CEC Health Coverage Options & Program Eligibility 4

Question 1

A consumer loses job-based coverage on March 15. How long do they have to enroll in a Marketplace plan using their SEP?

Accepted Answer

60 days from the loss

Answer

Consumers who lose qualifying coverage have a 60-day SEP window to enroll in a Marketplace plan before or after the qualifying event.

Question 2

Which of the following best describes the 'Medicaid gap' problem in non-expansion states?

Accepted Answer

Adults earn too much for Marketplace subsidies but too little to qualify

Answer

In non-expansion states, adults with income below 100% FPL don't qualify for Marketplace APTCs (which start at 100% FPL) and may not qualify for Medicaid, leaving them in a 'coverage gap.'

Question 3

Which Medicare part covers outpatient services, including doctor visits and preventive care?

Accepted Answer

Part B

Answer

Medicare Part B covers medically necessary outpatient services, preventive services, and durable medical equipment.

Question 4

Under the ACA, children may remain on a parent's health plan until what age?

Accepted Answer

26

Answer

The ACA requires health plans that offer dependent coverage to allow adult children to remain on a parent's plan until age 26, regardless of marital or student status.

Question 5

Which of the following is a characteristic of a Preferred Provider Organization (PPO)?

Accepted Answer

Allows out-of-network coverage at a higher cost

Answer

PPOs allow members to see out-of-network providers at a higher cost-sharing level without needing a referral, offering greater flexibility than HMOs.

(CEC) Certified Enrollment Counselor Practice Test

(CEC) Certified Enrollment Counselor Practice Test

CEC Health Coverage Options & Program Eligibility 4