17 Free Missouri Life & Health Practice Questions: Accident and Health Policy Types (2026)

Question 1 (Chapter 4)

An insured has an Accidental Death and Dismemberment (AD&D) policy with a principal sum of $50,000. While working on a project in Kansas City, the insured suffers an accidental injury resulting in the loss of one foot. What is the most likely benefit amount the insured will receive?

• A) $50,000 (The Principal Sum)
• B) $0, because the insured did not die
• C) $50,000 plus medical expenses
• D) $25,000 (The Capital Sum)

Question 2 (Chapter 4)

A Long-Term Care (LTC) policy in Missouri triggers benefits when the insured is unable to perform a certain number of Activities of Daily Living (ADLs). Which of the following is NOT considered a standard ADL?

• A) Driving
• B) Bathing
• C) Eating
• D) Transferring

Question 3 (Chapter 4)

Which medical expense plan allows an insured to choose, at the time service is needed, whether to use an HMO-style provider or a PPO-style provider?

• A) Point of Service (POS) Plan
• B) Exclusive Provider Organization (EPO)
• C) Medical Savings Account (MSA)
• D) Basic Hospital Expense Plan

Question 4 (Chapter 4)

An insured in St. Joseph has an Accidental Death and Dismemberment (AD&D) policy. While running a marathon, the insured suffers a massive heart attack and dies instantly. How will the insurer likely respond to the claim for the principal sum?

• A) The claim will be paid in full because the death occurred during a physical activity.
• B) The insurer will pay 50% of the principal sum as a 'capital sum' benefit.
• C) The claim will be paid only if the insured had a 'double indemnity' rider.
• D) The claim will be denied because the death was caused by a physical illness, not an accident.

Question 5 (Chapter 4)

An insured's dental plan classifies procedures into different categories. The insured receives a root canal and a porcelain crown. These procedures are typically classified as:

• A) Major Services
• B) Diagnostic and Preventive Services
• C) Basic Services
• D) Excluded Services

Question 6 (Chapter 4)

A child is covered under both parents' group health plans. The father's birthday is March 12, and the mother's birthday is August 25. Under the standard Coordination of Benefits 'Birthday Rule,' which plan is primary?

• A) The mother's plan, because her birthday occurs later in the calendar year.
• B) The plan of the parent who has been employed the longest.
• C) The plan with the lower deductible.
• D) The father's plan, because his birthday occurs earlier in the calendar year.

Question 7 (Chapter 4)

A specialized neurosurgeon in St. Louis purchases a Disability Income policy with an 'Own Occupation' definition of total disability. After a tremor develops in his hand, he can no longer perform surgery but takes a position as a medical school professor. How will the policy respond?

• A) It will pay full benefits because he cannot perform the duties of the specific occupation for which he is trained.
• B) It will pay no benefits because he is still able to work in a gainful occupation for which he is suited by education.
• C) It will pay 50% of the benefit because he is only partially disabled under the 'Any Occupation' definition.
• D) It will pay benefits only until he receives his first paycheck from the university.

Question 8 (Chapter 4)

A producer is selling a Disability Income policy to a client in Jefferson City. The client is concerned about future inflation eroding the value of the monthly benefit. Which rider should the producer recommend?

• A) Guaranteed Insurability Rider
• B) Social Insurance Supplement (SIS) Rider
• C) Cost of Living Adjustment (COLA) Rider
• D) Waiver of Premium Rider

Question 9 (Chapter 4)

A construction worker in Joplin has a 'Non-occupational' Disability Income policy. He is injured while working on a job site and is eligible for Workers' Compensation. How will his disability policy likely respond?

• A) It will pay full benefits in addition to Workers' Compensation.
• B) It will pay the difference between his salary and the Workers' Comp benefit.
• C) It will pay nothing because the injury occurred on the job.
• D) It will pay benefits only if he waives his right to Workers' Compensation.

Question 10 (Chapter 4)

Under an Accidental Death and Dismemberment (AD&D) policy with a principal sum of $75,000, what is the capital sum payable for the loss of sight in one eye, assuming a standard schedule where loss of one eye is 50% of the principal sum?

• A) $25,000
• B) $37,500
• C) $50,000
• D) $75,000

Question 11 (Chapter 4)

A Missouri resident has a hospital indemnity insurance policy that pays $200 per day for hospitalization. If hospitalized for 5 days due to a covered accident, what is the total benefit payable, regardless of the actual hospital charges incurred?

• A) $200
• B) $500
• C) $1,000
• D) $1,200

Question 12 (Chapter 4)

A producer is explaining the elimination period in a disability income policy to a client. Which statement best describes the elimination period?

• A) It is the maximum length of time benefits will be paid after a disability begins.
• B) It is the percentage of pre-disability income that the benefit will replace.
• C) It is the waiting period after the onset of a disability before benefit payments begin.
• D) It is the amount of the monthly premium that is waived while the insured is disabled.

Question 13 (Chapter 4)

An insured is covered by a Preferred Provider Organization (PPO) with a $500 deductible and 80/20 in-network / 60/40 out-of-network coinsurance. The insured seeks treatment from an out-of-network specialist, resulting in a $2,500 bill. Assuming the deductible has not been met, how much is the insured's total out-of-pocket responsibility?

• A) $900
• B) $1,300
• C) $1,500
• D) $500

Question 14 (Chapter 4)

A Missouri dental patient requires a complex series of treatments including an extraction, an implant, and a crown. The dentist submits a 'Pre-determination of Benefits' to the insurer. What is the primary purpose of this action?

• A) To guarantee that the dentist will be paid immediately.
• B) To allow the insurer to notify the patient of what will be covered and what the out-of-pocket costs will be before treatment begins.
• C) To waive the patient's deductible for the year.
• D) To legally require the patient to complete the treatment.

Question 15 (Chapter 4)

An insured is currently receiving benefits in a nursing home under a Long-Term Care policy. The insured must be transferred to a hospital for surgery for three days. Which policy provision ensures the nursing home does not give the insured's room to someone else?

• A) Restoration of Benefits
• B) Bed Reservation Benefit
• C) Waiver of Premium
• D) Nonforfeiture Benefit

Question 16 (Chapter 4)

A 65-year-old Missouri resident is enrolling in Medicare Part B and wants to buy a Medicare Supplement (Medigap) policy. During her initial Medigap open enrollment period, she applies for a standardized Medigap plan available to new Medicare beneficiaries. Which statement is true regarding her application?

• A) The insurer can deny her application due to her age.
• B) The insurer must accept her application without medical underwriting.
• C) The insurer can impose a pre-existing condition waiting period of up to two years regardless of her enrollment timing.
• D) She must wait until her annual election period to apply.

Question 17 (Chapter 4)

A Missouri resident buys a Vision insurance policy. Which of the following services is typically NOT covered under a standard Vision plan?

• A) Annual eye exam
• B) Prescription eyeglass lenses
• C) Frames up to a specified allowance
• D) Laser eye surgery (LASIK) for vision correction