Minnesota Accident and Health Exam: Full Content Breakdown and Strategy Guide

The Minnesota Accident and Health insurance licensing exam covers one of the broadest and most practically relevant bodies of knowledge in the insurance licensing curriculum. Health insurance, disability income, long-term care, Medicare, Medicaid, and the regulatory framework governing all of them — each is a distinct discipline with its own terminology, its own product structures, and its own Minnesota-specific statutory provisions. This post maps the complete content of the Minnesota A&H exam, identifies the highest-priority topics by exam weight, covers the Minnesota-specific law provisions that appear in the state section, and provides the strategic preparation approach that produces first-attempt passes.

Exam Specifications

Exam administrator: PSI Services LLC Exam format: Multiple choice, four options per question, one correct answer Scored questions: 85 Time allowed: 2 hours Passing score: 70% (scaled score of 70 or higher) Results: Immediate — displayed on screen at conclusion of exam Retakes: No limit; 24-hour wait between attempts; $45 fee per attempt Exam validity: 3 years from date of passing

Combined Life and A&H exam: Candidates who want both Life and A&H authority simultaneously take the combined Life, Accident and Health exam — 145 questions over 3 hours — covering both lines in a single session. The content of each line within the combined exam is the same as the standalone exams. The combined exam is the efficient choice for candidates pursuing both lines simultaneously.

Section 1: Types of Health Insurance Policies

Health insurance product types are the foundational content area of the A&H exam — the largest single section by question volume and the area where the most consistent exam questions originate.

Individual Health Insurance

Individual health insurance is purchased directly by the insured rather than through an employer group. Individual policies are medically underwritten — the insurer can evaluate the applicant's health history and set premiums, exclude conditions, or decline coverage based on underwriting findings. The ACA substantially changed individual market underwriting rules for policies sold through exchanges, but the exam tests both the traditional underwriting framework and the ACA-compliant individual market structure.

Key individual health policy provisions:

Entire contract clause: The policy and the application constitute the entire contract — no other documents are incorporated by reference

Time limit on certain defenses (incontestability): After the policy has been in force for two years (three years in some states), the insurer cannot contest the policy based on misrepresentation in the application, except for fraudulent misstatements

Grace period: A grace period of at least 10 days (weekly premium policies), 31 days (monthly premium), or 31 days (other modes) must be provided before the policy lapses for non-payment of premium

Reinstatement: A lapsed policy may be reinstated; the insurer may require evidence of insurability and payment of overdue premiums

Notice of claim: The insured must notify the insurer of a claim within 20 days of loss or as soon as reasonably possible

Proof of loss: Written proof of loss must be submitted within 90 days after the end of the period for which the insurer is liable

Physical examination: The insurer has the right to examine the insured as often as reasonably necessary during a pending claim

Group Health Insurance

Group health insurance covers multiple insureds — typically employees of a common employer — under a single master policy. The employer is the policyholder; employees receive certificates of coverage. Group health is subject to different underwriting rules than individual health — the group is underwritten as a whole rather than individual members being individually evaluated.

Group eligibility: Employees typically must work a minimum number of hours per week (commonly 30 hours) and may be subject to a probationary or waiting period before becoming eligible for coverage.

Coordination of benefits (COB): When an insured is covered under multiple group health plans, COB rules determine which plan pays first (primary) and which pays second (secondary). The primary insurer pays its full benefits; the secondary insurer may pay the remaining balance up to the total covered charges. COB prevents double recovery — the insured cannot collect more than 100% of covered charges from all sources combined.

COBRA continuation coverage: The Consolidated Omnibus Budget Reconciliation Act requires employers with 20 or more employees to offer continuation of group health coverage for qualifying events — termination of employment (other than gross misconduct), reduction in hours, death of the covered employee, divorce or legal separation, and a dependent child aging off the plan. COBRA continuation can last 18 months for the employee (extended to 29 months for disability) and 36 months for qualifying dependents. The qualified beneficiary pays up to 102% of the full group premium — no employer contribution.

HIPAA portability: The Health Insurance Portability and Accountability Act limits pre-existing condition exclusions in group plans, requires creditable coverage to count against waiting periods, and prohibits discrimination based on health status in group enrollment.

