AHIP Certification Exam Comprehensive &
Guide A+ Exam Prep Questions and Answers
Verified Solutions Latest Update 2026/2027
Answer:
-every Medicare beneficiary gets a ID card
-in 2019, they stopped using SS numbers for ID
-protects beneficiaries from identity theft
-need to bring card when you get care
-destroy old cards
-keep part D cards, Advantage cards or Medicap cards
• Medicare Law.
Answer:
-Title XVIII of the SS Act
-health insurance for the Aged and disabled
Subsections
Part A: Hospital Insurance Benefits like skilled nursing facilities, rehab, hospice
Part B: Supplementary insurance like outpatient services such as physician care
Part C: Medicare Advantage plans which must cover Part A and B benefits
Part D: Prescription drug coverage
Part E: Misc. Provisions like Medigap coverage and Medicare cost plans
• Different Ways to Get Medicare.
Answer:
-Original Medicare(Part A and B)
-Medicare Advantage plans(Part C with or w/o part D)
-Medicare cost plans
-PACE plans
-Medicare-Medicaid plans
-Medicare PDP(Part D)
-Original Medicare with Medigap
• Medigap.
,Answer:
a private insurance policy that pays the difference between the medical charge and the amount that
Medicare pays
• Medicaid.
Answer:
A federal and state assistance program that pays for health care services for people who cannot
afford them.
• Examples of Ways to Get Medicare.
Answer:
1. Mr. Jones: has
Medigap plan to cover Medicare cost sharing and stand along PDP to cover his drugs
2. Mrs. Hernandez: purchased Medicare advantage plan that includes
Part D to cover Medicare, drug and cost sharing benefits
-Mr. Watanabe recieves both Medicare and Medicaid benefits
-Ms. Krauss has purchased a Medicare advantage plan without Part D because she gets a generous
drug plan from a former employer
• Original Medicare.
Answer:
-has two parts: A and B
Part A: Hospital, skilled nursing facility, hospice and home health services
Part B: outpatient and professional services like those provided by a doctor or non-physician
professional, clinical lab services, durable medical equipment, preventive services and other med
services
• Medicare Advantage Plans.
Answer:
-Part C
Includes:
-HMO's, some plans include Part D
-PPO, some include Part D
-Private Fee for Service Plans(PFFS), some may offer part D but are not obligated
-Special Needs Plans(all include part D)
-Medical Savings account Plans(No Part D)
-Employer or Union Group Plans
,• All MA plans must:.
Answer:
-Cover all A and B benefits
-provide cost sharing equivalent to OG Medicare but may be different for specific services
-include annual max out of pocket limit on total enrollee cost sharing(deductibles, coinsurance,
copayments) for Part and b services
-OG Medicare does not have max limit
-Cover the following services even when provided by non network providers:
-emergency services, out of area services and out of area renal dialysis
• Extra Benefits Medicare Health plans might cover extra benefits like:.
Answer:
-vision services
-hearing aids
-routine dental services and/or dentures
-routine transport to medical appts.
-Chiropractic services
-annual physical exams
-in home safety assessments and fail prevention devices
-worldwide urgently needed and emergency services
-over the counter drugs
-*an annual physical is different from the annual wellness visit covered under Medicare which
doesnt include physical exam
• Medicare Cost Plans.
Answer:
-not part of Advantage plans, OG Medicare and only available in certain areas of the country
-must have at least Part B, dont need A
-if enrollees go to non network provider, the services covered under their OG Medicare benefits,
but they pay the higher Part A and/or B coinsurance and deductibles that apply under the OG rather
than their cost plan coinsurance and deductibles
-individuals can join anytime the plan is accepting new members, different
enrollment/disenrollment periods apply to Medicare cost plans than to Advantage or OG
-enrollees can leave anytime and return to OG
-can get PDP if offered or join a Part D plan, but Part D enrollment period apply to any benefit
changes
, • Deductible.
Answer:
Amount you must pay before you begin receiving any benefits from your insurance company
• Coinsurance.
Answer:
a provision under which both the insured and the insurer share the covered losses
• PACE Plans.
Answer:
-programs for All Inclusive Care for the Elderly
-allows people who otherwise need nursing home level of care to remain in the community
Qualifiers:
-age 55 or older
-live in service area of PACE org
-be certified by the state as needing a nursing home level of care
-at the time the individual joins, he or she can live safely in the community with the help of PACE
services
• Medicare/Medicaid (Medi-Medi) Plans.
Answer:
-serve individuals eligible for both
-dual eligibles
-include Part D PDP
• Part D.
Answer:
-stand alone PDP or coverage under Medicare health plan
• Medigap Coverage.
