AHIP Module 2 - Questions And Answers
Mr. Lopez has heard that he can sign up for a product called "Medicare
Advantage" but is not sure about what type of plan designs are available
through this program. What should you tell him about the types of health
plans that are available through the Medicare Advantage program? Correct
Ans - c. They are Medicare health plans such as HMOs, PPOs, PFFS, and
MSAs. Correct
Mr. Wells is trying to understand the difference between Original Medicare
and Medicare Advantage. What would be a correct description? Correct Ans
- a. Medicare Advantage is a way of covering all the Original Medicare
benefits through private health insurance companies. Correct
Mrs. Radford asks whether there are any special eligibility requirements for
Medicare Advantage. What should you tell her? Correct Ans - b. Mrs.
Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare
Advantage. Correct
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but
has recently stopped paying his Part B premium. Mr. Castillo is still covered
by Part A. He would like to enroll in a Medicare Advantage (MA) plan and is
still covered by Part A. What should you tell him? Correct Ans - a. He is
not eligible to enroll in a Medicare Advantage plan until he re-enrolls in
Medicare Part B. Correct
Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan several years
ago. Her doctor recently confirmed a diagnosis of end-stage renal disease
(ESRD). What options does Mrs. Billings have in regard to her MA plan during
the next open enrollment season? Correct Ans - a. She may remain in her
ABC MA plan or enroll in a Special Needs Plan (SNP) for individuals suffering
from ESRD if one is available in her area. Correct
Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis,
putting him at severe risk for pneumonia. Otherwise, he has no problems
functioning. Which type of SNP is likely to be most appropriate for him?
Correct Ans - a. C-SNP Correct
Mr. Kumar is considering a Medicare Advantage HMO and has questions
about his ability to access providers. What should you tell him? Correct Ans
- d. In most Medicare Advantage HMOs, Mr. Kumar must obtain his services
only from providers who have a contractual relationship with the plan
(except in an emergency). Correct
Mr. Lopez has heard that he can sign up for a product called "Medicare
Advantage" but is not sure about what type of plan designs are available
through this program. What should you tell him about the types of health
plans that are available through the Medicare Advantage program? Correct
Ans - c. They are Medicare health plans such as HMOs, PPOs, PFFS, and
MSAs. Correct
Mr. Wells is trying to understand the difference between Original Medicare
and Medicare Advantage. What would be a correct description? Correct Ans
- a. Medicare Advantage is a way of covering all the Original Medicare
benefits through private health insurance companies. Correct
Mrs. Radford asks whether there are any special eligibility requirements for
Medicare Advantage. What should you tell her? Correct Ans - b. Mrs.
Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare
Advantage. Correct
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but
has recently stopped paying his Part B premium. Mr. Castillo is still covered
by Part A. He would like to enroll in a Medicare Advantage (MA) plan and is
still covered by Part A. What should you tell him? Correct Ans - a. He is
not eligible to enroll in a Medicare Advantage plan until he re-enrolls in
Medicare Part B. Correct
Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan several years
ago. Her doctor recently confirmed a diagnosis of end-stage renal disease
(ESRD). What options does Mrs. Billings have in regard to her MA plan during
the next open enrollment season? Correct Ans - a. She may remain in her
ABC MA plan or enroll in a Special Needs Plan (SNP) for individuals suffering
from ESRD if one is available in her area. Correct
Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis,
putting him at severe risk for pneumonia. Otherwise, he has no problems
functioning. Which type of SNP is likely to be most appropriate for him?
Correct Ans - a. C-SNP Correct
Mr. Kumar is considering a Medicare Advantage HMO and has questions
about his ability to access providers. What should you tell him? Correct Ans
- d. In most Medicare Advantage HMOs, Mr. Kumar must obtain his services
only from providers who have a contractual relationship with the plan
(except in an emergency). Correct
