Georgia Navigator Practice Exam

What is the minimum percentage a health plan must pay of medical costs to be considered Minimum Value?

1. 40%

2. 50%

3. 60%

4. 70%

The correct answer is: 60%

To be classified as providing Minimum Value, a health plan must cover at least 60% of the total allowed costs of benefits provided under the plan. This standard is established under the Affordable Care Act (ACA) to ensure that plans provide a sufficient level of coverage for enrollees. The 60% threshold means that, on average, the plan will pay 60% of covered health care expenses, while the remaining 40% will be the responsibility of the consumer through cost-sharing mechanisms such as deductibles, copayments, and coinsurance. This requirement helps ensure that individuals have access to affordable care and reduces the risk of overwhelming out-of-pocket expenses. Plans that do not meet the Minimum Value standard may not qualify for certain tax credits and subsidies available to help lower-income individuals afford coverage. Therefore, achieving at least a 60% cost coverage is crucial for a plan's compliance with ACA guidelines.