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CERTIFIED ENROLLER EXAM - COVERED CALIFORNIA
NEWEST 2025/2026 NEWEST ACTUAL EXAM WITH
COMPLETE QUESTIONS AND VERIFIED ANSWERS
|ALREADY GRADED A+|
What is restricted scope Medi-Cal? - ANSWER-It is limited to
emergency services and is not considered minimum essential
coverage (MEC)
Will receiving financial assistance through Covered CA affect the
applicant's immigration status, or their chances of becoming a
lawful permanent resident or naturalized citizen? - ANSWER-It will
not affect the applicant ONLY if the individual receives long-term
care in a nursing home or is otherwise institutionalized in a long-
term care facility paid for by the government through the Medi-Cal
program or if the individual does not tell the truth on their
application for health coverage.
If the consumer is married and they are a victim of domestic
abuse or spousal abandonment, do they need to include their
spouse on the application? - ANSWER-No they do not and they
also do not need to file their income tax jointly.
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What is MAGI? - ANSWER-Modified Adjusted Gross Income
What is a catastrophic plan also known as minimum coverage
plan? - ANSWER-Is a coverage plan for people:
- UNDER the age of 30,
- Provides health care services, with very few exceptions, only
after out-of-pocket maximum is met
- People age 30 or above who have a certificate of exemption for
hardship
- The out-of-pocket maximum is $9,100 for self-only coverage
- With the exception of preventive services and the first 3 non-
preventive doctor visits, a minimum coverage plan covers 0% until
the out-of-pocket maximum is met
- Financial assistance is not available for this type of plan
Which counties qualify for CCHIP (County Children's Health
Initiative Program)? - ANSWER-San Francisco, San Mateo, and
Santa Clara counties
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True or False: Enrollees who receive premium assistance are
required to attest that they understand that payments made on
their behalf must be reconciled when they file their tax return for
the benefit year. - ANSWER-True
Dependent Coverage for individuals under the age of 26 can
enroll as a dependent in their parent's plan eve if they: -
ANSWER-- Get married
- Live in or out of their parents home
- Have or adopt a child
- Start or leave school
- Are not claimed as a tax dependent
- Turn down an offer of job-based coverage if it is deemed
unaffordable and does not meet the minimum value standards
What is Medicare? - ANSWER-The federal health insurnace
program for people who are 65 or older, certain younger eligible
people with disabilities, and people with End-Stage Renal
Disease (ESRD)
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Do consumers who are enrolled in Medicare Part A or Part C
meet the health insurance mandate? - ANSWER-Yes they do
Does Covered CA sell Medicare Advantage plans; HMOs and
PPOs, Medicare Part D prescription drug plans, or Medigap
policies? - ANSWER-No they do not
Can consumers who receive Medicare also be eligible for Medi-
Cal? - ANSWER-Depends on their income and assets, and may
still apply through Covered CA
True or False: Consumers enrolled in Medicare cannot purchase
a Covered CA health plan. - ANSWER-True
What is the exception to this rule? - ANSWER-Enrolled individuals
that are not enrolled in Medicare Part A with premium
What is COBRA? - ANSWER-Consolidated Omnibus Budget
Reconciliation Act of 1985
CERTIFIED ENROLLER EXAM - COVERED CALIFORNIA
NEWEST 2025/2026 NEWEST ACTUAL EXAM WITH
COMPLETE QUESTIONS AND VERIFIED ANSWERS
|ALREADY GRADED A+|
What is restricted scope Medi-Cal? - ANSWER-It is limited to
emergency services and is not considered minimum essential
coverage (MEC)
Will receiving financial assistance through Covered CA affect the
applicant's immigration status, or their chances of becoming a
lawful permanent resident or naturalized citizen? - ANSWER-It will
not affect the applicant ONLY if the individual receives long-term
care in a nursing home or is otherwise institutionalized in a long-
term care facility paid for by the government through the Medi-Cal
program or if the individual does not tell the truth on their
application for health coverage.
If the consumer is married and they are a victim of domestic
abuse or spousal abandonment, do they need to include their
spouse on the application? - ANSWER-No they do not and they
also do not need to file their income tax jointly.
, Page |2
What is MAGI? - ANSWER-Modified Adjusted Gross Income
What is a catastrophic plan also known as minimum coverage
plan? - ANSWER-Is a coverage plan for people:
- UNDER the age of 30,
- Provides health care services, with very few exceptions, only
after out-of-pocket maximum is met
- People age 30 or above who have a certificate of exemption for
hardship
- The out-of-pocket maximum is $9,100 for self-only coverage
- With the exception of preventive services and the first 3 non-
preventive doctor visits, a minimum coverage plan covers 0% until
the out-of-pocket maximum is met
- Financial assistance is not available for this type of plan
Which counties qualify for CCHIP (County Children's Health
Initiative Program)? - ANSWER-San Francisco, San Mateo, and
Santa Clara counties
, Page |3
True or False: Enrollees who receive premium assistance are
required to attest that they understand that payments made on
their behalf must be reconciled when they file their tax return for
the benefit year. - ANSWER-True
Dependent Coverage for individuals under the age of 26 can
enroll as a dependent in their parent's plan eve if they: -
ANSWER-- Get married
- Live in or out of their parents home
- Have or adopt a child
- Start or leave school
- Are not claimed as a tax dependent
- Turn down an offer of job-based coverage if it is deemed
unaffordable and does not meet the minimum value standards
What is Medicare? - ANSWER-The federal health insurnace
program for people who are 65 or older, certain younger eligible
people with disabilities, and people with End-Stage Renal
Disease (ESRD)
, Page |4
Do consumers who are enrolled in Medicare Part A or Part C
meet the health insurance mandate? - ANSWER-Yes they do
Does Covered CA sell Medicare Advantage plans; HMOs and
PPOs, Medicare Part D prescription drug plans, or Medigap
policies? - ANSWER-No they do not
Can consumers who receive Medicare also be eligible for Medi-
Cal? - ANSWER-Depends on their income and assets, and may
still apply through Covered CA
True or False: Consumers enrolled in Medicare cannot purchase
a Covered CA health plan. - ANSWER-True
What is the exception to this rule? - ANSWER-Enrolled individuals
that are not enrolled in Medicare Part A with premium
What is COBRA? - ANSWER-Consolidated Omnibus Budget
Reconciliation Act of 1985
