Free practice exam · no signup needed

Virginia Health Practice Exam

20 exam-style questions drawn from the same bank as our full Virginia Health course (Virginia Health Insurance Agent — Exam Prep). Answer all 20, then grade yourself — most state exams require 70% to pass. Explanations for every question are part of the full course.

1. The Part D late-enrollment penalty is calculated as:
Twice the standard Part D premium for two years after late enrollment10% of the national base beneficiary premium for every full 12 months the beneficiary was without creditable drug coverage, added permanently to the Part D premiumA flat $50 per month surcharge for any delay, regardless of length1% of the national base beneficiary premium for every full month the beneficiary was without creditable drug coverage for more than 63 continuous days, added permanently to the Part D premium
2. Under Va. Code §38.2-3411, a Virginia policy that covers family members must provide coverage for a newborn child:
From the moment of birthOnly after a 90-day waiting periodBeginning at age one monthOnly if added at the next open enrollment
3. The completed application is important to underwriting mainly because it:
Replaces the need for any policy languageDetermines the producer's licensing statusServes as the primary source of risk informationSets the insurer's investment strategy
4. Virginia's diabetes mandate generally requires accident-and-sickness policies to cover:
Diabetes care only for insureds over age 65Equipment, supplies, and self-management educationOnly insulin, and nothing else related to diabetesA single physician visit each calendar year
5. Federal COBRA generally applies to employer group health plans of employers with at least how many employees?
50 employees1 employee20 employees100 employees
6. In the ACA-compliant individual and small-group markets, premium variation by age is capped at what ratio between the oldest and youngest adult rates?
3 to 1, with tobacco use separately capped at a ratio of 1.5 to 13 to 1, with tobacco use separately capped at a ratio of 3.0 to 12 to 1, with tobacco use separately capped at a ratio of 1.5 to 15 to 1, with tobacco use separately capped at a ratio of 1.5 to 1
7. Standards for accident-and-sickness policy forms delivered in Virginia (incorporating the Uniform Accident and Sickness Policy Provisions) are codified primarily in:
Va. Code §32.1-127 et seq.Va. Code §59.1-200 et seq.Va. Code §38.2-3500 et seq.Va. Code §38.2-100 et seq.
8. If an applicant gives an answer the producer knows is inaccurate, the producer should:
Record the answer the applicant states and probe honestlyChange the answer to what the producer thinks is correctLeave the question blank to avoid any disputeSign the application on the applicant's behalf
9. A consumer between jobs wants a low-cost bridge until new employer coverage begins in three months. The most appropriate limited option is often:
A hospital indemnity policy aloneA short-term medical policy for the gap periodA guaranteed-issue whole life policyA specified-disease cancer policy alone
10. A producer repeatedly convinces clients to replace paid-up coverage with new policies mainly to generate first-year commissions, using misleading illustrations. This pattern is best described as:
Permissible needs-based replacement of coverageChurning through misrepresentation (a form of twisting)Routine coordination-of-benefits practiceA lawful rebate benefiting the policyholder
11. A client between jobs asks whether short-term limited-duration insurance is a reasonable long-term replacement for major medical. The producer should explain that short-term coverage:
Matches major medical benefit for benefit but renews on a shorter cycleIs guaranteed issue during open enrollment but excludes prescription drugsMay underwrite pre-existing conditions, cap benefits, and omit an OOP maxMust cover Essential Health Benefits but may impose a higher deductible
12. The primary purpose of the Virginia Life, Accident, and Sickness Insurance Guaranty Association is to:
Market Medicare supplement policies to seniorsLicense and discipline resident insurance producersPay covered claims when a member insurer becomes insolventSet premium rates for Virginia health insurers
13. A health insurance policy is described as a contract of adhesion. This means:
The insurer may modify the underlying contract terms unilaterally at any time during the policy period on 30 days' written notice to the named insuredThe contract is binding upon the insurer's corporate heirs, successors, and assigns only if a specific transfer rider is attached at policy deliveryThe policy was drafted entirely by the insurer and offered to the insured on a take-it-or-leave-it basis, so ambiguities are construed against the insurerBoth parties had the opportunity to negotiate every contract term as equals before the document was finally signed
14. A plan charges a $300 emergency-room copay. A member goes to the emergency department with chest pain and is admitted as an inpatient from the ER. On many plans the $300 copay is then:
Refunded only after the member files an appeal within the plan year endDoubled, because an admission converts the visit into an inpatient episodeWaived, because the emergency-room copay is often dropped upon admissionConverted into coinsurance calculated on the full inpatient allowed amount
15. Under the ACA's required appeals process for non-grandfathered plans, the maximum time a carrier may take to decide an URGENT internal appeal is:
72 hours30 days15 days24 hours
16. A client turned 65 three years ago but delayed enrolling in Medicare Part B because she was covered by her former employer's retiree health plan. The retiree plan is ending and she now wants to enroll in Part B. The correct outcome is:
She may enroll under the active-employee Special Enrollment Period with no late penalty because the retiree group plan qualifies as current employer coverage under §1837(i)She may enroll only during the General Enrollment Period (January 1 – March 31) and will owe a Part B late-enrollment penalty of 30% added to her premium for lifeShe may enroll immediately under a guaranteed-issue right with no late-enrollment penalty because the retiree health coverage qualifies as creditable Part B-equivalent coverageShe must wait until the next Annual Election Period (October 15 – December 7) and her Part B coverage will then begin effective January 1 of the following calendar year
17. A member is four days into an authorized inpatient stay when the carrier determines that further inpatient care is no longer medically necessary and stops authorization. This utilization-management tool is:
Retrospective review, which audits the claim after it has been submittedConcurrent review, which evaluates the necessity of each additional dayPre-authorization, which approves a service before it has been renderedMedical-necessity criteria development, which is updated on an annual cycle
18. A 68-year-old health savings account owner withdraws $4,000 to remodel a bathroom, which is not a qualified medical expense. The federal tax consequence of that distribution is:
No tax at all, because distributions after age 65 are tax-free for any purposeOnly the additional 20% tax, since the original contributions were deductibleOrdinary income tax on the withdrawal, plus the additional 20% tax as wellOrdinary income tax on the withdrawal, with no additional 20% tax applied
19. An insurer's claims adjuster tells an insured, 'Don't bother filing written proof of loss; we'll handle it,' and the insured relies on that. The insurer may be barred from later demanding written proof under:
The principle of indemnityEstoppel arising from the insured's relianceThe coordination-of-benefits clauseSubrogation against the adjuster personally
20. On what date did the No Surprises Act take effect, beginning the balance-billing restrictions described in this lesson?
January 1, 2022, restricting balance billing in three narrowly defined contextsJanuary 1, 2014, restricting balance billing in three narrowly defined contextsMarch 23, 2010, restricting balance billing in three narrowly defined contextsJanuary 1, 2020, restricting balance billing in three narrowly defined contexts

Want a different set? Refresh the page for 20 new questions — the full course has 500+, each with a complete explanation, plus full-length timed exam simulations and an AI tutor.