0.2 Study Plan & Strategy

Study Plan & Strategy

Quick Answer: Plan 4-5 weeks of study, budget time in proportion to the seven domain weights (Health Insurance Basics 20% and Medical Expense 20% get the most time; Regulations & Ethics 5% the least), drill the high-yield traps (Medicare enrollment windows, COBRA 18/29/36, HSA/HDHP annual limits, ACA metal tiers, prohibited practices), and practice with the OpenExamPrep question bank after each domain rather than only at the end. Aim for 80%+ on timed practice sets before exam day, because the 70% passing bar masks unscored pilot questions.

The Core Strategy: Time Follows Weight

The exam's seven domains have fixed national weights, so your study hours should follow the same proportions. If you have 40 total hours, an even distribution by weight looks like this:

Notice that the Regulations & Ethics block is small but the prohibited-practices concepts (twisting, rebating, coercion, defamation, boycotting) also appear inside other domains, so do not skip it. Conversely, Medicare looks like only 15%, but Medicare figures (Part A deductible $1,736, Part B premium $202.90, Part D OOP cap $2,100) are also tested indirectly inside Medical Expense and Group Health — so effective Medicare study time is higher than the raw weight suggests.

A Concrete 4-5 Week Plan

Week 1 — Health Insurance Basics + Medical Expense Foundations

• Days 1-3: Insurance principles, adverse selection, underwriting, MIB/consumer reports, FCRA adverse-underwriting notice.
• Days 4-5: Policy structure ( Declarations, insuring clause, conditions, exclusions, endorsements), cost sharing (deductible, coinsurance, copay, OOP max).
• Days 6-7: Basic vs major medical, HMO, PPO, POS/EPO. Take the OpenExamPrep practice set on these topics.

Week 2 — Consumer-Directed Health + ACA

• Days 1-2: HDHP + HSA. Memorize 2026 limits: HSA self $4,400 / family $8,750, age-55 catch-up $1,000; HDHP min deductible self $1,700 / family $3,400; max OOP self $8,500 / family $17,000.
• Days 3-4: FSA (use-it-or-lose-it, $680 rollover / 2.5-month grace period), HRA (excepted-benefit HRA $2,200), coordination of benefits.
• Days 5-7: ACA — 10 Essential Health Benefits, dependent to age 26, guaranteed issue, no pre-existing exclusions, metal tiers Bronze 60 / Silver 70 / Gold 80 / Platinum 90, premium tax credits, CSRs. Take the practice set.

Week 3 — Disability + Group Health + COBRA/HIPAA/ERISA

• Days 1-3: Disability — own-occ vs any-occ, presumptive, elimination period (0-365, common 90), benefit period (2yr/5yr/to 65/to life), residual/partial, noncancelable vs guaranteed renewable, BOE, SSDI, group vs individual taxation.
• Days 4-5: Group underwriting, contributory vs noncontributory, COBRA durations 18 / 29 / 36 months, 2% surcharge (150% if disability extension), HIPAA portability & privacy, ERISA.
• Days 6-7: Take the practice set; review missed questions.

Week 4 — Medicare, Medicaid, LTC

• Days 1-3: Medicare Parts A/B/C/D, Medigap, enrollment windows (IEP 7 months around 65, GEP, SEP), Medicaid.
• Days 4-5: Long-term care — tax-qualified (§7702B), per-diem up to $430/day (2026), ADL triggers 2-of-6 (eating, bathing, dressing, toileting, transferring, continence), cognitive impairment, inflation, partnership (DRA 2005).
• Days 6-7: Take the practice set; re-read any domain where you scored below 80%.

Week 5 (Buffer) — Regulations & Ethics + Full-Length Practice

• Days 1-2: Prohibited practices (twisting, rebating, coercion, misrepresentation, defamation, boycotting), replacements, parity, Medicare marketing rules, producer conduct, fiduciary.
• Days 3-5: Two full-length timed practice exams from the OpenExamPrep bank, reviewing every missed question.
• Days 6-7: Targeted re-study of the three weakest sub-topics; light review the day before the exam.

