ACA Essential Health Benefits & Plan Types 2

Question 1

Which of the following is an Essential Health Benefit mandated by the ACA?

Accepted Answer

Prescription drug coverage

Answer

Acupuncture and alternative medicine

Answer

Long-term care services

Answer

Vision care for adults

Question 2

What does an HMO (Health Maintenance Organization) typically require of its members?

Accepted Answer

Choosing a primary care physician and obtaining referrals for specialists

Answer

Seeing any provider without referrals

Answer

Paying higher premiums for broader network access

Answer

Equal coverage for out-of-network and in-network providers

Question 3

What best describes an Exclusive Provider Organization (EPO)?

Accepted Answer

A plan that only covers in-network care except in emergencies

Answer

A plan that covers out-of-network care at any cost level

Answer

A plan requiring referrals for all specialist visits

Answer

A plan exclusively offered to large employer groups

Question 4

What does 'actuarial value' represent in an ACA health plan?

Accepted Answer

The percentage of total covered healthcare costs the plan pays on average

Answer

The maximum premium an insurer can charge

Answer

The annual deductible a member must satisfy before coverage begins

Answer

The standard copay amount for primary care visits

Question 5

Which plan type typically offers the MOST provider flexibility but usually has higher monthly premiums?

Accepted Answer

PPO

Answer

HMO

Answer

EPO

Answer

HDHP

Question 6

A Health Savings Account (HSA) can be used in conjunction with which type of ACA health plan?

Accepted Answer

An HSA-qualified High-Deductible Health Plan (HDHP)

Answer

Any Bronze plan

Answer

Any HMO plan

Answer

A Platinum plan

Question 7

What is the primary advantage of a Bronze plan for a relatively healthy individual?

Accepted Answer

Lower monthly premiums

Answer

Lower deductibles than other metal tiers

Answer

Lower out-of-pocket maximums

Answer

Access to a wider provider network