Answer:
-sold by private insurance companies to fill gaps in coverage
-works only with OG Medicare
Guide A+ Exam Prep Questions and Answers
Verified Solutions Latest Update 2026/2027
Answer:
-every Medicare beneficiary gets a ID card
-in 2019, they stopped using SS numbers for ID
-protects beneficiaries from identity theft
-need to bring card when you get care
-destroy old cards
-keep part D cards, Advantage cards or Medicap cards
• Medicare Law.
Answer:
-Title XVIII of the SS Act
-health insurance for the Aged and disabled
Subsections
Part A: Hospital Insurance Benefits like skilled nursing facilities, rehab, hospice
Part B: Supplementary insurance like outpatient services such as physician care
Part C: Medicare Advantage plans which must cover Part A and B benefits
Part D: Prescription drug coverage
Part E: Misc. Provisions like Medigap coverage and Medicare cost plans
• Different Ways to Get Medicare.
Answer:
-Original Medicare(Part A and B)
-Medicare Advantage plans(Part C with or w/o part D)
-Medicare cost plans
-PACE plans
-Medicare-Medicaid plans
-Medicare PDP(Part D)
-Original Medicare with Medigap
• Medigap.
,Answer:
a private insurance policy that pays the difference between the medical charge and the amount that
Medicare pays
• Medicaid.
Answer:
A federal and state assistance program that pays for health care services for people who cannot
afford them.
• Examples of Ways to Get Medicare.
Answer:
1. Mr. Jones: has
Medigap plan to cover Medicare cost sharing and stand along PDP to cover his drugs
2. Mrs. Hernandez: purchased Medicare advantage plan that includes
Part D to cover Medicare, drug and cost sharing benefits
-Mr. Watanabe recieves both Medicare and Medicaid benefits
-Ms. Krauss has purchased a Medicare advantage plan without Part D because she gets a generous
drug plan from a former employer
• Original Medicare.
Answer:
-has two parts: A and B
Part A: Hospital, skilled nursing facility, hospice and home health services
Part B: outpatient and professional services like those provided by a doctor or non-physician
professional, clinical lab services, durable medical equipment, preventive services and other med
services
• Medicare Advantage Plans.
Answer:
-Part C
Includes:
-HMO's, some plans include Part D
-PPO, some include Part D
-Private Fee for Service Plans(PFFS), some may offer part D but are not obligated
-Special Needs Plans(all include part D)
-Medical Savings account Plans(No Part D)
-Employer or Union Group Plans
,• All MA plans must:.
Answer:
-Cover all A and B benefits
-provide cost sharing equivalent to OG Medicare but may be different for specific services
-include annual max out of pocket limit on total enrollee cost sharing(deductibles, coinsurance,
copayments) for Part and b services
-OG Medicare does not have max limit
-Cover the following services even when provided by non network providers:
-emergency services, out of area services and out of area renal dialysis
• Extra Benefits Medicare Health plans might cover extra benefits like:.
Answer:
-vision services
-hearing aids
-routine dental services and/or dentures
-routine transport to medical appts.
-Chiropractic services
-annual physical exams
-in home safety assessments and fail prevention devices
-worldwide urgently needed and emergency services
-over the counter drugs
-*an annual physical is different from the annual wellness visit covered under Medicare which
doesnt include physical exam
• Medicare Cost Plans.
Answer:
-not part of Advantage plans, OG Medicare and only available in certain areas of the country
-must have at least Part B, dont need A
-if enrollees go to non network provider, the services covered under their OG Medicare benefits,
but they pay the higher Part A and/or B coinsurance and deductibles that apply under the OG rather
than their cost plan coinsurance and deductibles
-individuals can join anytime the plan is accepting new members, different
enrollment/disenrollment periods apply to Medicare cost plans than to Advantage or OG
-enrollees can leave anytime and return to OG
-can get PDP if offered or join a Part D plan, but Part D enrollment period apply to any benefit
changes
, • Deductible.
Answer:
Amount you must pay before you begin receiving any benefits from your insurance company
• Coinsurance.
Answer:
a provision under which both the insured and the insurer share the covered losses
• PACE Plans.
Answer:
-programs for All Inclusive Care for the Elderly
-allows people who otherwise need nursing home level of care to remain in the community
Qualifiers:
-age 55 or older
-live in service area of PACE org
-be certified by the state as needing a nursing home level of care
-at the time the individual joins, he or she can live safely in the community with the help of PACE
services
• Medicare/Medicaid (Medi-Medi) Plans.
Answer:
-serve individuals eligible for both
-dual eligibles
-include Part D PDP
• Part D.
Answer:
-stand alone PDP or coverage under Medicare health plan
• Medigap Coverage.
Answer:
-sold by private insurance companies to fill gaps in coverage
-works only with OG Medicare
