Exam (elaborations)
CRPC - Healthcare
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- CRPC Sample Tests
Exam of 7 pages for the course CRPC Sample Tests at CRPC Sample Tests (CRPC - Healthcare)
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CRPC - HealthcarePurpose of health insurance? - ANS-Risk management
Affordable Care Act (ACA/Obamacare) - ANS-Designed to accomplish a fundamental
transformation of health insurance in the USA through shared responsibility.
Major changes induced by ACA include the following categories - ANS-1. Acquiring and
maintaining coverage
2. Health care costs
3. Requires essential health benefits from all plans
4. Eliminates cost sharing requirements for preventative care
5. Health insurance marketplace
10 Essential health insurance benefits defined by law - ANS-1. outpatient care
2. emergency services
3. hospitalization
4. maternity and newborn care
5. mental health and addition treatment
6. prescription drugs
7. rehab services
8. lab services
9. preventative services
10. pediatric services
What are the 5 levels of health care plans? - ANS-1. Catastrophic - 3 annual primary
care visits covered + preventative care; high deductible for all other care
2. Bronze (60 provider / 40 insured)
3. Silver (70 provider / 30 insured)
4. Gold (80 provider / 20 insured)
5. Platinum (90 provider / 10 insured)
**these plans cover the same services; it is how the COST for said services are shared
between the insured and the provider that determines the level
What is a deductible? - ANS-How much the insured must pay before the plan pays
anything
, What is co-insurance? - ANS-a percentage of the expenses that is paid by the
insurance company once the deductible has been met for covered services.
What is a co-payment? - ANS-A set amount that the insured will pay for a service, such
as a doctor's visit.
**copayment may or may not be applied to the deductible, depending on the plan.
What is an HSA? - ANS-Health Savings Account, offered for High Deductible plans
such as bronze or silver plans.
Tax exempt trust or custodial account established by an individual or employer for the
purpose of paying qualified medical expenses of the owner, their spouse, or
dependents.
When is an individual eligible to contribute to an HSA? - ANS-1. covered under a high
deductible plan
2. not entitled to coverage under any other health plan that is not a high deductible plan
3. are not enrolled in medicare
4. cannot be claimed as a dependent on another persons income tax return
Qualified medical expenses for purpose of an HSA: - ANS-diagnosis, cure, mitigation,
treatment/prevention of disease (prescription drugs, transportation, and qualified long
term care expenses).
Contributions to HSAs must.... - ANS-Be in cash. Unless you are processing a rollover
from another HSA account, then does not need to be in cash and does not have to meet
contribution limits of $3,600 for an individual, $7,200 for a couple.
HSA distributions after account owner has passed - ANS-1. If spouse named bene,
account stays intact as a HSA and updates into the name of the spouse.
2. non-spouse named as bene: HSA is dissolved as of DOD and the fair market value is
included in the bene's taxable income.
3. estate named as the bene: HSA is dissolved as of DOD and the fair market value is
included in the deceased final income tax return.
Incapacity planning must address 2 main concerns: - ANS-1. Management of the clients
property
2. Decision making for the clients personal and medical care
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