17 Free Arizona Accident & Health Exam Practice Questions (2026)

Answer: B

Disability income insurance provides regular benefit payments (e.g., weekly or monthly) to replace a portion of the insured's lost income when they are unable to work due to a covered injury or sickness. It does not reimburse medical expenses (that's medical expense insurance), pay lump sums for specific losses (that's accidental death and dismemberment), or cover long-term care services.

Answer: D

Long-term care insurance covers costs for assistance with activities of daily living (e.g., bathing, dressing, eating) when needed due to chronic illness, disability, or cognitive impairment (e.g., Alzheimer's). It is not for acute medical treatment, income replacement, or travel expenses.

Answer: D

The uniform required provision for proof of loss in individual accident and health policies mandates that the insured must file proof of loss within 90 days after the loss occurs. If the insured is legally incapacitated, the timeframe may be extended, but otherwise, failure to file within 90 days may allow the insurer to deny the claim if prejudiced by the delay. Options A, B, and C do not match this 90-day requirement.

Answer: D

The uniform required provision for time of payment of claims states that the insurer must pay benefits immediately upon receiving proof of loss. For periodic payments (such as monthly disability benefits), payments must be made at least monthly, and no payment can be delayed more than 60 days after proof of loss is received. This ensures timely payment of ongoing benefits. Options A, B, and C do not match the 60-day maximum delay for periodic payments.

Answer: D

The illegal occupation provision is a uniform optional provision that allows the insurer to deny or reduce benefits if the disability occurs while the insured is engaged in an illegal occupation, such as committing a felony. The provision does not distinguish between felonies and misdemeanors; it applies to any illegal occupation. The insured does not need to prove the disability was unrelated to the illegal activity for the provision to potentially apply. Arizona law does not prohibit illegal occupation provisions; they are permitted as uniform optional provisions. Therefore, the claim would likely be denied or the benefit reduced due to the disability occurring during the commission of a felony.

Answer: A

The rehabilitation benefit provides payments to the insured while they are engaged in an approved rehabilitation program aimed at restoring their ability to work. It is not tied to hospitalization, permanent disability status, or SSDI receipt. Option B is incorrect as hospitalization alone does not trigger the benefit. Option C is incorrect as the benefit is for active rehabilitation, not permanent disability. Option D is incorrect as SSDI receipt does not automatically trigger the rehabilitation benefit under a private policy.

Answer: A

The misstatement of age provision is a uniform optional provision that allows the insurer to adjust the benefit amount to what the premium paid would have purchased at the correct age, rather than denying the claim or voiding the policy. Options B, C, and D are incorrect: the claim is not denied for fraud (it's an innocent misstatement), the policy is not voided, and premiums are not increased for the existing contract.

Answer: A

A recurrent disability provision states that if disability recurs from the same or related cause within a specified period (often 6 months) after returning to work, it is considered a continuation of the prior disability. Therefore, a new elimination period is not required. Option B is incorrect because it is not treated as a new disability. Option C is incorrect; recurrent disability does not automatically imply partial disability or a 50% benefit. Option D is incorrect; the provision does not change the occupational definition of disability.

Answer: D

The ACA requires all non-grandfathered individual and small group plans to cover ten categories of essential health benefits, which include mental health and substance use disorder services. Options A, B, and C are not essential health benefits: routine foot care for healthy individuals is not covered, weight loss programs without a medical condition are not required, and cosmetic surgery for aesthetic purposes is explicitly excluded as an EHB.

Answer: A

POS plans combine features of HMOs and PPOs. While they require a primary care physician (PCP) and typically require referrals for specialist care to receive the highest level of benefits, they allow members to self-refer to out-of-network specialists. However, doing so results in reduced benefits (higher deductibles, coinsurance, or copays) compared to seeing an in-network provider or obtaining a referral. Option B is incorrect because benefits are reduced without a referral. Option C is incorrect because POS plans do allow out-of-network access, albeit at a higher cost. Option D is incorrect because emergency care rules are separate; non-emergency specialist care without a referral is still covered, just at a lower level.

