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Pass with Confidence: AHIP 2025 Exam Answers for 2024/2025 R346,96
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Pass with Confidence: AHIP 2025 Exam Answers for 2024/2025

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Pass with Confidence: AHIP 2025 Exam Answers for 2024/2025

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  • June 11, 2024
  • December 25, 2024
  • 10
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

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  • pass with confidence ahip 2025 exam answers for 2

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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 healthcare premiums for all individuals
B) To guarantee affordable health insurance for all Americans
C) To increase taxes for high-income earners
D) To eliminate all private health insurance plans
Answer: B) To guarantee affordable health insurance for all Americans
Rationale: The ACA was designed to make healthcare more affordable
and accessible to all Americans by providing health insurance
marketplaces, expanding Medicaid, and regulating health insurance
plans to prevent discrimination against those with pre-existing
conditions.


2. Which of the following is NOT typically covered by Medicare Part A?
A) Hospital stays
B) Skilled nursing facility care
C) Prescription drugs
D) Hospice care
Answer: C) Prescription drugs
Rationale: Medicare Part A generally covers hospital stays, skilled
nursing care, and hospice services. Prescription drugs are typically
covered under Medicare Part D, not Part A.


3. What is a key feature of a Health Maintenance Organization (HMO)?
A) The plan offers broad flexibility in choosing healthcare providers.
B) Members must choose a primary care physician (PCP).

,C) There is no need for referrals to see a specialist.
D) Out-of-network care is always covered.
Answer: B) Members must choose a primary care physician (PCP).
Rationale: HMO plans typically require members to select a primary
care physician who acts as a gatekeeper for referrals to specialists. They
tend to have more restrictive networks of healthcare providers.


4. Under the Health Insurance Portability and Accountability Act
(HIPAA), which of the following is protected?
A) Employer’s right to access an employee’s medical records
B) The privacy of patients' medical information
C) The right of insurers to deny coverage based on pre-existing
conditions
D) Employers’ ability to refuse to cover dependents
Answer: B) The privacy of patients' medical information
Rationale: HIPAA was enacted to protect the privacy and security of
individuals' health information, ensuring that medical records and other
personal health information are kept confidential.


5. What is the purpose of the Medicare Advantage (Part C) plan?
A) To cover only outpatient services
B) To provide an alternative to Original Medicare by combining Parts A
and B, sometimes with additional benefits
C) To offer a private insurance option for dental care only
D) To offer government-funded prescription drug coverage

,Answer: B) To provide an alternative to Original Medicare by combining
Parts A and B, sometimes with additional benefits
Rationale: Medicare Advantage (Part C) is a private insurance plan that
provides all the coverage of Original Medicare (Part A and Part B), often
with additional benefits like vision, hearing, and dental coverage.


6. What is a characteristic of a Preferred Provider Organization (PPO)?
A) Requires referrals to see specialists
B) Has a more limited network of healthcare providers
C) Offers more flexibility in choosing providers than an HMO
D) Covers only preventive care
Answer: C) Offers more flexibility in choosing providers than an HMO
Rationale: PPOs offer greater flexibility than HMOs, allowing members
to see specialists and out-of-network providers without a referral,
though out-of-network care may come with higher costs.


7. Which of the following is a common provision found in a health
insurance policy?
A) Coverage for all types of alternative medicine
B) A maximum limit on out-of-pocket expenses
C) Unlimited lifetime benefits
D) Coverage for only emergency care
Answer: B) A maximum limit on out-of-pocket expenses
Rationale: Most health insurance policies include an out-of-pocket
maximum, which limits the amount a member has to pay in a given year

, for covered services. This is designed to prevent financial hardship in
the case of major health issues.


8. What does "pre-existing condition" mean in the context of health
insurance?
A) A medical condition diagnosed before the purchase of the insurance
policy
B) Any medical condition diagnosed after the insurance policy is
purchased
C) A condition that can be treated only through outpatient care
D) A condition that is automatically covered by health insurance
Answer: A) A medical condition diagnosed before the purchase of the
insurance policy
Rationale: A pre-existing condition refers to a health issue that existed
before the individual applied for health insurance. Under the ACA,
insurers cannot deny coverage or charge higher premiums due to pre-
existing conditions.


9. What is the purpose of the Health Insurance Marketplace?
A) To allow private insurers to set their own prices
B) To help individuals compare and purchase health insurance plans
C) To provide government-funded health insurance for all
D) To monitor insurance fraud
Answer: B) To help individuals compare and purchase health insurance
plans
Rationale: The Health Insurance Marketplace, established under the
ACA, allows individuals to compare different health insurance plans and

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