HMO, PPO, POS, and HDHP Structures

Health Maintenance Organization (HMO): A managed care plan where members receive care from a network of providers for a fixed monthly premium. Referrals from a primary care physician (PCP) are typically required to see specialists. Out-of-network care is generally not covered except in emergencies.

Preferred Provider Organization (PPO): Members can see any provider but pay less when using in-network providers. No referral required for specialists. Out-of-network coverage is available at higher cost-sharing. More flexibility than HMO, typically higher premiums.

Point of Service (POS): A hybrid of HMO and PPO. Members designate a PCP who coordinates care. In-network care follows HMO rules (lower cost); out-of-network care is covered at PPO-style rates with higher cost-sharing.

High Deductible Health Plan (HDHP): A plan with a higher deductible than traditional plans, paired with lower premiums. HDHPs are the qualifying plans for Health Savings Accounts (HSAs). For 2026, the minimum deductible for an HDHP is $1,650 (individual) or $3,300 (family). HSA contribution limits for 2026 are $4,300 (individual) and $8,550 (family).

Section 2: Disability Income Insurance

Disability income insurance replaces a portion of the insured's earned income when they are unable to work due to illness or injury. It is one of the most important and most consistently tested A&H coverage types.

The definition of disability: The definition used in the policy determines when benefits are payable. Three common definitions:

Own occupation: The insured is disabled if unable to perform the material duties of their specific occupation. Most favorable to the insured. Benefits are payable even if the insured can work in a different occupation.

Any occupation: The insured is disabled if unable to perform the duties of any occupation for which they are reasonably suited by education, training, or experience. Most restrictive definition.

Modified own occupation / transitional: A hybrid — own occupation definition for the first two years, transitional to any occupation definition thereafter. Common in individual DI policies.

Elimination period: The waiting period between the onset of disability and the commencement of benefits — functionally a time deductible. Common elimination periods are 30, 60, 90, 180, or 365 days. Longer elimination periods produce lower premiums.

Benefit period: The maximum duration for which disability benefits will be paid. Common benefit periods are 2 years, 5 years, to age 65, or lifetime (rare in current market). Longer benefit periods produce higher premiums.

Benefit amount: Typically 60–70% of the insured's pre-disability earned income. The percentage is deliberately less than 100% to preserve an incentive to return to work.

Residual (partial) disability: Pays a proportionally reduced benefit when the insured returns to work but cannot earn their full pre-disability income. The residual benefit is typically calculated as the percentage of income loss multiplied by the full benefit amount.

Non-cancelable vs. guaranteed renewable:

Non-cancelable: The insurer cannot cancel the policy, increase premiums, or reduce benefits as long as premiums are paid. Maximum protection for the insured.

Guaranteed renewable: The insurer cannot cancel the policy, but may increase premiums on a class basis (not individually). Less protection than non-cancelable.

Conditionally renewable: The insurer may decline to renew under specific conditions defined in the policy.

Optionally renewable: The insurer may decline to renew at any anniversary or premium due date.

Social Security integration: Some DI policies are integrated with Social Security Disability Insurance (SSDI) — the policy benefit is reduced by any SSDI benefits received. Integration reduces premiums.

Section 3: Long-Term Care Insurance

Long-term care (LTC) insurance pays for services that assist individuals who cannot perform activities of daily living (ADLs) due to chronic illness, disability, or cognitive impairment. LTC is consistently tested on the A&H exam and has Minnesota-specific regulatory requirements.

Activities of daily living (ADLs): The six standard ADLs used to trigger LTC benefits are: bathing, dressing, toileting, transferring (moving from bed to chair), continence, and eating. Benefit eligibility typically requires inability to perform two or more ADLs without substantial assistance.

Cognitive impairment trigger: LTC benefits may also be triggered by severe cognitive impairment (such as Alzheimer's disease) even if the insured can physically perform ADLs.

Benefit triggers must be certified: A licensed healthcare practitioner must certify that the insured meets the benefit trigger criteria.

