Certified Application Counselor Practice Test

A qualified health plan must provide which of the following?

1. Coverage solely for inpatient services

2. Essential health benefits and preventive services without added costs

3. Unlimited coverage for all medical services

4. Full coverage for alternative therapies

The correct answer is: Essential health benefits and preventive services without added costs

A qualified health plan is mandated to provide essential health benefits, which include a comprehensive range of healthcare services necessary for individuals and families. These essential health benefits cover items such as hospitalization, prescription drugs, preventive services, laboratory services, and pediatric care, among others. Importantly, preventive services must be offered without any cost-sharing, meaning patients do not need to pay out-of-pocket costs like copayments or deductibles for these services. This provision is designed to encourage individuals to seek necessary preventive care, which is crucial for maintaining overall health and early detection of health issues. The other options do not accurately reflect what a qualified health plan is required to offer. Coverage solely for inpatient services would be too limited and does not align with the broader scope of essential health benefits. While qualified health plans do offer extensive coverage, they do not provide unlimited coverage for all medical services, as there are typically limits and conditions based on the specifics of the plan. Furthermore, while some plans may include alternative therapies, they are not universally required, and coverage for such services is not part of the essential benefits mandated by law.