The life and health insurance licensing exam varies by state, but most states structure the exam in a predictable way. Here's the short answer: most combined life and health exams have 150-165 questions, with a testing time of 2-2.5 hours. States that offer separate life and health exams tend to have 100-125 questions each.
The exam is administered by state-contracted testing providers — primarily Pearson VUE, PSI, and Prometric. Each state sets its own exam specifications, question counts, and passing thresholds, so the exact numbers vary. What doesn't change: all state exams are multiple-choice, and they test your knowledge of insurance concepts, policy provisions, state insurance law, and ethics.
While you should always verify the current exam specifications on your state's Department of Insurance website, here are typical structures across major states:
Many states offer separate life and health exams for candidates who only want one license:
Some states have moved to combined exams only — you take the full combined test regardless of which license type you're seeking. Others still offer the split. Check with your state's insurance department for current exam structure.
Life and health insurance exam questions come from two major categories in virtually every state: general insurance knowledge and state-specific insurance law. The ratio varies by state, but a common split is roughly 60-70% general knowledge and 30-40% state law.
Most states require a passing score of 60-70% to pass the life and health insurance exam. The most common passing threshold is 70% — which means you need to answer at least 70 out of 100 questions correctly (or equivalent, depending on the exam structure).
Some states scale the exam so the passing score is expressed as a scaled score rather than a percentage. For example, an exam might require a scaled score of 70 on a 0-100 scale. Scaled scoring adjusts for variation in exam difficulty between different test versions, so the required performance is consistent even if specific question sets vary.
A few important notes about the exam structure:
Pretest questions. Most state exams include some number of unscored pretest questions — items being evaluated for future exams. These questions look identical to real scored questions. You won't know which questions are pretest questions. This means a 150-question exam might have 10 unscored pretest questions, so only 140 questions actually count toward your score. Factor this in when doing the math — you might actually be passing even if your pace felt off.
No penalty for wrong answers. Insurance licensing exams don't subtract points for incorrect answers. Every unanswered question scores zero; a guessed answer has at least some chance of being correct. Always answer every question, even if you're uncertain. Never leave questions blank.
Most candidates who fail the life and health insurance exam fail because they underestimated the state law section or focused too heavily on memorizing policy types without understanding how they work in practice.
Get the right study materials for your state. Generic national study guides cover general knowledge well but may not adequately cover state-specific law. Look for study materials explicitly designed for your state's exam — Kaplan Financial Education, ExamFX, and PassMasters all offer state-specific licensing exam prep.
Study state law as seriously as product knowledge. The state law section catches many candidates because it feels like regulation memorization rather than insurance knowledge. Know your state's specific requirements for: CE hours to renew, what constitutes rebating vs. permissible discounts, the replacement rules for life insurance, and the state's definition of unfair trade practices. These topics appear directly on most state exams.
Use practice exams extensively. You should complete at least 500-700 practice questions before taking your exam, with the last week of prep focused on timed, full-length practice tests. Track your performance by topic — if you're consistently missing disability income questions or Medicare supplement questions, spend more time on those areas specifically before your exam date.
You can also link your study to Arizona Life and Health Insurance Exam: Full Guide 2026 if you're in Arizona — the state-specific guide covers Arizona's exam structure in detail. For licensing steps, the Life and Health Insurance License: How to Get Licensed article walks through the full process from eligibility through your first appointment.
Failing the insurance exam is common — pass rates on first attempts typically run 50-65% depending on the state. Most states allow you to retake the exam after a waiting period, usually 24 hours to a few days. Some states limit the number of retakes within a window before requiring additional waiting periods.
If you fail, get your score report. Most testing providers give you a category-by-category breakdown of performance — this tells you exactly which topic areas to focus your additional study on before your next attempt. Don't just restudy everything equally; work on the specific areas where your score was weakest.
Candidates who fail once and prepare specifically based on their score report typically pass on their second attempt. The exam is not an intelligence test — it's a knowledge and preparation test. With the right materials and enough practice questions, passing is genuinely achievable for anyone willing to put in the work.
With your exam date approaching, here's what to verify and do in the final days.
Confirm your exam appointment, testing location, and what ID you need to bring. Most testing centers require two forms of ID, with the primary ID being a government-issued photo ID that matches the name in your registration exactly. Name mismatches can prevent you from testing — verify this detail.
Review the specific exam topics for your state one more time. Pay special attention to any state-specific provisions you haven't fully memorized — things like your state's free-look period length, COBRA extension rules, or specific definition of an unfair trade practice under your state code.
In the final day before the exam, do a light review rather than intensive new studying. Your goal is consolidation and confidence, not last-minute cramming. Get adequate sleep. Research shows cognitive performance on tests is meaningfully impaired by sleep deprivation — being well-rested matters.
On exam day, arrive early, read each question fully before answering, and flag any questions you're unsure about for review if the testing platform allows it. Answer every question before submitting. Then find out your result — most testing providers give immediate pass/fail results at the testing center.