CACs Affordable Care Act Basics 2

Question 1

Under the ACA, what is the maximum out-of-pocket limit for an individual in a Marketplace plan for plan year 2024?

Accepted Answer

$9,450

Answer

For 2024, the ACA out-of-pocket maximum for individual coverage is $9,450; once reached, the plan pays 100% of covered in-network costs.

Question 2

Which federal agency administers the Health Insurance Marketplace (Healthcare.gov)?

Accepted Answer

Centers for Medicare & Medicaid Services (CMS)

Answer

The Centers for Medicare & Medicaid Services (CMS), within HHS, operates the federally facilitated Marketplace at Healthcare.gov.

Question 3

A consumer's ACA plan covers an emergency visit at an out-of-network hospital. Under the ACA's essential health benefit rules, which statement is TRUE?

Accepted Answer

Plans must cover emergency services without prior authorization

Answer

The ACA requires all non-grandfathered plans to cover emergency services without prior authorization, even from out-of-network providers.

Question 4

What does 'creditable coverage' mean in the context of the ACA and Special Enrollment Periods?

Accepted Answer

Prior health insurance that counts toward satisfying waiting periods

Answer

Creditable coverage refers to prior qualifying health coverage that may be used to satisfy enrollment requirements and avoid gaps triggering penalties.

Question 5

Under the ACA, which of the following is NOT considered a minimum essential coverage (MEC) type?

Accepted Answer

A short-term limited-duration health plan

Answer

Short-term limited-duration plans are explicitly excluded from the definition of minimum essential coverage under the ACA.

(CACs) Certified Application Counselor Practice Test

(CACs) Certified Application Counselor Practice Test

CACs Affordable Care Act Basics 2