Unit 13 - Affordable Care Act
All of the following are essential health benefits EXCEPT
DENTAL CARE Essential health benefits cover the essential needs, such as ambulance, emergency, hospital, and maternity and newborn care.
Which fo the following is NOT an essential health benefit found in qualified health plans?
DENTAL SERVICES Qualified health plans (QHPs) must offer essential health benefits such as emergency, rehabilitative and pediatric services. Dental services are not included in the list of essential health benefits.
Which of the following is NOT an essential health benefit found in qualified health plans?
DENTAL SERVICES Qualified health plans (QHPs) must offer essential health benefits such as emergency, rehabilitative and pediatric services. Dental services are not included in the list of essential health benefits.
Which of the following statements applies to both grandfathered and non-grandfathered health plans?
DEPENDENT COVERAGE MUST BE EXTENDED TO ADULT CHILDREN UNTIL AGE 26 Laws that protect consumers under both grandfathered and non-grandfathered health plans include the following: dependent coverage was extended to age 26; no lifetime dollar limits may be applied to essential health benefits; and policies may not be canceled if a mistake on an application is an honest mistake.
Which of the following statements applies to both grandfathered and non-grandfathered health plans?
DEPENDENT COVERAGE MUST BE EXTENDED TO ADULT CHILDREN UNTIL AGE 26 Laws that protect consumers under both grandfathered and non-grandfathered health plans included the following: dependent coverage was extended to age 26; no lifetime dollar limits may be applied to essential health benefits; and policies may not be canceled if a mistake on an application is an honest mistake.
Excepted benefits are not included as minimum essential coverage. Which of the following is NOT an excepted benefit?
MEDICARE Medicare is considered a minimum essential coverage. The other 3 types of insurance are excepted benefits.
Which of the following statements regarding emergency medical services under the ACA is FALSE?
PRE-AUTHORIZATION MUST BE OBTAINED BY THE INSURED OR FAMILY MEMBER Emergency medical services are essential health benefits. As such, pre-authorization is not required whether the provider is in-network or out-of-network. Out-of-network providers must adhere to normal cost-sharing requirements and may not impose administrative requirements or coverage limits that are more restrictive than services provided by in-network providers.
All of the following reforms began in 2010 under the Affordable Care Act EXCEPT
PRE-EXISTING COVERAGE FOR ALL INSUREDS, REGARDLESS OF AGE Pre-existing coverage was extended to all insureds in 2014.
