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Eligibility and Enrollment Flashcards

7 cards from real CACS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Eligibility and Enrollment flashcards as text

  1. A consumer loses job-based coverage on March 15. How long does she have to enroll in a Marketplace plan using a Special Enrollment Period?

    Answer: 60 days from the loss date

    Consumers who lose qualifying health coverage have a 60-day Special Enrollment Period to enroll in a Marketplace plan.

  2. Which income level determines eligibility for Medicaid in states that have adopted the ACA Medicaid expansion?

    Answer: Up to 133% FPL (effectively 138% with the 5% income disregard)

    Expansion states cover adults up to 133% FPL, but the standard 5% income disregard raises the effective threshold to 138% FPL.

  3. A 17-year-old living with her parents applies for coverage. What program is she most likely eligible for if family income is at 160% FPL?

    Answer: Medicaid

    Children in families below expansion Medicaid thresholds typically qualify for Medicaid, and at 160% FPL most states cover children through Medicaid or CHIP.

  4. Which document is NOT an acceptable form of proof of citizenship for Marketplace enrollment?

    Answer: State-issued driver's license alone

    A driver's license alone does not prove U.S. citizenship; it must be accompanied by a document that establishes citizenship.

  5. A married couple files taxes jointly. Their combined MAGI is $58,000. They have no children. Which statement is correct regarding their Marketplace eligibility?

    Answer: They must use household income, not individual income, to determine eligibility

    Marketplace eligibility is based on the household's Modified Adjusted Gross Income (MAGI), not individual income.

  6. A lawfully present immigrant who has been in the U.S. for 3 years with a green card wants to enroll. Which statement is true?

    Answer: They are eligible for Marketplace coverage immediately

    Lawfully present immigrants are eligible to enroll in Marketplace plans and may qualify for APTCs regardless of how long they have been in the U.S.

  7. A consumer moves to a new state in July. What type of enrollment opportunity does this qualify her for?

    Answer: Special Enrollment Period due to a change in residence

    Moving to a new state and gaining access to new Marketplace plans triggers a 60-day Special Enrollment Period.