LTC benefit types:

Nursing facility care: Skilled, intermediate, or custodial care in a licensed nursing facility

Home health care: Care provided in the insured's home by a licensed agency

Adult day care: Supervised care in a community facility during daytime hours

Assisted living facility care: Care in a residential facility providing personal care services

Elimination period and benefit period: Same concepts as disability income — an elimination period (typically 30–180 days) must be satisfied before benefits begin, and a benefit period defines the maximum duration of benefit payments.

Inflation protection: LTC policies may offer inflation protection riders — typically 5% compound inflation — that increase the daily benefit amount over time to keep pace with rising care costs.

Minnesota LTC specialty CE: Minnesota requires producers who sell LTC insurance to complete an 8-hour initial LTC certification before selling LTC products. This certification must be specific to Minnesota Medicaid and Minnesota Partnership plans. After the initial certification, a 5-hour refresher is required at each subsequent renewal. This is a state-specific regulatory requirement that appears on the Minnesota state law section of the A&H exam.

Minnesota Partnership for Long-Term Care: Minnesota participates in the Long-Term Care Partnership Program — a collaboration between states and private LTC insurers that provides Medicaid asset protection for policyholders who exhaust their partnership-qualified LTC policy benefits. Under partnership rules, assets equal to the benefits paid by the partnership-qualified policy are protected from Medicaid spend-down requirements.

Section 4: Medicare and Medicare Supplement Insurance

Medicare is a federal health insurance program for individuals age 65 and older, certain younger individuals with disabilities, and individuals with end-stage renal disease. Medicare is consistently one of the highest-volume content areas on the Minnesota A&H exam.

Medicare Parts

Medicare Part A — Hospital Insurance:

Covers inpatient hospital care, skilled nursing facility care following a qualifying hospital stay, hospice care, and some home health care

Premium: Most Medicare beneficiaries pay $0 for Part A if they or their spouse worked at least 40 quarters and paid Medicare taxes

Deductible: $1,676 per benefit period (2025)

Benefit periods: A benefit period begins the day the beneficiary is admitted to a hospital or skilled nursing facility and ends when they have been out of the facility for 60 consecutive days

Medicare Part B — Medical Insurance:

Covers physician services, outpatient care, preventive services, and durable medical equipment

Premium: $185.00/month (standard 2025 premium, subject to income-related adjustments — IRMAA)

Annual deductible: $257 (2025)

Coinsurance: 20% of Medicare-approved amount after deductible

Medicare Part C — Medicare Advantage:

Private insurance plans that provide Part A and Part B benefits, often including Part D (prescription drug coverage) and additional benefits not covered by original Medicare

Administered by private insurers approved by CMS

Producers selling Medicare Advantage must complete Medicare Advantage sales certification and comply with CMS marketing regulations

Medicare Part D — Prescription Drug Coverage:

Voluntary outpatient prescription drug benefit provided through private insurers

Premium varies by plan; income-related adjustments apply above certain income levels

Coverage gap (the "donut hole") has been substantially modified by recent legislation — verify current Phase structure with CMS materials at time of study

Medicare Supplement (Medigap) Insurance

Medicare supplement policies are sold by private insurers to cover the gaps left by original Medicare (Parts A and B) — primarily the Part A deductible, Part B coinsurance, and hospital costs beyond Medicare's coverage limits.

Standardized plans: Medigap policies are federally standardized. Plans are identified by letters (Plan A through Plan N, with some letters retired). Each plan with the same letter offers identical benefits regardless of which insurer sells it — the only variation is premium. Plan G is currently the most comprehensive plan available to new Medicare beneficiaries.

Open enrollment: The Medicare supplement open enrollment period begins the month a beneficiary is both age 65 or older and enrolled in Part B, and lasts 6 months. During this period, insurers must accept all applicants regardless of health status and cannot charge higher premiums based on pre-existing conditions. Outside open enrollment, medical underwriting applies in most circumstances.

Guaranteed issue rights: Specific triggering events — such as losing employer coverage, moving out of a Medicare Advantage plan's service area, or the plan being discontinued — give beneficiaries guaranteed issue rights to purchase a Medigap policy without medical underwriting.

