Practice Test Geeks(CACs) Certified Application Counselor Practice Test
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Healthcare Programs & Coverage Options Flashcards

7 cards from real CACS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Healthcare Programs & Coverage Options flashcards as text

  1. A consumer's employer offers health coverage, but the employee-only premium costs more than 9.02% of household income (2023 threshold). What does this mean for Marketplace eligibility?

    Answer: The coverage is considered unaffordable and the consumer may qualify for Marketplace APTC

    If employer coverage is unaffordable (employee-only premium exceeds the affordability threshold), the consumer may qualify for Marketplace subsidies.

  2. American Indians and Alaska Natives (AI/ANs) enrolled in a federally recognized tribe have special rights on the Marketplace. Which of the following is a unique benefit available to them?

    Answer: Ability to change plans monthly and zero cost-sharing at Indian Health Service facilities for incomes up to 300% FPL

    AI/ANs can change Marketplace plans monthly and receive zero cost-sharing for income up to 300% FPL when using IHS or tribal facilities.

  3. What is the maximum out-of-pocket limit for Marketplace plans in 2024 for an individual (single person)?

    Answer: $9,450 (subject to annual adjustment)

    The ACA sets an annual out-of-pocket maximum for Marketplace plans, adjusted yearly; for 2024 it is $9,450 for self-only coverage.

  4. Under the ACA's 'family glitch' fix (effective 2023), affordability of employer coverage for family members is now based on:

    Answer: The cost of covering the whole family under the employer plan

    The 2023 rule change tests affordability using the family premium, not the employee-only premium, opening Marketplace subsidies to more families.

  5. A consumer who loses Medicaid coverage due to an annual renewal determination loses coverage on March 31. When must they enroll in a Marketplace plan to avoid a gap in coverage?

    Answer: Within 60 days of loss of coverage

    Loss of qualifying coverage triggers a 60-day Special Enrollment Period to enroll in a Marketplace plan.

  6. Which Medicaid eligibility category was newly created by the ACA for non-elderly, non-pregnant adults without disabilities in expansion states?

    Answer: Adult Expansion Group (133% FPL)

    The ACA created the new 'adult group' for non-disabled adults ages 19–64 with income up to 133% FPL in states that expanded Medicaid.

  7. A consumer is comparing a High Deductible Health Plan (HDHP) paired with a Health Savings Account (HSA). Which statement about HSAs is accurate?

    Answer: HSA funds roll over year to year and can be invested

    HSA balances roll over indefinitely and can be invested, making them a long-term tax-advantaged savings tool for medical expenses.