The High-Yield Traps (Memorize These)

These are the recurring concepts that separate passing candidates from failing ones, because they are tested directly and indirectly across multiple domains:

Medicare Enrollment Windows

• IEP (Initial Enrollment Period): 7-month window around age 65 (3 months before, month of, 3 months after).
• GEP (General Enrollment Period): Jan 1-Mar 31 each year, coverage starts the month after enrollment.
• SEP (Special Enrollment Period): for active employment coverage, no late penalty.
• Late enrollment penalty: Part B 10% per 12-month period delayed; Part D 1% per month.

COBRA Durations

• 18 months — qualifying event = termination or reduction of hours.
• 29 months — SSA disability determination within 60 days of the qualifying event (extension of the 18).
• 36 months — death of employee, divorce/legal separation, entitlement to Medicare, dependent ceasing to be a child.
• Surcharge: 2% admin; 150% if the disability extension applies.

HSA / HDHP IRS Limits (Change Annually)

Every year the IRS (Rev. Proc. 2025-19 for 2026) revises these figures — do not memorize a single year and assume it is permanent. For 2026:

• HSA contribution: self $4,400, family $8,750, catch-up $1,000.
• HDHP min deductible: self $1,700, family $3,400.
• HDHP max OOP: self $8,500, family $17,000.
• Excepted-benefit HRA: $2,200.

ACA Metal Tiers and OOP Max

• Bronze 60 / Silver 70 / Gold 80 / Platinum 90 — actuarial value percentages.
• 2026 ACA OOP max: self $10,600, family $21,200.
• 10 Essential Health Benefits: ambulatory, emergency, hospitalization, maternity/newborn, mental health/substance use, prescription drugs, rehabilitative, laboratory, preventive/wellness/chronic, pediatric (incl. dental/vision).
• Dependent coverage to age 26; guaranteed issue; no pre-existing condition exclusions.

Medicare 2026 Figures

• Part A: deductible $1,736; daily coinsurance $434 (days 61-90), $868 (lifetime reserve); SNF $217/day (days 21-100); premium-free for ~99% (40+ quarters); full premium $565/mo.
• Part B: standard premium $202.90/mo; deductible $283; 20% coinsurance after deductible; IRMAA for high-income.
• Part D: OOP cap $2,100 (was $2,000 in 2025); deductible $615; $0 catastrophic; $35 insulin cap; $0 ACIP adult vaccines.

Prohibited Practices

• Twisting — misrepresentation in a replacement sale to induce policy replacement.
• Rebating — anything of value not specified in the policy to induce the sale; illegal in most states.
• Coercion, misrepresentation, defamation, boycotting — also prohibited.
• Unfair Claims Settlement Practices Act governs claims conduct.

Why Practice After Each Domain

Reading alone produces recognition; retrieval practice produces recall, and the exam rewards recall under time pressure. After each domain block in the plan above, take the corresponding OpenExamPrep practice question set rather than saving all questions for the end. This:

1. Surfaces weak areas early when you still have time to re-study.
2. Trains you on the question style (qualifiers like "except" and "most correct").
3. Builds the timing habit (~1 minute per question).
4. Converts the figures above into long-term memory through repeated retrieval.

Aim for 80%+ on a timed full-length practice set before you sit for the real exam. The 70% passing bar includes unscored pilot questions you cannot identify, so a practice score at 70% leaves no margin — 80%+ gives you a comfortable buffer.

Final Week Dos and Don'ts

Do:

• Take two timed full-length practice exams.
• Re-read your flagged weak sub-topics, not the whole guide.
• Confirm your state's exact passing score, fee, and scheduling portal.
• Sleep well the night before; A&H rewards careful reading more than cramming.

Don't:

• Don't memorize 2025 HSA/HDHP or Medicare figures — they changed for 2026.
• Don't conflate COBRA's 18/29/36 durations or the 2% vs 150% surcharge.
• Don't confuse ACA metal tiers with one another (60/70/80/90).
• Don't skip Regulations & Ethics — its concepts recur inside other domains.
• Don't leave questions blank; there is no penalty for guessing.