Health Coverage Programs 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 Health Coverage Programs flashcards as text
Which federal health program is jointly funded by the federal government and individual states?
Answer: Medicaid
Medicaid is a joint federal-state program; states administer it within federal guidelines and both levels of government share the funding.
What is the role of an Advance Premium Tax Credit (APTC) in the Marketplace?
Answer: It is paid directly to insurers to lower monthly premiums
APTCs are paid in advance directly to the insurance company on the enrollee's behalf, reducing the monthly premium the consumer owes.
Under Medicaid, what does the term 'spend-down' refer to?
Answer: Reducing income to qualify by deducting medical expenses
A Medicaid spend-down allows individuals whose income exceeds the limit to deduct medical expenses until their net income falls within eligibility thresholds.
CHIP eligibility is primarily based on which factor?
Answer: Income relative to the Federal Poverty Level
CHIP eligibility for children is primarily income-based, targeting families with household incomes that exceed Medicaid limits but remain below state-set upper thresholds.
Which of the following statements about Medicare Part B is correct?
Answer: It covers outpatient services, doctor visits, and preventive care
Medicare Part B covers outpatient medical services, physician visits, durable medical equipment, and preventive services, requiring a standard monthly premium.
What happens to a consumer's premium tax credit if their actual income at year-end is higher than they estimated during enrollment?
Answer: They may owe repayment of excess credits when filing taxes
If a consumer received more APTC than their actual income supports, they must repay some or all of the excess when filing their federal income tax return.
Which coverage type allows employers with fewer than 50 full-time employees to offer health benefits through the Small Business Health Options Program?
Answer: SHOP Marketplace plans
The SHOP Marketplace is specifically designed for small employers (typically fewer than 50 FTEs) to purchase group health coverage for their employees.