MNsure Core Curriculum Assessment 24-25 | Quizlet

Here are two scenarios of a conversation a Contact Center representative might have with a consumer. Choose the one with plain language.

On the Eligibility System, METS, it shows you did not qualify for MA or MinnesotaCare but you did qualify for a QHP with advanced premium tax credit. I am checking the system that determines eligibility. It shows that you do not qualify for Medical Assistance or MinnesotaCare but you do qualify for private health insurance with financial assistance. You can purchase a private health plan through MNsure and receive help with paying for your premiums.

I am checking the system that determines eligibility. It shows that you do not qualify for Medical Assistance or MinnesotaCare but you do qualify for private health insurance with financial assistance. You can purchase a private health plan through MNsure and receive help with paying for your premiums.

True or False: If someone does not qualify for Medical Assistance because their income is over 133% of the federal poverty guideline, they will not qualify for MinnesotaCare either.

True False

False

Which of these are true about MinnesotaCare? (Hint: Select all that apply)

Typically begins the first of the month after the first premium payment is received (if a premium is required). There may be a premium There may be co-pays Has a household income limit of up to 133% of the federal poverty guidelines.

Typically begins the first of the month after the first premium payment is received (if a premium is required). There may be a premium There may be co-pays

Which application section is not included on the Application Without Financial Assistance?

Applicant Details Summary Household Income

Household Income

What options are available for consumers who need information provided in an alternative format? (Hint: Select all the apply)

Contact MNsure's Accessibility and Equal Opportunity Office (AEO) by phone Email AEO at MNsure.org Tell the consumer they are responsible for finding a resource to translate materials

Contact MNsure's Accessibility and Equal Opportunity Office (AEO) by phone Email AEO at MNsure.org

Which entity is responsible for reviewing requested rate increases by insurance companies for qualified health plans through MNsure?

Minnesota Department of Health Department of Employment and Economic Development Minnesota Department of Commerce Minnesota Department of Human Services

Minnesota Department of Commerce

The uninsured are more likely to:

Have income below 200% of the federal poverty guideline To be over 50 years old To consider themselves in excellent health To have a college education

Have income below 200% of the federal poverty guideline

True or False: If their employer offers health insurance, a consumer may still be eligible for Medical Assistance.

True False

True

What are the two types of financial assistance options potentially available to those eligible for a qualified health plan? (Hint: Select two)

MinnesotaCare Medical Assistance Advanced Premium Tax Credits Cost-sharing reductions

Advanced Premium Tax Credits Cost-sharing reductions

True or False: Under the Affordable Care Act, consumers who have access to employer-sponsored health insurance coverage that meets certain standards may not be eligible for financial help through MNsure.

True False

True

Which of these are true about Medical Assistance? (Hint: Select all that apply)

Typically begins the first of the month after the month of application but can be retroactive. Household income limit up to 133% of the federal poverty guidelines with a higher limit for pregnant women and children. There may be premiums There may be co-pays

Typically begins the first of the month after the month of application but can be retroactive. Household income limit up to 133% of the federal poverty guidelines with a higher limit for pregnant women and children. There may be premiums There may be co-pays

A consumer eligible to purchase a qualified health plan can enroll:

Only during open enrollment During open enrollment or if they qualify for a special enrollment At any time of the year Only if they have a life event

During open enrollment or if they qualify for a special enrollment

A consumer eligible for Medical Assistance or MinnesotaCare can enroll:

only during open enrollment during open enrollment or if they qualify for a special enrollment period at any time during the year

at any time during the year

The vision of MNsure is to create a statewide resource that provides access to _______ health insurance and _______ medical assistance programs.

private;public free;all complete;federal affordable;free

affordable;free

What is needed to be eligible for a special enrollment period?

A special application An open enrollment waiver A qualifying life event Any life event change

A qualifying life event.

Which of these is the BEST tool for calculating a consumer's eligibility for financial assistance through MNsure?

Plan Comparison Tool Find a Plan Tool Completing the MNsure application

Completing the MNsure application

Which team at MNsure is responsible for taking calls directly from consumers?

Contact Center Broker Service Line Assister Resource Center Plan Provider Team

Contact Center

The mission of MNsure is to ensure that all Minnesotans have the _______ of health insurance.

goal coverage security best

coverage

True or False: The MNsure application allows a consumer to apply for Medical Assistance, MinnesotaCare, and qualified health plans for individuals and families that live in Minnesota.

True False

True

Ricardo has questions about applying for health insurance through MNsure but would feel more comfortable getting information in his native language, Spanish. What language services are available for Ricardo? (Hint: Select all that apply)

MNsure's contact center can use the Language Line to conference in an interpreter MNsure has brochures and information available in Spanish Ricardo can meet with a navigator who speaks Spanish MNsure will reimburse Ricardo if he hires an interpreter

MNsure's contact center can use the Language Line to conference in an interpreter MNsure has brochures and information available in Spanish Ricardo can meet with a navigator who speaks Spanish

Which of the following is NOT a type of private plan available through MNsure:

Medical Dental-only coverage Long-term care Catostrophic

Long-term care

If a consumer applies online and receives a notification that they appear to be eligible for Medical Assistance or MinnesotaCare, they will:

have the option to enroll online through MNsure be informed they will need to go to their county's office to enroll in person be informed they will receive more information from the Department of Human Services be informed they will receive information from MNsure to enroll

have the option to enroll online through MNsure

A consumer can appeal for the following reasons: (Hint: Select all that apply)

Denied eligibility They don't want to pay for health insurance Failure of MNsure to determine eligibility in a timely manner Effective date of coverage is incorrect

Denied eligibility Failure of MNsure to determine eligibility in a timely manner Effective date of coverage is incorrect

The Affordable Care Act: (Hint: Select all that apply)

Eliminated denials of coverage on pre-existing conditions Created the affordable health insurance marketplace Eliminated premium payments

Eliminated denials of coverage on pre-existing conditions Created the affordable health insurance marketplace

Under the Affordable Care Act, health insurance coverage is extended to young adults under their parents until they turn what age?

18 19 26 30

26

Private plans are classified using metal levels (gold, silver, bronze) to help consumers compare health plans by:

Cost to consumer vs. cost covered by plan Clinic availability and hospitals Consumer ratings and staffing

Cost to consumer vs. cost covered by plan

Which of the following are examples of situations that could qualify for a special enrollment period? (Hint: Select all the apply)

Having a baby Losing a job that provided insurance Getting Married Being a member of a federally recognized tribe

Having a baby Losing a job that provided insurance Getting Married Being a member of a federally recognized tribe

Which type of assister can offer advice regarding which qualified health plan is the best fit for a consumer?

Navigator Broker Certified Application Counselor

Broker