EXAM 2026|2027 ACTUAL COMPLETE REAL EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED
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How long does a person have to enroll in a managed care plan?
- ANSWER-10
days to pick a managed care plan or will be
auto enrolled.
When enrolled in Medicaid when does FFS and MMC start? -
ANSWER-FFS is retro of current month, MMC follows 15th of
month rule. Between 1st-15th 1st of following month, 16th and
last day 1st of subsequent month
What is CHP continuous coverage? - ANSWER-Children have
12 months of continuous coverage, if income goes up,
subsidized premium stays the same, if income goes down, and
subsidized premium may decrease
What is the CHP newborn policy? - ANSWER-family must apply
for and have the newborn found eligible for coverage within 60
days of the newborn's DOB in order to be eligible to have the
coverage to go retroactive to the first of the newborn's birth
month
,What happens if a plan is not selected of 60 days of a new
birth? - ANSWER-If newborn is found eligible but a plan was
not selected by 60 days the newborn will become ineligible for
retroactive CHP can still enroll in 15th of the month rule
What is Child Health Plus? - ANSWER-Health insurance
program for NYS uninsured children no co-pays, co-insurance
or deductibles must be under 19 and NYS resident. Based on
household size and FPL
Who is ineligible for CHP? - ANSWER-if eligible for Medicaid,
don't have access
to other insurance and don't have access
for NYSHIP
What are CHP health options? - ANSWER-options are
presented in order of quality rating by county, full pay CHP
options presented in order by premium amount, lowest to
highest $, all children in a family are directed to enroll in the
same health plan
What is the maximum number of children that you have to pay
for on CHP? -
ANSWER-
3
What are the premium ranges for CHP? - ANSWER-0-$60
,What is the income eligibility for Medicaid adults 19-64? -
ANSWER-0-138%
FPL
What is the income eligibility for Medicaid for children 1-18? -
ANSWER-0-154%
FPL
What is the income eligibility for Medicaid for 19-20 year olds
living with there
parents? - ANSWER-0-
155% FPL
What are the income eligibility for pregnant women and
infants? - ANSWER-0-
223%
FPL
What are the Essential Plan requirements to Temporary Non-
Immigrants? - ANSWER-for short-term visa holder to prove
they are a resident of NYS, are currently working in NYS, are
sending their children in school in NYS, own or rent a home in
NYS
Who are eligible for Essential Plan 3 or 4? - ANSWER-
Temporary Nonimmigrants (Non Immigrant Visa Holders) who
pass residency review and are between 21-64 years of age
under 138%FPL
, What can Temporary Non-Immigrants who do not pass
residency review get? -
ANSWER-Emergency
Medicaid
What is Aliessa Immigration Status? - ANSWER-must be 21
years old, 5 year ban( Qualified Alien Status, such as a Lawfully
Permanent resident(LPR) who is a green card holder PRUCUL
Who are eligible for Medicaid Essential Plan 3 or 4 with Federal
Financial
Participation (FFB)? - ANSWER-refugees, Asylees, Native
Americans in a
Federally recognized tribe, born outside the US, veterans,
victims of trafficking, Cuban-Haitians entrants, family members
would be included
What are federal subsidies? - ANSWER-makes QHP's more
affordable
What is the cost-reduction method of PTC? - ANSWER-
subsidize premium
costs
What is the cost reduction method for CSR? - ANSWER-
reduce out of pocket
costs(deductible) copay,
coinsurance, MOOP