17 Free Pennsylvania Life & Health Practice Questions: Pennsylvania Mandated Benefits, Medigap, Long-Term Care and Seniors (2026)

Question 1 (Chapter 8)

A life insurance policyholder in Pennsylvania has an accelerated (living) benefit rider. Which of the following conditions, if met, would typically trigger a payment under this rider according to 31 Pa. Code Ch. 90f.3?

• A) The policyholder is diagnosed with a chronic illness that requires assistance with at least one Activity of Daily Living (ADL) for an indefinite period.
• B) The policyholder experiences a significant financial hardship, regardless of health status.
• C) The policyholder reaches age 65 and wishes to use the funds for retirement planning.
• D) The policyholder is diagnosed with a terminal illness, with a life expectancy of 24 months or less.

Question 2 (Chapter 8)

Maria receives her new Accident and Health (A&H) insurance policy in Pennsylvania. She reviews it and decides it does not meet her needs. What is the minimum 'free look' period she has to return the policy for a full refund of premiums paid, as per Pennsylvania regulations?

• A) 14 days from the date of policy delivery.
• B) 20 days from the date of policy delivery.
• C) 30 days from the date of policy delivery.
• D) 10 days from the date of policy delivery.

Question 3 (Chapter 8)

When a Pennsylvania resident enters into a viatical settlement, what specific disclosure must the viatical settlement provider make to the viator regarding the transaction, as required by 40 P.S. § 626.7?

• A) The provider must disclose the exact profit margin they expect to make from the settlement.
• B) The provider must disclose that the viator has the right to rescind the contract within 30 days after its execution.
• C) The provider must disclose that the viator may be eligible for accelerated benefits from their insurer.
• D) The provider must disclose the names of all other viators who have settled policies with them.

Question 4 (Chapter 8)

A policyholder with a serious mental illness (as defined in 40 P.S. § 764g) seeks treatment under their group health plan. What does Pennsylvania law require regarding this coverage?

• A) Coverage must be provided at parity with the coverage provided for other physical illnesses.
• B) Coverage can be limited to 10 outpatient visits per year.
• C) Coverage is only required if the policyholder pays an additional premium for a mental health rider.
• D) Coverage is limited to inpatient hospitalization only.

Question 5 (Chapter 8)

A client is interested in Long-Term Care (LTC) insurance. Which of the following is a 'benefit trigger' that would allow them to receive benefits under 31 Pa. Code Ch. 89a.124?

• A) A physician's certification that the insured is unable to perform a specified number of Activities of Daily Living (ADLs).
• B) The insured reaching the age of 80, regardless of health status.
• C) The insured being admitted to a hospital for any reason for more than 24 hours.
• D) The insured choosing to retire from their primary occupation.

Question 6 (Chapter 8)

Under Pennsylvania law, what is the 'inflation protection' requirement for Long-Term Care policies (31 Pa. Code Ch. 89a.112)?

• A) The insurer must automatically increase the benefit amount by 10% every year.
• B) Inflation protection is not required in Pennsylvania.
• C) The insurer must offer the applicant the option to purchase inflation protection.
• D) The insurer must provide a fixed benefit that never changes.

Question 7 (Chapter 8)

A Pennsylvania resident is enrolled in a Medicare Advantage (Part C) plan. What does this plan typically provide?

• A) Coverage that replaces Original Medicare (Parts A and B) and often includes prescription drug coverage.
• B) Only supplemental coverage for hospital costs.
• C) Coverage only for hospice care.
• D) Coverage only for out-of-pocket expenses not covered by Medicare.

Question 8 (Chapter 8)

Under Act 73 of 2016, what is the requirement for health insurance policies regarding orally administered chemotherapy medication?

• A) It must be covered, but the cost-sharing cannot be less favorable than for intravenously administered chemotherapy.
• B) It is not required to be covered.
• C) It must be covered at 100% with no cost-sharing.
• D) It is only covered if the patient is in a clinical trial.