Section 5: Medicaid and Minnesota-Specific Health Programs

Medicaid: A joint federal-state program providing health coverage to low-income individuals. Medicaid is administered by states within federal guidelines. Minnesota expanded Medicaid under the ACA.

Medical Assistance: Minnesota's name for its Medicaid program. Covers adults with incomes up to 138% of the Federal Poverty Level (FPL).

MinnesotaCare: Minnesota's Basic Health Program (BHP) — a state-specific program unique to Minnesota that provides low-cost coverage for individuals with incomes between 138% and 200% of FPL. MinnesotaCare fills the gap between Medicaid and marketplace coverage, providing near-universal access across all income levels. This is a high-priority Minnesota state law topic — no other state has an identical program, and the exam tests whether candidates understand what MinnesotaCare is and how it differs from both Medicaid and marketplace plans.

MNsure: Minnesota's state-based health insurance exchange. The only platform through which Minnesotans can access financial assistance (APTC and CSR) to purchase individual health insurance. Producers who sell on-exchange plans through MNsure must be registered with MNsure.

Section 6: The ACA and Health Insurance Regulation

ACA essential health benefits: Non-grandfathered individual and small group plans must cover ten essential health benefit categories: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services, laboratory services, preventive and wellness services, and pediatric services including oral and vision care.

ACA guaranteed issue and community rating: Individual and small group insurers must accept all applicants regardless of health status (guaranteed issue) and cannot vary premiums based on health history. Premiums may only vary based on age, tobacco use, geographic area, and family size.

Pre-existing condition protections: Insurers cannot exclude pre-existing conditions from coverage in ACA-compliant plans.

Special enrollment periods (SEPs): Outside of open enrollment, qualifying life events — loss of coverage, marriage, birth, adoption, moving — trigger a 60-day SEP window for marketplace enrollment.

Section 7: Minnesota State Law — A&H Provisions

Minnesota Department of Commerce oversight: The Commissioner of Commerce regulates health insurance carriers and producers in Minnesota. Producers must hold an active A&H line of authority and maintain carrier appointments before transacting health insurance business.

Minnesota unfair claims practices: Minn. Stat. §72A.20 prohibits specific unfair claims settlement practices in the A&H context — denying claims without reasonable investigation, misrepresenting policy provisions in claim communications, and compelling insureds to litigate to collect valid claims.

Mental health parity: Minnesota has strong mental health parity requirements — health insurance policies that cover mental health and substance use disorder services must provide those benefits at parity with medical and surgical benefits. Coverage limits, cost-sharing, and prior authorization requirements for mental health services cannot be more restrictive than those applied to comparable medical or surgical benefits.

Minnesota Continuation Law: Minnesota requires insurers and employers to offer continuation of group health coverage to employees and dependents following qualifying events — similar to COBRA but covering smaller employers (those with fewer than 20 employees who are exempt from federal COBRA requirements). Minnesota continuation provides up to 18 months of coverage.

Minnesota Life and Health Guaranty Association (Minn. Stat. §61B): Protects A&H policyholders if an insurer becomes insolvent. Coverage limits apply — producers may not use guaranty association protection in sales presentations to minimize concerns about insurer financial stability.

LTC producer certification (Minnesota-specific): As noted above, the 8-hour initial LTC certification and 5-hour biennial refresher are Minnesota-specific requirements for producers selling LTC insurance. These requirements appear regularly in the state law section of the A&H exam.

Strategic Approach: Maximizing Your Score

Master Medicare inside and out. Medicare — Parts A through D, Medicare Advantage, and Medicare supplement — generates a disproportionately high share of A&H exam questions relative to its share of the curriculum. Candidates who know Medicare comprehensively — including the specific dollar amounts for current deductibles and premiums, the standardized Medigap plan letters, the open enrollment rules, and the guaranteed issue triggers — pick up significant points that candidates who only study health insurance basics miss.

Know Minnesota's unique programs. MinnesotaCare is specifically tested because it is Minnesota-specific — no other state's exam tests it. MNsure as the state exchange, Medical Assistance as Minnesota's Medicaid name, and the LTC producer certification requirements are all high-priority state law topics that reward candidates who invest time in Minnesota-specific study.

