1. Which of the following is the primary purpose of the Affordable
Care Act (ACA)?
A) To expand Medicaid eligibility across all states
B) To increase healthcare costs for high-income individuals
C) To provide affordable healthcare coverage for individuals and families
D) To eliminate private insurance companies
Answer: C) To provide affordable healthcare coverage for individuals
and families
Rationale: The ACA's primary goal is to make healthcare more
affordable for individuals and families, primarily by expanding Medicaid,
creating health insurance exchanges, and providing subsidies to those
who qualify.
2. What is the term for the amount a policyholder must pay before
their health insurance begins to cover expenses?
A) Premium
B) Deductible
C) Co-payment
D) Coinsurance
Answer: B) Deductible
Rationale: The deductible is the amount a policyholder must pay out-of-
pocket for healthcare services before the insurance company starts to
pay for covered services.
3. Which of the following health insurance programs is primarily
designed to provide coverage for individuals over 65 and some
younger individuals with disabilities?
,A) Medicaid
B) Medicare
C) CHIP
D) TRICARE
Answer: B) Medicare
Rationale: Medicare is a federal program that provides health coverage
for people aged 65 and older, and certain younger individuals with
disabilities.
4. A health insurance policy that requires members to get referrals
from a primary care physician (PCP) before seeing a specialist is
known as:
A) Health Maintenance Organization (HMO)
B) Preferred Provider Organization (PPO)
C) Point of Service (POS)
D) High Deductible Health Plan (HDHP)
Answer: A) Health Maintenance Organization (HMO)
Rationale: HMOs typically require members to select a primary care
physician who coordinates their care, and members must obtain
referrals to see specialists.
5. Under the Affordable Care Act (ACA), which of the following is NOT
a requirement for a health insurance plan to be considered "minimum
essential coverage"?
A) Coverage for maternity and newborn care
B) Coverage for adult dental and vision care
,C) Coverage for prescription drugs
D) Coverage for mental health and substance use disorder services
Answer: B) Coverage for adult dental and vision care
Rationale: While adult dental and vision care are important health
services, they are not mandatory for health insurance plans to be
considered "minimum essential coverage" under the ACA.
6. In which of the following situations would a person be eligible for
Medicaid?
A) A 65-year-old with an income above 138% of the federal poverty
level
B) A 25-year-old woman pregnant with twins
C) A 45-year-old employed full-time with a large employer’s insurance
plan
D) A 33-year-old with a disability but high income
Answer: B) A 25-year-old woman pregnant with twins
Rationale: Medicaid eligibility can extend to low-income individuals,
pregnant women, children, elderly individuals, and those with
disabilities. Pregnant women in low-income brackets are often eligible
for Medicaid, regardless of their age.
7. A health insurance plan with a network of preferred providers, but
which allows coverage for out-of-network providers at a higher cost, is
known as:
A) HMO
B) PPO
, C) POS
D) EPO
Answer: B) PPO
Rationale: A Preferred Provider Organization (PPO) allows policyholders
to see out-of-network providers, but with higher out-of-pocket costs. In-
network care typically has lower co-pays and coinsurance.
8. What is the "Medicare Part D" primarily designed to provide?
A) Hospital insurance
B) Prescription drug coverage
C) Vision and dental coverage
D) Long-term care coverage
Answer: B) Prescription drug coverage
Rationale: Medicare Part D provides prescription drug coverage to
Medicare beneficiaries, helping to cover the cost of prescription
medications.
9. Which of the following is a key feature of a "High Deductible Health
Plan" (HDHP)?
A) Low monthly premiums with high deductibles
B) Low out-of-pocket maximums and low deductibles
C) Coverage for vision and dental care
D) A fixed amount for all medical services
Answer: A) Low monthly premiums with high deductibles
Rationale: HDHPs generally have lower premiums but require
policyholders to pay higher deductibles before the insurance plan starts
Care Act (ACA)?
A) To expand Medicaid eligibility across all states
B) To increase healthcare costs for high-income individuals
C) To provide affordable healthcare coverage for individuals and families
D) To eliminate private insurance companies
Answer: C) To provide affordable healthcare coverage for individuals
and families
Rationale: The ACA's primary goal is to make healthcare more
affordable for individuals and families, primarily by expanding Medicaid,
creating health insurance exchanges, and providing subsidies to those
who qualify.
2. What is the term for the amount a policyholder must pay before
their health insurance begins to cover expenses?
A) Premium
B) Deductible
C) Co-payment
D) Coinsurance
Answer: B) Deductible
Rationale: The deductible is the amount a policyholder must pay out-of-
pocket for healthcare services before the insurance company starts to
pay for covered services.
3. Which of the following health insurance programs is primarily
designed to provide coverage for individuals over 65 and some
younger individuals with disabilities?
,A) Medicaid
B) Medicare
C) CHIP
D) TRICARE
Answer: B) Medicare
Rationale: Medicare is a federal program that provides health coverage
for people aged 65 and older, and certain younger individuals with
disabilities.
4. A health insurance policy that requires members to get referrals
from a primary care physician (PCP) before seeing a specialist is
known as:
A) Health Maintenance Organization (HMO)
B) Preferred Provider Organization (PPO)
C) Point of Service (POS)
D) High Deductible Health Plan (HDHP)
Answer: A) Health Maintenance Organization (HMO)
Rationale: HMOs typically require members to select a primary care
physician who coordinates their care, and members must obtain
referrals to see specialists.
5. Under the Affordable Care Act (ACA), which of the following is NOT
a requirement for a health insurance plan to be considered "minimum
essential coverage"?
A) Coverage for maternity and newborn care
B) Coverage for adult dental and vision care
,C) Coverage for prescription drugs
D) Coverage for mental health and substance use disorder services
Answer: B) Coverage for adult dental and vision care
Rationale: While adult dental and vision care are important health
services, they are not mandatory for health insurance plans to be
considered "minimum essential coverage" under the ACA.
6. In which of the following situations would a person be eligible for
Medicaid?
A) A 65-year-old with an income above 138% of the federal poverty
level
B) A 25-year-old woman pregnant with twins
C) A 45-year-old employed full-time with a large employer’s insurance
plan
D) A 33-year-old with a disability but high income
Answer: B) A 25-year-old woman pregnant with twins
Rationale: Medicaid eligibility can extend to low-income individuals,
pregnant women, children, elderly individuals, and those with
disabilities. Pregnant women in low-income brackets are often eligible
for Medicaid, regardless of their age.
7. A health insurance plan with a network of preferred providers, but
which allows coverage for out-of-network providers at a higher cost, is
known as:
A) HMO
B) PPO
, C) POS
D) EPO
Answer: B) PPO
Rationale: A Preferred Provider Organization (PPO) allows policyholders
to see out-of-network providers, but with higher out-of-pocket costs. In-
network care typically has lower co-pays and coinsurance.
8. What is the "Medicare Part D" primarily designed to provide?
A) Hospital insurance
B) Prescription drug coverage
C) Vision and dental coverage
D) Long-term care coverage
Answer: B) Prescription drug coverage
Rationale: Medicare Part D provides prescription drug coverage to
Medicare beneficiaries, helping to cover the cost of prescription
medications.
9. Which of the following is a key feature of a "High Deductible Health
Plan" (HDHP)?
A) Low monthly premiums with high deductibles
B) Low out-of-pocket maximums and low deductibles
C) Coverage for vision and dental care
D) A fixed amount for all medical services
Answer: A) Low monthly premiums with high deductibles
Rationale: HDHPs generally have lower premiums but require
policyholders to pay higher deductibles before the insurance plan starts