Question 9 (Chapter 8)

A Pennsylvania health policy must include coverage for childhood immunizations under 40 P.S. § 3503. What is the scope of this mandate?

• A) It applies to all children as recommended by the Department of Health.
• B) It applies only to children under age 5.
• C) It is optional for the insurer.
• D) It only covers vaccines for polio and measles.

Question 10 (Chapter 8)

An insurer is marketing a Medicare Supplement policy in Pennsylvania. Under 31 Pa. Code Ch. 89.786, which of the following actions is strictly prohibited during the marketing process?

• A) Providing the applicant with the required Outline of Coverage
• B) Using the term 'Medicare Supplement' to describe the policy
• C) Representing that the policy is endorsed by the federal government
• D) Explaining the differences between Plan A and Plan F

Question 11 (Chapter 8)

Under Pennsylvania law, a group health insurance policy must provide coverage for the treatment of alcohol abuse and dependency. Which of the following is true regarding this mandated benefit under 40 P.S. §§ 908-1–908-8?

• A) Coverage is optional at the discretion of the employer
• B) Insurers may exclude coverage for inpatient detoxification services
• C) Insurers must provide coverage for the treatment of alcohol abuse and dependency as part of group health policies.
• D) The mandate only applies to individual policies, not group plans

Question 12 (Chapter 8)

A Pennsylvania resident is enrolled in a group health plan. Under 40 P.S. § 764g, what is the 'serious mental illness' mandate?

• A) It requires coverage for all mental health conditions without limits
• B) It allows insurers to cap benefits for mental health at $5,000 per year
• C) It mandates that plans provide coverage for serious mental illnesses at the same level as other physical illnesses
• D) It only applies to outpatient therapy

Question 13 (Chapter 8)

A Pennsylvania resident is divorced. Under 20 Pa. C.S.A. § 6111.2, what is the effect of the divorce on a life insurance policy where the ex-spouse is named as the beneficiary?

• A) The ex-spouse remains the beneficiary unless the policy is changed
• B) The ex-spouse must sign a waiver to be removed
• C) The divorce automatically revokes the ex-spouse as the beneficiary
• D) The death benefit is split 50/50 between the ex-spouse and the estate

Question 14 (Chapter 8)

Under 40 P.S. § 775.1, what is the requirement regarding the coverage of an adopted child in a Pennsylvania health insurance policy?

• A) Adopted children are only covered after a 6-month waiting period
• B) Adopted children are not covered under family plans
• C) Adopted children must be covered from the date of placement for adoption
• D) Coverage is only required if the child is under age 1

Question 15 (Chapter 8)

A 70-year-old Pennsylvania resident is applying for a Medicare Supplement policy. The producer is reviewing the 'suitability' of the purchase. Under 31 Pa. Code Ch. 89.787, which factor must the producer evaluate?

• A) The applicant's credit score.
• B) Whether the applicant already has a Medigap policy and if the new policy will replace existing coverage.
• C) The applicant's political affiliation.
• D) The applicant's ability to pass a physical examination.

Question 16 (Chapter 8)

A Pennsylvania resident is looking for a Medicare Supplement plan. What is the 'guaranteed issue' right under 31 Pa. Code Ch. 89.790?

• A) The right to purchase any Medigap policy at any time regardless of health status.
• B) The right to enroll in a Medigap plan without medical underwriting during specific windows, such as when losing other creditable coverage.
• C) The right to receive a discount on premiums based on age.
• D) The right to have Medicare pay for all out-of-pocket costs.

Question 17 (Chapter 8)

A Pennsylvania health insurance policy must cover childhood immunizations under 40 P.S. § 3503. What is the scope of this mandate?

• A) It only covers immunizations for children under age 2.
• B) It requires coverage for all immunizations recommended by the Advisory Committee on Immunization Practices (ACIP).
• C) It is limited to the flu vaccine.
• D) It only covers immunizations if the child is in school.