and without regard to age if the child is mentally or physically incapable of earning a living due to disability

Correct answer: D. Under 26 years of age; and without regard to age if the child is mentally or physically incapable of earning a living due to disability

Explanation: M.G.L. c. 175, § 108(3)(a) (individual policies that are health benefit plans) requires coverage of children under 26 years of age and children mentally or physically incapable of earning their own living (proof of incapacity to be furnished within 31 days of the date coverage would otherwise end); § 110(P) imposes the same under-26 and disabled-dependent rule on group policies, and c. 176J, § 1 defines an eligible dependent child through the end of the twenty-sixth year or without regard to age if disabled. The age-19/23 and age-21/25 options reflect pre-2010 practice and are not current Massachusetts law. See M.G.L. c. 175, §§ 108 and 110(P).

• A. Genetic tests may be required as long as results are kept confidential
• B. No insurer, agent or broker may require genetic tests or genetic information as a condition of issuance or renewal, nor discriminate in premiums, rates, coverage length or terms based on genetic information; a violation is an unfair or deceptive act under c. 93A and c. 176D
• C. Genetic tests may be required only for applicants over age 50
• D. Genetic information may be used for rating but not for declining coverage

Correct answer: B. No insurer, agent or broker may require genetic tests or genetic information as a condition of issuance or renewal, nor discriminate in premiums, rates, coverage length or terms based on genetic information; a violation is an unfair or deceptive act under c. 93A and c. 176D

Explanation: M.G.L. c. 175, § 108H prohibits any company, officer, agent or broker from cancelling, refusing to issue or renew, or making any distinction in premiums, rates, length of coverage or other terms of individual (§ 108) or group (§ 110) hospital and surgical expense coverage based on genetic information, and prohibits requiring genetic tests or genetic information as a condition of issuance or renewal; any violation constitutes an unfair method of competition or unfair or deceptive act under chapters 93A and 176D. Options A, C and D each permit some use that the statute forbids for this type of coverage. See M.G.L. c. 175, § 108H.

• A. October 15 through December 7, effective January 1
• B. January 1 through March 31, effective July 1
• C. February 1 through March 31 of each year, for coverage effective June 1 of that year or no later than when Medicare coverage first becomes effective, whichever is earlier
• D. The month of the person's birthday, effective the first of the following month

Correct answer: C. February 1 through March 31 of each year, for coverage effective June 1 of that year or no later than when Medicare coverage first becomes effective, whichever is earlier

Explanation: M.G.L. c. 176K, § 3(d) requires every participating carrier to make available all of its Medicare supplement policies to every eligible person during the required open enrollment period, which commences February 1 and ends March 31 of each year, for coverage effective June 1 of that year or no later than when Medicare coverage is first effective, whichever is earlier; 211 CMR 71.10 repeats these dates. Section 3(a)-(b) also bars denial or pricing discrimination based on age, health status or claims experience, and bars any waiting period or pre-existing condition exclusion. Option A is the federal Medicare Advantage/Part D annual election period, and B and D are not Massachusetts rules. See M.G.L. c. 176K, § 3; 211 CMR 71.10.

• A. A 10-day right to return; the outline of coverage may be delivered with the policy
• B. A 30-day right to return for a full refund, treated as if the policy had never been issued; the outline of coverage must be provided at the time the application is presented, with an acknowledgment of receipt obtained (except for direct response sales)
• C. A 20-day right to return; the outline of coverage is provided only on request
• D. No right to return; Medicare supplement sales are final once issued

Correct answer: B. A 30-day right to return for a full refund, treated as if the policy had never been issued; the outline of coverage must be provided at the time the application is presented, with an acknowledgment of receipt obtained (except for direct response sales)

Explanation: 211 CMR 71.13 requires Medicare supplement policies to state that if the policy is sent back within 30 days after receipt the issuer will treat it as if it had never been issued and return all payments, and requires issuers to provide an outline of coverage to all applicants at the time the application is presented and, except for direct response policies, obtain an acknowledgment of receipt. The 10-day and 20-day periods belong to individual life policies under $25,000 (§ 187H) and life replacements (211 CMR 34.06) respectively, and D is wrong because a right to return is mandatory. See 211 CMR 71.13.

• A. It is included in his gross income, but no 20% additional tax applies because he is over age 65
• B. It is completely tax free because he is over age 65
• C. It is included in income and also subject to the 20% additional tax
• D. It is tax free up to his lifetime contribution total and taxable above that

Correct answer: A. It is included in his gross income, but no 20% additional tax applies because he is over age 65

Explanation: HSA distributions not used for qualified medical expenses are included in gross income. The 20% additional tax, however, does not apply to distributions made after the owner reaches age 65, becomes disabled, or dies. So the withdrawal is taxable as ordinary income but escapes the penalty. See IRS Publication 969.

