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Guaranteed Success: AHIP 2025 Exam Answers Verified 2024/2025
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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 provide a government-run health insurance program
C) To expand access to health insurance and reduce health care costs
D) To eliminate all private insurance companies
Answer: C) To expand access to health insurance and reduce health
care costs
Rationale: The primary goal of the ACA was to expand access to health
insurance, reduce healthcare costs, and improve the quality of care, not
eliminate private insurance or increase the number of uninsured.
2. What does the term "pre-existing condition" refer to in the context
of health insurance?
A) A health condition that occurs after purchasing insurance
B) A health condition that existed before applying for health insurance
C) A type of insurance that covers only accidents
D) A condition that can be excluded from coverage at any time
Answer: B) A health condition that existed before applying for health
insurance
Rationale: A pre-existing condition is a health condition that a person
had before applying for health insurance coverage. Under the ACA,
insurers can no longer deny coverage or charge higher premiums based
on pre-existing conditions.
3. Which of the following best describes the purpose of Medicaid?
,A) A government program providing health insurance for the elderly
B) A private insurance option for people under 65
C) A public assistance program that provides healthcare to low-income
individuals
D) A program for people with high-deductible health plans
Answer: C) A public assistance program that provides healthcare to
low-income individuals
Rationale: Medicaid is a government-funded program that provides
healthcare services to low-income individuals and families. It is distinct
from Medicare, which serves older adults and some disabled
individuals.
4. What is the "Individual Mandate" in the context of the Affordable
Care Act?
A) A rule that requires employers to provide health insurance to
employees
B) A requirement that all individuals have health insurance or pay a
penalty
C) A rule that provides subsidies for those purchasing insurance
D) A provision that eliminates the need for health insurance
Answer: B) A requirement that all individuals have health insurance or
pay a penalty
Rationale: The individual mandate, which was part of the ACA, required
most Americans to have health insurance or face a financial penalty.
This provision was repealed in 2017, but it was a core element of the
ACA during its early years.
,5. Which of the following types of insurance is typically included in a
Medicare Advantage plan?
A) Dental and vision care
B) Long-term care
C) Prescription drug coverage
D) Mental health coverage only
Answer: C) Prescription drug coverage
Rationale: Medicare Advantage plans (Part C) offer a combination of
Medicare Part A (hospital insurance) and Part B (medical insurance),
often with added benefits like prescription drug coverage (Part D),
vision, and dental care. Long-term care is not typically covered under
Medicare Advantage.
6. Under the Affordable Care Act, what is the maximum amount an
insurance company can charge for essential health benefits?
A) It depends on the insurer
B) There is no limit to the amount an insurer can charge
C) Premiums can be capped based on income
D) Premiums are standardized for all insurers
Answer: C) Premiums can be capped based on income
Rationale: Under the ACA, insurance companies cannot charge
excessively for essential health benefits, and premiums are capped
based on a person’s income level. Subsidies are available for those who
qualify to help reduce premiums.
7. Which of the following is a feature of a Health Maintenance
Organization (HMO)?
, A) Members can visit any healthcare provider without a referral
B) Care is generally provided by a network of physicians and hospitals
C) There are high out-of-pocket costs for members
D) It does not require members to choose a primary care physician
Answer: B) Care is generally provided by a network of physicians and
hospitals
Rationale: HMO plans typically require members to choose a primary
care physician (PCP) and obtain referrals to see specialists. Care is
usually limited to a network of healthcare providers, and out-of-pocket
costs tend to be lower than in other plans.
8. What does a high-deductible health plan (HDHP) typically have?
A) A low deductible and low monthly premiums
B) High deductibles and low monthly premiums
C) Low premiums but high co-pays for doctor visits
D) No deductibles but high premiums
Answer: B) High deductibles and low monthly premiums
Rationale: High-deductible health plans (HDHPs) typically feature
higher deductibles and lower monthly premiums. These plans are often
paired with Health Savings Accounts (HSAs) to help cover the costs of
the deductible.
9. What is the purpose of a Health Savings Account (HSA)?
A) To pay for medical expenses tax-free
B) To cover long-term care costs
C) To provide coverage for mental health services only
D) To reduce the cost of purchasing insurance
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