CACs Health Coverage Programs 2

Question 1

Which federal program provides health coverage to people with end-stage renal disease (ESRD) regardless of age?

Accepted Answer

Medicare

Answer

Medicare covers individuals with ESRD regardless of age because it is a specific eligibility pathway under Medicare Part A and Part B.

Question 2

Under the ACA, which metal tier plan covers approximately 90% of average healthcare costs?

Accepted Answer

Platinum

Answer

Platinum plans have the highest actuarial value at approximately 90%, meaning the plan covers about 90% of average covered costs.

Question 3

A family's Modified Adjusted Gross Income (MAGI) is used to determine eligibility for which programs?

Accepted Answer

Marketplace plans and Medicaid

Answer

MAGI-based income rules apply to Marketplace coverage, premium tax credits, cost-sharing reductions, Medicaid, and CHIP eligibility determinations.

Question 4

What is the purpose of a Special Enrollment Period (SEP)?

Accepted Answer

To permit enrollment outside the standard Open Enrollment Period due to a qualifying life event

Answer

SEPs allow consumers who experience qualifying life events — such as losing coverage, marriage, or moving — to enroll in a health plan outside Open Enrollment.

Question 5

Which program offers coverage to children in families that earn too much for Medicaid but cannot afford private insurance?

Accepted Answer

CHIP

Answer

CHIP (Children's Health Insurance Program) fills the coverage gap for children in families whose income exceeds Medicaid limits but is still low enough to qualify for subsidized coverage.

(CACs) Certified Application Counselor Practice Test

(CACs) Certified Application Counselor Practice Test

CACs Health Coverage Programs 2