Show:
QHP
ACA
IAP
Eligibility
Misc
100
What does QHP stand for?
What is Qualified Health Plan
100
What are three main benefits of the affordable care act
What are: 1) Creates more avenues for coverage 2) Provides guarantees and security 3) Helps compare plans.
100
This is a rule or condition that the consumer must fulfill to qualify for a specific program.
What is an elgibility requirement.
100
True or False: If a person is NOT eligible for an Advanced Premium Tax Credit, they will NOT be able to purchase a health plan through MNSURE
What is False.
100
This program is a procedural way to navigate through the system.
What is One Source
200
What are three factors that a Qualified Health Plan must have.
What is 1) provide a base level of essential health benefits 2) limit the costs shared by consumers 3) meet other requirements to ensure people have good quality choices.
200
Why is medical coverage so important?
What is 1) most of us will need medical care at some point in our live and 2) Medical care is very expensive and 3) provides access and ecourages preventative care
200
The umbrella term that refers to the group of programs where eligible consuers receive assistance to help pay health care costs.
What is Insurance Affordibility Programs
200
What are the three requirements for eligibility for a Qualified Health Plan through MNSURE
What are 1) US Citizen or National who is lawfully present 2) Not Incarcerated 3) MN Resident
200
These are the main goals for MNSURE
What is 1) better consumer experience 2) Affordability and 3) Access to health care.
300
Deductibles and co-insurance are a part of this.
What is Cost-Sharing
300
The ACA is significant because of it's ___________ and reach
What is Scope and reach
300
The order in which eligibility is determined.
What is Program Hierarchy. Medical assistance ---->Minnesota Care (MCRE) -----> APTC/CSR
300
Name three ways in which a consumer may obtain health insurance.
What is 1) an employer sponsored health plan 2) Government subsidized plan 3) Purchasing coverage themselves
300
These are three main benefits of the Affordable Care Act
What is 1) extends coverage 2) expands patient's bill of rights and 3) protects choices.
400
What are the costs that are counted as part of a consumers out of pocket maximum. ( Hint: there are four main areas)
What are: 1) Deductible 2) Co-pay 3) Co- insurance 4) In network services
400
This is how the ACA promotes competition.
What is by creating organized markets and by removing barriers for insurance coverages.
400
This helps to reduce out of pocket expenses such as co-payments and deductibles.
What is Cost Savings Reductions (CSR)
400
These are the 4 areas of eligibility for an Advanced Premium Tax Credit
What are 1) Eligible for a QHP 2) Enrolled in a QHP 3) Part of a tax filing unit and 4) Income between 200-400 % FPL
400
Health Insurance Companies are required to spend ____ to ____ cents on the dollar to deliver or imporove health care.
What is 80-85 cents.
500
Name 7 of the 10 Essential Health Benefits that a qualified health plans covers.
What are: 1) Ambulatory patient services ( doctor visits), 2) emergency services 3) Hospitalization 4) Maternity and newborn care 5) Mental health and substance use services 6) Prescription drugs 7) Rehabilitative and habilitative services 8) Laboratory services 9) Preventative and wellness services & disease management 10) Pediatric services - including dental and vision
500
These are examples of what insurance companies could do before the ACA.
What is 1) require you to pay more money to get or maintain coverage when sick 2) Refuse coverage to people with existing medical issues 3) Drop coverage if someone developed medical issue 4) Cancel coverage based on a mistake on the application.
500
A consumer has an excess advanced premium tax credit. The consumer must _________________ and ________________ until this has been completed
What is repay the excess tax credit up to certain limits and can not re-enroll for a QHP for next year .
500
Name 6 of the 9 consumers/groups exempt from obtaining health care coverage by January 1st 2014.
Who are 1) Those not able to afford coverage 2) Those experiencing a hardship 3) Those who have income below tax filing threshold 4) members of a federally recognized tribe 5) members of some religious sects 6) part of Healthcare sharing ministries 7) those experiencing short coverage gaps 8) those who are incarcerated 9) those who are NOT lawfully present.
500
Catastrophic plans typically have higher ___________ and offer less __________. In addition, this is not available under these plans.
What are deductibles (higher) and coverage (less). Premium tax credits are not availalbe with these plans.