AHIP Final Exam Practice Test Questions and Answers | Version | Verified Answers (over 200 Questions)

AHIP Final Exam Practice Test Questions and Answers | Version | Verified Answers (over 200 Questions) 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 Answer--------They are Medicare health plans such as HMOs, PPOs, PFFS, SNPs, and MSAs (W) Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage. What would be a correct description? - -----Correct Answer--------Medicare Advantage is a way of covering all of the Original Medicare benefits through private health insurance companies. During a sales presentation in Ms. Sullivan's home, she tells you that she has heard about a type of Medicare health plan known as Private Fee-forService (PFFS). She wants to know if this would be available to her. What should you tell her about PFFS plans? ------Correct Answer--------A PFFS plan is one of various types of Medicare Advantage plans offered by private entities and she may enroll in one if it is available in her area. (W) Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What should you tell her? ------ Correct Answer--------Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but has recently stopped paying his Part B premium. He would like to enroll in a Medicare Advantage (MA) plan and is still covered by Part A. What should you tell him? ------Correct Answer--------He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B (W) 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 Answer- -------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 Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access providers. What should you tell him? ------Correct Answer--------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).