Answer: A

Under COBRA, a qualifying event such as voluntary or involuntary termination of employment (for reasons other than gross misconduct) or reduction in hours allows the covered employee, their spouse, and dependent children to elect continuation coverage for up to 18 months. The 29-month period applies only if a disability determination is made within the first 60 days of COBRA coverage, extending the standard 18 months. The 36-month period applies to other qualifying events such as death of the covered employee, divorce or legal separation, or a dependent child losing dependent status. Option D is incorrect because COBRA provides the right to continue coverage, not an immediate termination.

Answer: D

D is correct. Federal COBRA applies only to group health plans of employers with 20 or more employees, so this 15-employee plan is outside COBRA entirely. Where it applies, a dependent child who loses dependent status has a 36-month continuation right; employees who lose coverage through termination or reduced hours have 18 months, extended to 29 months for a qualifying disability. A, B and C quote COBRA periods that would be correct for a larger employer; for small employers only state continuation rules can apply.

Answer: A

Critical illness (or specified disease) insurance policies typically pay a lump-sum benefit upon the diagnosis of a covered condition, such as heart attack, stroke, or kidney failure, provided the diagnosis meets the policy's specific criteria (e.g., confirmed by a specialist, meets clinical definitions) and any applicable survival period (e.g., 30 days post-diagnosis) is satisfied. The benefit is not tied to hospitalization duration, actual expenses incurred, or employment status. Option B is incorrect because hospitalization duration is not a standard requirement for benefit payment. Option C describes indemnity or reimbursement-style policies (like medical expense insurance), not lump-sum critical illness policies. Option D is incorrect as return-to-work requirements are not standard for critical illness benefits; they may apply to disability income policies.

Answer: D

Individuals who are eligible for Medicare due to age (65 or older) and who are currently employed and covered by an employer group health plan from an employer with 20 or more employees can delay enrolling in Medicare Part B without incurring a late enrollment penalty. This is because the employer coverage is considered creditable coverage. They can enroll in Part B during a Special Enrollment Period (SEP) that begins when the employer coverage ends. Medicare Part A is typically premium-free for those who have paid Medicare taxes, so enrolling in Part A is generally advisable even if delaying Part B, but it is not mandatory to avoid penalties. Option A is incorrect because the penalty can be avoided if the employer coverage is creditable (20+ employees). Option B is misleading; while enrolling in premium-free Part A is common and recommended, it is not required to delay Part B without penalty. Option C is incorrect because eligibility for Medicare begins at age 65 (or earlier due to disability), regardless of employment status.

Answer: D

The ACA requires non-grandfathered individual and small group health plans to cover a set of preventive services (such as immunizations, screenings, and counseling) without imposing any cost-sharing requirements (copayments, coinsurance, or deductibles) when provided by in-network providers. This applies to all such plans, whether sold inside or outside the Health Insurance Marketplace. Employer-sponsored plans are also subject to this rule if they are non-grandfathered. Option A is incorrect because cost-sharing is prohibited for preventive services under the ACA. Option B is incorrect because the requirement applies beyond Marketplace plans. Option C is incorrect because the ACA prohibits annual dollar limits on essential health benefits, including preventive services.

Answer: D

Coordination of benefits (COB) provisions determine which plan pays first when an individual is covered under more than one group health plan. For the employee, the plan of the employer for whom the employee is currently employed is primary. For a dependent child, the 'birthday rule' typically applies: the plan of the parent whose birthday (month and day, not year) falls earlier in the calendar year is primary. If the parents have the same birthday, the plan of the parent who has been covered longer is primary. Option A is incorrect because duration of coverage is not the determining factor. Option B is incorrect because it does not account for scenarios where the employee might be a dependent on a spouse's plan or where the birthday rule applies to children. Option C is incorrect because premium amount does not determine primary status under standard COB rules.

Answer: C

Federal law mandates that state Medicaid programs cover certain core services, known as mandatory benefits. These include inpatient hospital services, outpatient hospital services, physician services, laboratory and X-ray services, and home health services, among others. Prescription drugs, dental care for adults, and vision care for adults are optional benefits that states may choose to cover but are not required to do so under federal Medicaid law. Therefore, inpatient hospital services is a mandatory service that Arizona's Medicaid program must cover. Options A, B, and D are incorrect because they describe optional services under federal Medicaid rules.