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Assured Success: AHIP Final Exam Solutions 2024/2025

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Assured Success: AHIP Final Exam Solutions 2024/2025

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  • June 11, 2024
  • December 25, 2024
  • 11
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

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  • assured success ahip final exam solutions 202420

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3  reviews

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By: TheAlphanurse • 6 months ago

GREAT DOC!! DETAILED ANSWERS. VALUE FOR MONEY HONESTLY. GOOD WORK

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By: kihumba • 6 months ago

GREAT DOCUMENT. VERIFIED EXAM QUESTIONS. GREAT VALUE FOR MONEY

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1. Which of the following is the primary purpose of the Affordable
Care Act (ACA) in relation to health insurance?
A) To eliminate private health insurance
B) To reduce the number of people who are uninsured
C) To replace Medicare and Medicaid
D) To limit employer-sponsored health plans
Answer: B) To reduce the number of people who are uninsured
Rationale: The ACA was designed to increase access to health
insurance, lower healthcare costs, and reduce the number of uninsured
Americans through subsidies, Medicaid expansion, and the
establishment of health insurance marketplaces.


2. Which of the following is NOT a characteristic of a Health
Maintenance Organization (HMO)?
A) Requires members to have a primary care physician (PCP)
B) Provides coverage for out-of-network care
C) Requires referrals for specialist care
D) Typically has lower out-of-pocket costs
Answer: B) Provides coverage for out-of-network care
Rationale: HMO plans generally do not cover out-of-network care
except in emergencies. They emphasize preventative care and require
members to use a primary care physician (PCP) for referrals to
specialists.


3. What is the purpose of the Medicare Advantage (MA) program?

,A) To provide federal insurance to individuals under 65
B) To offer a private alternative to Original Medicare
C) To expand Medicaid eligibility
D) To provide prescription drug coverage only
Answer: B) To offer a private alternative to Original Medicare
Rationale: Medicare Advantage (Part C) allows beneficiaries to enroll in
a private plan approved by Medicare that provides all the benefits of
Original Medicare (Part A and Part B), often with additional benefits like
vision and dental coverage.


4. Which of the following statements about Medicaid eligibility is
true?
A) Medicaid eligibility is determined solely by income
B) Medicaid is available only to individuals with disabilities
C) Eligibility for Medicaid can vary by state
D) All low-income individuals are eligible for Medicaid, regardless of age
Answer: C) Eligibility for Medicaid can vary by state
Rationale: Medicaid eligibility criteria, including income thresholds and
benefits, vary by state. While the program provides coverage for low-
income individuals, the specifics of eligibility, including the expansion
under the ACA, are determined at the state level.


5. What is the purpose of the Individual Mandate under the
Affordable Care Act (ACA)?
A) To require employers to offer health insurance to employees
B) To mandate that individuals purchase health insurance or face a tax
penalty

,C) To limit insurance premiums for older individuals
D) To eliminate out-of-pocket costs for preventive care
Answer: B) To mandate that individuals purchase health insurance or
face a tax penalty
Rationale: The Individual Mandate, which was in effect until 2019 (and
still applies in some states), required most Americans to have health
insurance or pay a tax penalty, to encourage a larger risk pool and make
the insurance market more sustainable.


6. Which of the following is a key difference between a Preferred
Provider Organization (PPO) and a Health Maintenance Organization
(HMO)?
A) PPOs have lower premiums than HMOs
B) PPOs require referrals for specialist care, while HMOs do not
C) PPOs provide coverage for out-of-network care, whereas HMOs
generally do not
D) PPOs require members to choose a primary care physician
Answer: C) PPOs provide coverage for out-of-network care, whereas
HMOs generally do not
Rationale: PPOs provide more flexibility with out-of-network care, often
covering a portion of the costs, while HMO plans typically do not cover
out-of-network care except in emergencies.


7. Which of the following is an example of a cost-sharing feature in a
health insurance plan?
A) Health savings account (HSA)
B) Premium

, C) Deductible
D) Medicaid
Answer: C) Deductible
Rationale: A deductible is a cost-sharing feature, meaning the amount
the insured must pay out-of-pocket for healthcare services before the
insurer begins to pay. Premiums are the fixed monthly payments made
to keep coverage active, but they are not considered cost-sharing.


8. Which of the following is covered under Medicare Part D?
A) Hospital care
B) Prescription drugs
C) Mental health services
D) Long-term care
Answer: B) Prescription drugs
Rationale: Medicare Part D provides prescription drug coverage to
individuals who are enrolled in Original Medicare (Parts A and B) or a
Medicare Advantage plan. It helps cover the cost of prescription
medications.


9. Under the ACA, which of the following is considered an essential
health benefit that must be covered by all health plans sold on the
Marketplace?
A) Cosmetic surgery
B) Chiropractic care
C) Maternity and newborn care
D) Weight-loss surgery

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