Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 1/5
In the individual health insurance market under the ACA, a carrier may NOT:
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Guaranteed issue in the individual market requires carriers to accept every applicant without regard to health status, medical history, or preexisting conditions. Carriers may, however, condition coverage on payment of the first premium, limit enrollment to open and special enrollment periods, and offer different benefit designs across metal tiers. This prohibition on health-based denials is a core ACA individual market rule examined under the definitions in AH-III.C.3, where guaranteed issue is a named concept.
Why the other options are wrong
- B) Paying the initial premium is a legitimate condition for coverage to become effective.
- C) Enrollment is legitimately limited to OEP and SEP windows outside of special circumstances.
- D) Offering plans across bronze, silver, gold, and platinum tiers is permitted and expected.
Memory hook
No health questions, no denials; but first premium and enrollment windows still rule.