Disability income definitions matter. The definition of disability — own occupation vs. any occupation — generates exam questions at every level: the definition itself, its implications for when benefits are payable, and why own-occupation coverage is more valuable for certain professions. Know all three definitions and their practical distinctions.

Use numerical anchors for Medicare. The Medicare questions that test specific dollar amounts — Part A deductible, Part B premium and deductible, Part B coinsurance percentage, HSA contribution limits — reward candidates who memorize current figures. Build a reference sheet with all Medicare dollar amounts and review it immediately before the exam.

Connect LTC to Minnesota Partnership. The Minnesota Partnership for Long-Term Care is a state-specific program that connects private LTC insurance to Medicaid asset protection. Understanding the relationship between the two — specifically that partnership-qualified benefits protect equivalent assets from Medicaid spend-down — addresses a content area that purely general study misses.

Frequently Asked Questions

How much of the A&H exam covers Medicare specifically?

Medicare — including original Medicare (Parts A through D), Medicare Advantage, and Medicare supplement insurance — typically generates 15–25% of the questions on the Minnesota A&H exam, making it the single most tested subject area within the A&H content. This is disproportionate to Medicare's share of the curriculum volume because the Medicare content is highly specific and testable — the exam can ask about exact benefit periods, specific premium amounts, the six-month Medigap open enrollment window, or the standardized plan letters with precision that rewards memorization over general familiarity. Allocate more study time to Medicare than any other single A&H topic.

I plan to sell mostly individual health insurance through MNsure. Is the A&H exam heavily weighted toward the products I will actually sell?

The A&H exam covers the full breadth of accident and health insurance products — individual health, group health, disability income, LTC, Medicare, and Medicaid — regardless of which products you intend to sell. The exam is a licensing requirement that demonstrates broad product knowledge, not a test of the specific products in your distribution channel. Candidates who narrow their study to individual ACA-compliant health plans will encounter questions about disability income, LTC, Medicare supplement, and Minnesota continuation law that they have not prepared for. Study the complete content outline even if your anticipated practice is narrower than the full A&H curriculum.

What is the most important Minnesota-specific topic on the A&H exam?

MinnesotaCare — Minnesota's Basic Health Program — is the most distinctively Minnesota-specific topic on the A&H exam because it exists only in Minnesota and cannot be known from general insurance study. Understand that MinnesotaCare serves Minnesotans with incomes between 138% and 200% of FPL, that it functions as a bridge between Medicaid (below 138% FPL) and marketplace coverage (above 200% FPL), that it is administered by the state with federal funding, and that it provides near-universal coverage access across income levels in a way that no other state has replicated. The LTC producer certification requirement — the 8-hour initial and 5-hour biennial refresher specific to Minnesota Medicaid and Partnership plans — is the second most distinctively Minnesota-specific topic and appears regularly in exam questions about what producers must do before selling LTC products.

The exam covers both individual and group health insurance. How deeply does it test group-specific rules like COBRA and HIPAA?

COBRA and HIPAA are consistently tested on the Minnesota A&H exam at a level that requires more than surface familiarity. COBRA questions test the employer size threshold (20 or more employees), the qualifying events, the duration of continuation coverage (18 months for employees, 29 months for disabled individuals, 36 months for qualifying dependents), and the maximum premium the qualified beneficiary pays (102% of the full group premium). HIPAA questions test the limits on pre-existing condition exclusion periods, the creditable coverage concept, and the prohibition on health-status discrimination in group enrollment. Know the specific numbers and the specific rules — not just the general concept that these federal laws exist.

The Minnesota A&H exam covers a genuinely broad curriculum — from individual health policy provisions through Medicare supplement standardized plans to Minnesota's unique MinnesotaCare program. The candidates who pass on their first attempt are those who study the complete content outline at appropriate depth, allocate concentrated study time to Medicare and Minnesota-specific programs, memorize the specific numbers and timeframes that generate precision exam questions, and walk into the PSI testing environment knowing exactly what the exam tests across every section.

Visit JustInsurance to enroll today and complete your Minnesota A&H prelicensing with a state-approved course built to the current PSI content outline, including practice exams designed to prepare you for every topic in this guide.