Covered California Certified Enroller Practice Exam

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If a plan costs more than a specific percentage of an individual's income, it is considered what?

  1. Unaffordable

  2. Subsidized

  3. Comprehensive

  4. Ineligible

The correct answer is: Unaffordable

When a plan costs more than a specific percentage of an individual's income, it is classified as unaffordable. The Affordable Care Act (ACA) establishes guidelines around what constitutes affordability in terms of health insurance coverage. This guideline helps determine the maximum amount an individual should have to pay for health coverage without excessive financial burden. If health insurance premiums exceed this percentage of income, individuals may not be encouraged or able to purchase that coverage without facing significant economic strain. Consequently, they may qualify for financial assistance through subsidies or have access to other programs that provide support for individuals facing high costs relative to their income. The other concepts present in the options relate to other aspects of health insurance but do not define the specific situation of exceeding affordability thresholds. For instance, subsidized coverage means that financial assistance is available, while comprehensive refers to the breadth of benefits included in a plan. Ineligible typically pertains to individuals or plans that do not meet certain criteria for participation in the marketplace, which is unrelated to the concept of affordability.