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Indiana Navigator Certification Exam Study Guide 2026/2027 (Practice Questions and Answers Based on

HEAL100 Health Care — exam and revision material · Other

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Health Care exam material, 10 pages. Originally published on StudyMerit.

Pages
10
Academic year
2025/2026
Language
English

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Name: Score: 20 Multiple choice questions Term What are the eligibility redeterminations? - Is triggered automatically whenever the federal poverty level changes - Happens only when the enrollee turns 65 or becomes eligible for Medicare - Happens every 12 months or sooner if enrollee reports income, HH size, or residence changes - Occurs bi-annually to ensure the plan still meets the employer's needs 1 of 20 Term What are the two ways that consumers can get stand-alone dental plans? 1. as part of a health plan 2. by itself through a separate, stand-alone dental plan No - partial advanced payment may be helpful for those who expect an income increase and want to avoid owing taxes Aged, blind, and disabled category. - Medicare will be primary and Medicaid is the secondary payer. Plans offered in all states through FFM - Are QHPs + eligible for people who want PTCs and cost-sharing reductions 2 of 20

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Term AO means... Division of Family Resources (DFR) Application organization - Must be registered Authorized representative - Designated individual/organization to act on their behalf in the app, redetermination, and ongoing communications with state process. Be a resident of Indiana 3 of 20 Term What is cost-sharing? Meet the requirement to maintain minimum essential coverage - Are health plans that existed during passage of the law + do not maintain substantial changes to their policies after law passed Hoosier Healthwise CHIP HIP Plus Medicaid for the aged, blind, and disabled MED Works Breast and Cervical Cancer Program Some PE categories (PE: infants, children, parents/caregivers, former foster care children) The share of costs covered by an individual's insurance that they pay out of their own pocket. What are examples of cost-sharing: deductibles, coinsurance, and copayments. - Outpatient = $4 - Inpatient = $75 - Preferred drugs = $4 - Non-preferred drugs = $8 - Non-emergency ER visit = $8 (same for HIP Plus members) 4 of 20

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Term Hoosier Care Connect covers those... - Allows uninsured/underinsured people to obtain temporary coverage quickly = immediate care. - Must still complete a full application to determine eligibility for continued coverage. - In Indiana who are not eligible for Medicare and who are 65+, blind, disabled, enrolled in MED Works, or receiving SSI - Enrollees select either Anthem or MHS to ensure individual gets best care for their individualized needs Includes: - Pregnant women - Children up to 19 years old = Package A is children of low income households = Package C is CHIP for children (ONLY CHILDREN) of higher income families - Covers doctor visits, meds, mental healthcare, dental care, surgeries, family planning - Little or no cost Hoosier Healthwise CHIP HIP Plus Medicaid for the aged, blind, and disabled MED Works Breast and Cervical Cancer Program Some PE categories (PE: infants, children, parents/caregivers, former foster care children) 5 of 20 Term What does the Small Business Health Options Program (SHOP) do? It provides direct health insurance coverage for federal government employees. It allows individuals to purchase health insurance directly from the federal government. It helps small business owners provide medical and dental insurance to their employees. It helps large corporations manage their self-funded health insurance pools. 6 of 20

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