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Guaranteed Pass with AHIP 2025 Certified Exam Answers

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Guaranteed Pass with AHIP 2025 Certified Exam Answers

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

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  • guaranteed pass with ahip 2025 certified exam answ

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By: TheAlphanurse • 6 months ago

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

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GREAT DOCUMENT. VERIFIED EXAM QUESTIONS. GREAT VALUE FOR MONEY

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1. Which of the following is a primary purpose of the Affordable Care
Act (ACA) in relation to health insurance?
A) To eliminate private health insurance companies
B) To reduce the cost of healthcare for employers
C) To increase access to health insurance and provide consumer
protections
D) To limit the coverage of pre-existing conditions
Answer: C) To increase access to health insurance and provide
consumer protections
Rationale: The ACA aims to increase access to health insurance, ensure
that coverage is affordable, and protect consumers from discrimination,
such as denying coverage for pre-existing conditions. It does not
eliminate private insurers or limit coverage for pre-existing conditions;
rather, it mandates coverage of such conditions.


2. Under Medicare, which part covers prescription drugs?
A) Part A
B) Part B
C) Part C
D) Part D
Answer: D) Part D
Rationale: Medicare Part D is the part of Medicare that provides
prescription drug coverage. Part A covers hospital insurance, Part B
covers medical insurance, and Part C refers to Medicare Advantage,
which is a private plan alternative to Original Medicare (Parts A and B).

,3. In a Preferred Provider Organization (PPO) plan, what is the main
advantage for the insured?
A) Must choose a primary care physician (PCP)
B) Can see specialists without referrals
C) Lower monthly premiums than Health Maintenance Organization
(HMO) plans
D) Coverage is limited to only in-network providers
Answer: B) Can see specialists without referrals
Rationale: PPO plans typically offer more flexibility than HMO plans,
allowing beneficiaries to see specialists and out-of-network providers
without a referral, although seeing in-network providers is cheaper.
They do not require a PCP or limit coverage to in-network providers.


4. What does the term "cost-sharing" refer to in a health insurance
policy?
A) The amount the insurer pays to cover medical expenses
B) The amount of money paid to the healthcare provider
C) The portion of medical costs the insured is responsible for paying,
such as deductibles, copayments, and coinsurance
D) The government subsidy for low-income individuals
Answer: C) The portion of medical costs the insured is responsible for
paying, such as deductibles, copayments, and coinsurance
Rationale: Cost-sharing refers to the part of the medical costs that the
insured must pay, such as deductibles (the amount you pay before
insurance kicks in), copayments (a fixed amount paid for a service), and
coinsurance (a percentage of the total cost).

,5. What is the primary function of the Health Insurance Marketplace
established by the ACA?
A) To provide insurance plans exclusively for low-income individuals
B) To allow individuals and small businesses to compare and purchase
health insurance plans
C) To regulate health insurance premiums
D) To offer health insurance plans only to those who qualify for
Medicare
Answer: B) To allow individuals and small businesses to compare and
purchase health insurance plans
Rationale: The Health Insurance Marketplace (also known as the
Exchange) allows individuals and small businesses to compare available
health insurance plans, potentially with subsidies based on income. It is
not limited to low-income individuals or Medicare beneficiaries.


6. Which of the following statements about Medicaid is correct?
A) Medicaid is a federally funded program, but it is administered by the
state governments.
B) Medicaid benefits are identical in every state.
C) Medicaid covers only people with incomes above the poverty line.
D) Medicaid is available only to children and pregnant women.
Answer: A) Medicaid is a federally funded program, but it is
administered by the state governments.
Rationale: Medicaid is jointly funded by the federal government and
the states but is administered by the states, which means eligibility
rules and benefits can vary from state to state. Medicaid provides

, coverage to low-income individuals, including children, pregnant
women, seniors, and people with disabilities.


7. In which of the following situations would an individual most likely
be eligible for a Special Enrollment Period (SEP) under the Affordable
Care Act?
A) Changing employers within the same industry
B) Moving to a new city but remaining in the same state
C) Gaining or losing eligibility for Medicaid
D) Turning 26 and aging off of a parent's health plan
Answer: C) Gaining or losing eligibility for Medicaid
Rationale: A Special Enrollment Period (SEP) is available for certain life
events, such as gaining or losing eligibility for Medicaid, which includes
changes like losing Medicaid coverage or becoming eligible for it due to
a change in circumstances.


8. What is the purpose of the "individual mandate" under the
Affordable Care Act (ACA)?
A) To require that individuals purchase health insurance or face a
penalty
B) To allow insurance companies to refuse coverage to individuals with
pre-existing conditions
C) To mandate that employers provide health insurance to their
employees
D) To set a minimum benefit level for health insurance plans
Answer: A) To require that individuals purchase health insurance or face
a penalty

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