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AHIP CERTIFICATION 2024/2025 FINAL EXAM QUESTIONS AND DETAILED ANSWERS| LATEST VERSIONS R346,73
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AHIP CERTIFICATION 2024/2025 FINAL EXAM QUESTIONS AND DETAILED ANSWERS| LATEST VERSIONS

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AHIP CERTIFICATION 2024/2025 FINAL EXAM QUESTIONS AND DETAILED ANSWERS| LATEST VERSIONS

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  • June 11, 2024
  • December 25, 2024
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  • 2023/2024
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3  reviews

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By: alex71 • 5 months ago

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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)?
a) To reduce taxes on insurance companies
b) To provide health insurance to uninsured individuals
c) To increase premiums for employer-sponsored health plans
d) To eliminate Medicaid
Answer: b) To provide health insurance to uninsured individuals
Rationale: The Affordable Care Act (ACA) aimed primarily at expanding
access to health insurance, particularly for those who were uninsured
or underinsured. This was accomplished through Medicaid expansion
and the establishment of health insurance exchanges.


2. Under Medicare, which of the following is covered by Part A?
a) Prescription drugs
b) Hospital stays
c) Doctor’s office visits
d) Preventive care
Answer: b) Hospital stays
Rationale: Medicare Part A primarily covers inpatient hospital stays,
skilled nursing facility care, hospice care, and some home health care.


3. Which type of health insurance plan allows patients to see any
doctor or specialist without a referral?
a) Health Maintenance Organization (HMO)
b) Preferred Provider Organization (PPO)

,c) Point of Service (POS)
d) High Deductible Health Plan (HDHP)
Answer: b) Preferred Provider Organization (PPO)
Rationale: PPO plans offer flexibility in choosing healthcare providers
and allow individuals to see any doctor or specialist without a referral,
unlike HMOs that require referrals for specialist visits.


4. What is the purpose of a health insurance deductible?
a) To limit the total amount an individual pays for covered services
b) To reduce monthly premiums for insured individuals
c) To cover the cost of preventive care
d) To specify the amount an insured person must pay out-of-pocket
before insurance begins to pay
Answer: d) To specify the amount an insured person must pay out-of-
pocket before insurance begins to pay
Rationale: A deductible is the amount the insured individual must pay
for covered healthcare services before the insurer starts paying.


5. Which of the following is true about Medicare Advantage (Part C)
plans?
a) They are only available to individuals under age 65
b) They are offered by private insurance companies and provide at least
the same benefits as Original Medicare
c) They do not cover prescription drugs
d) They are only available to low-income individuals

,Answer: b) They are offered by private insurance companies and
provide at least the same benefits as Original Medicare
Rationale: Medicare Advantage (Part C) plans are offered by private
insurance companies and must cover all the benefits of Original
Medicare (Part A and Part B). They often include additional benefits,
such as prescription drug coverage.


6. Which of the following best describes a High Deductible Health Plan
(HDHP)?
a) It has lower monthly premiums and higher deductibles
b) It covers all medical expenses with no out-of-pocket costs
c) It requires members to use only in-network healthcare providers
d) It offers the same benefits as a PPO plan
Answer: a) It has lower monthly premiums and higher deductibles
Rationale: HDHPs are characterized by lower premiums but higher
deductibles compared to traditional plans. They are often paired with
Health Savings Accounts (HSAs) to help individuals save for medical
expenses.


7. Which of the following is a key feature of a Health Maintenance
Organization (HMO)?
a) Flexibility to visit any healthcare provider without a referral
b) High premiums with no out-of-pocket costs
c) A requirement to get referrals from a primary care physician to see a
specialist
d) Coverage for only emergency care outside the network

, Answer: c) A requirement to get referrals from a primary care physician
to see a specialist
Rationale: HMO plans typically require members to select a primary
care physician (PCP), who must provide referrals to see specialists or
receive certain treatments.


8. Under the Affordable Care Act, which of the following is prohibited?
a) Charging individuals with pre-existing conditions higher premiums
b) Limiting the number of doctors a patient can see
c) Offering health plans only to people above a certain income level
d) Providing tax credits for individuals buying insurance
Answer: a) Charging individuals with pre-existing conditions higher
premiums
Rationale: The ACA made it illegal for health insurers to charge higher
premiums or deny coverage based on pre-existing conditions.


9. Which of the following is considered an essential health benefit
under the Affordable Care Act?
a) Cosmetic surgery
b) Maternity and newborn care
c) Acupuncture
d) Long-term care
Answer: b) Maternity and newborn care
Rationale: Essential health benefits under the ACA include maternity
and newborn care, mental health services, and prescription drug
coverage, among others.

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