Free Virginia Health Insurance Practice Exam Online

Correct answer: B. At parity with, and no more restrictively than, medical and surgical benefits

Virginia Code Section 38.2-3412.1 requires that financial requirements and treatment limitations applicable to mental health and substance use disorder benefits be no more restrictive than those applied to medical and surgical benefits, establishing a parity standard.

• A: Virginia's mandate does not condition mental health and substance use disorder coverage on the purchase of a separate optional rider; it is a required benefit of the base policy.
• C: The statute is not limited to inpatient care; it covers the range of medically necessary mental health and substance use disorder services, including outpatient treatment.
• D: Insurers do not have unrestricted discretion because the statute imposes an affirmative parity requirement that carriers must follow.

Correct answer: A. Limiting the hospital stay to less than 48 hours without the attending physician determining a shorter stay is appropriate in consultation with the patient

Virginia Code Section 38.2-3418.6 prevents an insurer from restricting inpatient coverage below a minimum stay determined appropriate by the attending physician in consultation with the patient, following the federal model for mastectomy-related hospital stays.

• B: The statute addresses length of hospital stay, not a blanket ban on prior authorization procedures for the surgery itself.
• C: The statute mandates minimum stay protections for mastectomy patients, which presumes the surgery itself is a covered benefit rather than excluded.
• D: The statute concerns stay-length protections, not network-participation requirements for the surgeon.

Correct answer: B. From the age of diagnosis through a statutorily defined age, generally covering young children up through the early school years and beyond as prescribed by the statute

Virginia Code Section 38.2-3418.17 requires coverage for the diagnosis and treatment of autism spectrum disorder, including applied behavior analysis, for covered individuals within the age parameters set by the statute, targeting the developmental window when early intervention is most effective.

• A: The mandate is not limited to infants under age one; autism spectrum disorder is typically diagnosed later in early childhood.
• C: The autism mandate is not restricted to individuals over age 65; that population is generally covered by Medicare rather than this commercial accident and sickness mandate.
• D: The mandate is not limited to adults age 26 and older; it is specifically aimed at early childhood diagnosis and treatment.

Correct answer: B. Surgery for the treatment of morbid obesity

The mandate is directed at surgical treatment of morbid obesity meeting medical necessity criteria, not general gym membership subsidies for the whole policyholder population.

• A: Virginia Code Section 38.2-3418.13 requires coverage for surgery to treat morbid obesity when medically necessary and the statutory eligibility criteria are met.
• C: The mandate is about medically necessary treatment of morbid obesity, not elective cosmetic liposuction performed purely for aesthetic reasons.
• D: The statute addresses surgical treatment rather than over-the-counter nutritional supplements.

Correct answer: A. It must be covered on the same basis as if the service had been provided in person, provided it is a covered service and appropriately delivered via telemedicine

Virginia Code Section 38.2-3418.16 requires that a health care service be covered under a policy if the same service would be covered when provided in person, effectively creating coverage parity for appropriately delivered telemedicine services.

• B: Virginia's telemedicine statute prohibits insurers from excluding a service solely because it was delivered via telemedicine rather than in person.
• C: The mandate applies to private accident and sickness insurance policies subject to Title 38.2, not exclusively to Medicaid billing.
• D: The statute does not require or authorize a doubled reimbursement rate for telemedicine visits.