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AHIP 2025 Final Test Verified Solutions for a Sure Pass
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Voorbeeld van de inhoud
1. Which of the following is a primary goal of the Affordable Care Act(ACA)?
A) To increase the number of uninsured Americans
B) To reduce healthcare costs through cost-sharing only
C) To provide affordable health insurance to more Americans
D) To eliminate private health insurance in favor of public plans
Answer: C) To provide affordable health insurance to more Americans
Rationale: The ACA was designed to make health insurance more
affordable for Americans and reduce the number of uninsured
individuals. It did this through mechanisms like Medicaid expansion,
health insurance marketplaces, and regulations that prevent insurers
from denying coverage due to pre-existing conditions.
2. Which of the following is true about Medicare Advantage (MA)
plans?
A) They are run by the federal government
B) They provide benefits only for seniors over the age of 80
C) They offer benefits through private insurance companies approved
by Medicare
D) They are part of the Medicaid program
Answer: C) They offer benefits through private insurance companies
approved by Medicare
Rationale: Medicare Advantage plans are a part of Medicare but are
offered through private insurance companies that contract with the
federal government to provide benefits. They must cover at least the
same services as Original Medicare, but may offer additional benefits
such as vision, dental, and hearing.
,3. What is the primary purpose of the Health Insurance Marketplace
(Marketplace)?
A) To serve as a government-run insurance program
B) To provide a forum for insurance companies to sell plans without
restrictions
C) To allow individuals and families to shop for and enroll in affordable
health insurance plans
D) To regulate healthcare providers
Answer: C) To allow individuals and families to shop for and enroll in
affordable health insurance plans
Rationale: The Health Insurance Marketplace allows individuals and
families to compare different health insurance plans and find coverage
that fits their needs and budget. It was created by the Affordable Care
Act (ACA).
4. Which of the following is an example of a Medicare Part D benefit?
A) Hospital care
B) Prescription drug coverage
C) Skilled nursing facility care
D) Emergency care
Answer: B) Prescription drug coverage
Rationale: Medicare Part D provides prescription drug coverage, which
is essential for beneficiaries who need medication. It is separate from
the hospital insurance (Part A) and medical insurance (Part B) parts of
Medicare.
,5. Under the ACA, what is the "individual mandate"?
A) Individuals are required to purchase insurance from their employer
B) Individuals must maintain health insurance or pay a penalty
C) Individuals can only purchase insurance during the open enrollment
period
D) Individuals must select their insurance based on their income level
Answer: B) Individuals must maintain health insurance or pay a
penalty
Rationale: The individual mandate, which was part of the ACA, required
most Americans to have health insurance or pay a penalty when filing
their taxes. However, the penalty was effectively eliminated at the
federal level starting in 2019, though some states have their own
mandates.
6. What is the purpose of Medicaid?
A) To provide healthcare to those with a high income
B) To offer health insurance to the elderly only
C) To provide health insurance to low-income individuals and families
D) To cover health expenses for military personnel
Answer: C) To provide health insurance to low-income individuals and
families
Rationale: Medicaid is a joint federal and state program that provides
health coverage to low-income individuals, including families, the
elderly, pregnant women, and people with disabilities. It is designed to
help people who cannot afford private insurance.
, 7. Which of the following is NOT covered under the ACA’s essential
health benefits?
A) Maternity and newborn care
B) Prescription drugs
C) Cosmetic surgery
D) Mental health and substance use disorder services
Answer: C) Cosmetic surgery
Rationale: Cosmetic surgery is not considered one of the ACA's
essential health benefits. Essential health benefits include services like
maternity care, prescription drugs, and mental health services, but they
do not cover elective procedures like cosmetic surgery unless medically
necessary.
8. What is a common feature of a Health Maintenance Organization
(HMO) plan?
A) It allows for out-of-network coverage without additional charges
B) It requires members to get a referral from a primary care physician
(PCP) to see a specialist
C) It offers a large network of providers with no need for referrals
D) It covers only emergency care
Answer: B) It requires members to get a referral from a primary care
physician (PCP) to see a specialist
Rationale: HMO plans require members to choose a primary care
physician (PCP) and get referrals from the PCP to see specialists. They
typically have a more limited network of doctors but often have lower
premiums.
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