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AHIP 2025 Verified Final Test Answers for 2024/2025 $17.99
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AHIP 2025 Verified Final Test Answers for 2024/2025

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AHIP 2025 Verified Final Test Answers for 2024/2025

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

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  • ahip 2025 verified final test answers for 2024202

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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 not typically covered under a standard
health insurance plan?
a) Emergency medical services
b) Routine vision care
c) Hospitalization for surgery
d) Prescription medications
Answer: b) Routine vision care
Rationale: Routine vision care, such as regular eye exams or glasses, is
often not covered under basic health insurance plans unless the policy
specifically includes vision benefits. Most plans primarily cover
emergency medical services, hospitalization, and prescriptions, but
vision and dental care are often separate plans.


2. What does the term “premium” refer to in a health insurance
policy?
a) The amount paid out-of-pocket for each medical visit
b) The total amount the insurance company pays for claims
c) The monthly payment to keep the insurance active
d) The deductible amount to be paid before coverage kicks in
Answer: c) The monthly payment to keep the insurance active
Rationale: The premium is the amount that the policyholder must pay
regularly (usually monthly) to maintain their health insurance coverage.
It does not refer to out-of-pocket costs or deductibles, but rather the
cost for maintaining the insurance policy.


3. Under the Affordable Care Act (ACA), which of the following is true
regarding health insurance coverage?

,a) Health insurance plans can deny coverage for pre-existing conditions
b) Insurers are required to offer at least one “essential health benefit”
c) People can be penalized for not having health insurance
d) Age cannot be used to determine insurance premiums
Answer: b) Insurers are required to offer at least one “essential health
benefit”
Rationale: Under the ACA, insurers are required to provide a set of
essential health benefits, such as emergency services, maternity care,
and mental health services. The ACA also prohibits discrimination based
on pre-existing conditions, ensures that premiums cannot be based
solely on age, and removed the individual mandate penalty for not
having insurance in many states.


4. A "copayment" in a health insurance plan refers to:
a) The total amount a policyholder must pay for a medical procedure
b) A flat fee paid by the insured at the time of a service
c) The percentage of a claim the insured must pay
d) The maximum out-of-pocket cost that the insured will pay in a year
Answer: b) A flat fee paid by the insured at the time of a service
Rationale: A copayment is a fixed amount paid by the insured at the
time of a medical service, such as a doctor’s visit or prescription. It is
separate from other costs like deductibles or coinsurance.


5. What is the primary purpose of a "deductible" in a health insurance
plan?
a) To limit the number of medical services an insured person can use
b) To share the cost of medical care between the insured and the

,insurer
c) To specify the amount the insured must pay out-of-pocket before the
insurance plan begins to pay
d) To reimburse the insured for medical services already paid for
Answer: c) To specify the amount the insured must pay out-of-pocket
before the insurance plan begins to pay
Rationale: The deductible is the amount a policyholder must pay out-of-
pocket for healthcare services before the insurance company begins to
cover the costs. This amount must be met before the insurer begins
sharing costs with the insured through coinsurance or other coverage
options.


6. Under the Health Insurance Portability and Accountability Act
(HIPAA), what protection is provided to individuals in the healthcare
system?
a) Protects individuals from being denied coverage due to pre-existing
conditions
b) Guarantees individuals access to free healthcare services
c) Ensures that all healthcare providers accept the same insurance plans
d) Offers tax benefits for employers who provide health insurance
Answer: a) Protects individuals from being denied coverage due to pre-
existing conditions
Rationale: HIPAA provides protections regarding health insurance
coverage, particularly in terms of preventing discrimination based on
pre-existing conditions and ensuring that individuals maintain coverage
if they change or lose their job.

, 7. Which type of health insurance plan typically has the lowest
premiums but higher out-of-pocket costs for medical services?
a) Health Maintenance Organization (HMO)
b) Preferred Provider Organization (PPO)
c) High Deductible Health Plan (HDHP)
d) Point of Service (POS) Plan
Answer: c) High Deductible Health Plan (HDHP)
Rationale: High Deductible Health Plans have lower premiums
compared to traditional plans, but they require the insured to pay a
higher deductible and more out-of-pocket expenses before the
insurance coverage begins. These plans are often paired with Health
Savings Accounts (HSAs) to help cover costs.


8. Which of the following is not an essential health benefit required by
the Affordable Care Act?
a) Prescription drugs
b) Maternity and newborn care
c) Long-term care
d) Preventive and wellness services
Answer: c) Long-term care
Rationale: The ACA requires that health insurance plans cover essential
health benefits, which include services like maternity care, prescription
drugs, and preventive services. However, long-term care is generally not
an essential health benefit and may require separate coverage or
policies.

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