CACs - Certified Application Counselor Health Coverage Programs Questions and Answers

Question 1

A 45-year-old single adult with no disabilities has an annual income that is 120% of the Federal Poverty Level (FPL). They live in a state that has expanded its Medicaid program. Which health coverage program are they most likely eligible for?

Accepted Answer

Medicaid

Answer

In states that have expanded Medicaid under the Affordable Care Act (ACA), non-disabled adults under age 65 with household incomes up to 138% of the FPL are generally eligible for Medicaid. Since this individual's income is at 120% FPL, they would qualify for Medicaid.

Question 2

What is the primary purpose of the Children's Health Insurance Program (CHIP)?

Accepted Answer

To provide low-cost or free health coverage for children in families who earn too much to qualify for Medicaid but cannot afford private insurance.

Answer

CHIP provides health coverage to uninsured children in families with incomes that are too high to qualify for Medicaid but too low to afford private coverage. It is specifically designed to cover this gap population of children.

Question 3

An individual is generally eligible for Medicare before the age of 65 under which of the following circumstances?

Accepted Answer

They have been receiving Social Security Disability Insurance (SSDI) benefits for 24 months.

Answer

Individuals under 65 can qualify for Medicare if they have a qualifying disability. Typically, this eligibility begins after they have received Social Security Disability Insurance (SSDI) benefits for 24 months. Other qualifying conditions include End-Stage Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS).

Question 4

Which of the following is a key requirement for an individual to be eligible for Advance Premium Tax Credits (APTCs) to lower the cost of a Health Insurance Marketplace plan?

Accepted Answer

The individual must not be eligible for other minimum essential coverage, like Medicaid or Medicare.

Answer

To qualify for APTCs, an individual must not be eligible for other forms of minimum essential coverage, such as Medicaid, Medicare, or affordable employer-sponsored insurance. They must also have a household income between 100% and 400% of the FPL (with exceptions extending this range due to recent legislation).

Question 5

Maria is a single mother with one child, age 10. Their household income is 150% of the FPL. Her state has expanded Medicaid to 138% FPL for adults, and its CHIP program covers children in families with incomes up to 200% FPL. What are the likely eligibility determinations for Maria and her child?

Accepted Answer

Maria is eligible for a subsidized Marketplace plan, and her child is eligible for CHIP.

Answer

Maria's income at 150% FPL is above the 138% FPL threshold for adult Medicaid in her state, making her ineligible for that program. However, her income is within the range for Marketplace subsidies. Her child's eligibility is determined separately; since the household income of 150% FPL is below the state's 200% FPL limit for CHIP, the child will likely qualify for CHIP.

(CACs) Certified Application Counselor Practice Test

(CACs) Certified Application Counselor Practice Test

CACs - Certified Application Counselor Health Coverage Programs Questions and Answers