"Health Insurance Concepts Exam 2025: Comprehensive
Assessment of Policies, Coverage, and Regulations"
1. Describe the factors that determine Medicaid eligibility for low-income
individuals.
Medicaid eligibility is determined by income level, household
size, and state-specific criteria.
Medicaid eligibility is determined by the type of medical services
needed.
Medicaid eligibility is uniform across all states without exceptions.
Medicaid eligibility is solely based on age and employment status.
2. Sally obtained a health insurance policy from her local agent. Sally's
policy would cover all her medical needs and provide security for the
unknown. Sally was required to pay $50 each month toward this policy.
What is Sally's $50 payment each month known as?
Policy payment
Premium payment
Policy reimbursement
Life of policy payment
3. Describe how HMOs' approach to health care costs influences their
promotion of preventive health measures.
HMOs promote preventive health measures because it reduces
overall health care costs by avoiding expensive treatments.
HMOs focus on maximizing treatment options for patients.
HMOs are required by law to promote preventive health
measures.
HMOs do not influence health care costs significantly.
, 4. The Affordable Care Act (ACA) covers 10 categories of essential health
benefits (EHBs) which must be included in ACA compliant health
insurance plans. These benefits or services ensure that there are no
medical gaps in coverage for the consumer. Which of the following are
considered essential health benefits?
Mental health services, laboratory testing, and prescription
drug coverage
Prescription drug coverage, preexisting conditions coverage, and
vision benefits for children
Emergency services, dependent coverage up to age 26, and
vision benefits for children
Laboratory testing, emergency services and fertility services
5. Which level of government administers Medicaid programs?
Federal
State
National
Local
6. Why do HMOs encourage their clients to practice healthy lifestyles and
to seek preventive care?
It is cheaper because healthy people go to the doctor less often.
People with healthy lifestyles never get sick, thus costing less.
It is cheaper to prevent an illness than to treat an illness.
7. What level of government is in charge of Medicaid?
State
Local
Federal
Assessment of Policies, Coverage, and Regulations"
1. Describe the factors that determine Medicaid eligibility for low-income
individuals.
Medicaid eligibility is determined by income level, household
size, and state-specific criteria.
Medicaid eligibility is determined by the type of medical services
needed.
Medicaid eligibility is uniform across all states without exceptions.
Medicaid eligibility is solely based on age and employment status.
2. Sally obtained a health insurance policy from her local agent. Sally's
policy would cover all her medical needs and provide security for the
unknown. Sally was required to pay $50 each month toward this policy.
What is Sally's $50 payment each month known as?
Policy payment
Premium payment
Policy reimbursement
Life of policy payment
3. Describe how HMOs' approach to health care costs influences their
promotion of preventive health measures.
HMOs promote preventive health measures because it reduces
overall health care costs by avoiding expensive treatments.
HMOs focus on maximizing treatment options for patients.
HMOs are required by law to promote preventive health
measures.
HMOs do not influence health care costs significantly.
, 4. The Affordable Care Act (ACA) covers 10 categories of essential health
benefits (EHBs) which must be included in ACA compliant health
insurance plans. These benefits or services ensure that there are no
medical gaps in coverage for the consumer. Which of the following are
considered essential health benefits?
Mental health services, laboratory testing, and prescription
drug coverage
Prescription drug coverage, preexisting conditions coverage, and
vision benefits for children
Emergency services, dependent coverage up to age 26, and
vision benefits for children
Laboratory testing, emergency services and fertility services
5. Which level of government administers Medicaid programs?
Federal
State
National
Local
6. Why do HMOs encourage their clients to practice healthy lifestyles and
to seek preventive care?
It is cheaper because healthy people go to the doctor less often.
People with healthy lifestyles never get sick, thus costing less.
It is cheaper to prevent an illness than to treat an illness.
7. What level of government is in charge of Medicaid?
State
Local
Federal