• A. It is automatically refunded to the employee as taxable wages
• B. It rolls over in full to the next plan year in every FSA
• C. It converts to an HSA balance owned by the employee
• D. It is generally forfeited, unless the plan offers a limited carryover or grace period

Correct answer: D. It is generally forfeited, unless the plan offers a limited carryover or grace period

Explanation: Health FSAs operate under a use-it-or-lose-it rule: unused amounts generally do not carry over to the following year. An employer may design the plan to allow a limited carryover of a capped amount or a short grace period, but neither is required, and full unlimited rollover is never permitted. See IRS Publication 969.

• A. Employees fund the HRA through pre-tax salary reduction
• B. The HRA must be funded solely by the employer; employees may not contribute
• C. Employer and employee must each fund half of the annual amount
• D. The HRA is funded by the health insurer out of premium refunds

Correct answer: B. The HRA must be funded solely by the employer; employees may not contribute

Explanation: An HRA must receive contributions from the employer only; employees may not contribute, and there is no salary-reduction feature. Employer contributions and reimbursements for qualified medical expenses are not included in the employee's income. See IRS Publication 969.

• A. Both sets of benefits are fully taxable
• B. Both sets of benefits are received income tax free
• C. Her benefits are tax free, while the coworker's employer-paid benefits are taxable income
• D. Her benefits are taxable, while the coworker's benefits are tax free

Correct answer: C. Her benefits are tax free, while the coworker's employer-paid benefits are taxable income

Explanation: The taxation of disability benefits follows who paid the premium. When the insured pays the entire cost of the coverage on an after-tax basis, the benefits are excluded from income; when the employer pays the premium, amounts the employee receives for disability must be reported as income. See irs.gov on life and disability insurance proceeds.

• A. A W-2 employee whose employer pays no part of the premium
• B. Any taxpayer who buys individual coverage on a public exchange
• C. A shareholder owning 1% of a C corporation's stock
• D. A more-than-2% S corporation shareholder who received wages from the corporation

Correct answer: D. A more-than-2% S corporation shareholder who received wages from the corporation

Explanation: The deduction is an adjustment to income available to the self-employed: sole proprietors with a net profit, partners with net self-employment earnings, and more-than-2% S corporation shareholders who received wages from the corporation. It is claimed on Schedule 1 of Form 1040 rather than as an itemized deduction. Ordinary employees and small C corporation shareholders do not qualify. See IRS Form 7206 instructions.

• A. Insurance companies and other private companies approved by Medicare
• B. The federal government directly, through Social Security offices
• C. State Medicaid agencies under federal contract
• D. Hospitals participating in Medicare Part A

Correct answer: A. Insurance companies and other private companies approved by Medicare

Explanation: Part D drug coverage is offered to everyone with Medicare, but the plans themselves are sold and run by insurance companies and other private companies approved by Medicare, not by the government directly. Beneficiaries choose among competing private plans. See medicare.gov.

• A. A flat one-time fee equal to three months of premium
• B. 1% of the national base beneficiary premium for each full uncovered month, added to the premium for as long as the person has Medicare drug coverage
• C. 10% of the plan's own premium for each uncovered year, charged for twice the number of years without coverage
• D. 5% of the national base beneficiary premium for each uncovered quarter, charged for five years

Correct answer: B. 1% of the national base beneficiary premium for each full uncovered month, added to the premium for as long as the person has Medicare drug coverage

Explanation: The penalty is 1% of the national base beneficiary premium multiplied by the number of full months the person was eligible but had neither Part D nor other creditable coverage. The amount is added to the monthly premium and generally continues for as long as the person has Medicare drug coverage. Option C describes the Part B late penalty pattern, not Part D. See medicare.gov.

• A. All generic drugs became free at the pharmacy
• B. Premiums were capped at $35 per month for every Part D plan
• C. An annual cap on out-of-pocket costs for covered drugs, set at $2,000 for 2025 and indexed in later years
• D. Deductibles were eliminated from all Part D plans

Correct answer: C. An annual cap on out-of-pocket costs for covered drugs, set at $2,000 for 2025 and indexed in later years

Explanation: Beginning in 2025, Part D enrollees' out-of-pocket costs for covered drugs are capped at $2,000 per year; once the cap is reached, the enrollee pays nothing more for covered Part D drugs that year. The cap is indexed annually ($2,100 in 2026). The $35 cap applies only to covered insulin products, not to premiums. See medicare.gov and cms.gov.