AHIP Test Exam Questions and Answers
2024/2025 Best Exam for Nursing
You are mailing invitations to new Medicare beneficiaries for a marketing event. You
want an idea of how many people to expect, so you would like to request RSVPs.
What should you keep in mind? - CORRECT ANSWERS ou may request
RSVPs, but you are not permitted to require contact information.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
qualify for the Part D low-income subsidy. Where might he turn for help with his
prescription drug costs? - CORRECT ANSWERS Mr. Wu may still qualify for
help in paying Part D costs through his State Pharmaceutical Assistance Program.
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 ANSWERS C-
SNP
Dr. Elizabeth Brennan does not contract with the PFFS plan but accepts the plan's
terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment.
How much may Dr. Brennan charge? - CORRECT ANSWERS Dr. Brennan can
charge Mary Rogers no more than the cost sharing specified in the PFFS plan's
terms and condition of payment which may include balance billing up to 15 percent
of the Medicare rate.
Mrs. Lee is discussing with you the possibility of enrolling in a Private Fee-for-Service
(PFFS) plan. As part of that discussion, what should you be sure to tell her? -
CORRECT ANSWERS PFFS plans may choose to offer Part D benefits but are
not required to do so.
Which of the following statement is correct about Medicare Savings Account (MSA)
Plans?
I. MSAs may have either a partial network, full network, or no network of providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug
benefits .
III. An individual who is eligible for health care benefits through the Veteran's
Administration may enroll in an MSA.
, AHIP Test Exam Questions and Answers
2024/2025 Best Exam for Nursing
IV. Non-network providers must accept the same amount that Original Medicare
would pay them as payment in full. - CORRECT ANSWERS I, II, and IV only
For which of the following individuals would a Cost Plan be most appropriate? -
CORRECT ANSWERS Ms. Baker who is enrolled in Medicare Part B and is
willing to continue paying Part B premiums plus any plan premiums.
Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare.
What should she be aware of when considering enrollment in a Medicare Health
Plan? - CORRECT ANSWERS She can enroll in any type of Medicare
Advantage (MA) plan except an MA Medical Savings Account (MSA) plan.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus covered
by both Medicare and Medicaid. He decides to enroll in a Medicare Advantage (MA)
PPO plan. Later he sees an out-of-network doctor to receive a Medicare covered
service. How much may the doctor collect from Mr. Rivera? - CORRECT ANSWERS
The doctor may only collect from Mr. Rivera the cost sharing allowable under the
state's Medicaid program.
Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of health
status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network
but may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only
obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a
standalone PDP or through their plan. - CORRECT ANSWERS I, II, and III only
All plans must cover at least the standard Part D coverage or its actuarial
equivalent. What costs would a beneficiary incur for prescription drugs in 2019
under the standard coverage? - CORRECT ANSWERS Standard Part D
coverage would require payment of an annual deductible, 25% cost-sharing up to
the coverage gap, a portion of costs for both generics and brand-name drugs in the
coverage gap, and co-pays or co-insurance after the coverage gap.
2024/2025 Best Exam for Nursing
You are mailing invitations to new Medicare beneficiaries for a marketing event. You
want an idea of how many people to expect, so you would like to request RSVPs.
What should you keep in mind? - CORRECT ANSWERS ou may request
RSVPs, but you are not permitted to require contact information.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
qualify for the Part D low-income subsidy. Where might he turn for help with his
prescription drug costs? - CORRECT ANSWERS Mr. Wu may still qualify for
help in paying Part D costs through his State Pharmaceutical Assistance Program.
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 ANSWERS C-
SNP
Dr. Elizabeth Brennan does not contract with the PFFS plan but accepts the plan's
terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment.
How much may Dr. Brennan charge? - CORRECT ANSWERS Dr. Brennan can
charge Mary Rogers no more than the cost sharing specified in the PFFS plan's
terms and condition of payment which may include balance billing up to 15 percent
of the Medicare rate.
Mrs. Lee is discussing with you the possibility of enrolling in a Private Fee-for-Service
(PFFS) plan. As part of that discussion, what should you be sure to tell her? -
CORRECT ANSWERS PFFS plans may choose to offer Part D benefits but are
not required to do so.
Which of the following statement is correct about Medicare Savings Account (MSA)
Plans?
I. MSAs may have either a partial network, full network, or no network of providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug
benefits .
III. An individual who is eligible for health care benefits through the Veteran's
Administration may enroll in an MSA.
, AHIP Test Exam Questions and Answers
2024/2025 Best Exam for Nursing
IV. Non-network providers must accept the same amount that Original Medicare
would pay them as payment in full. - CORRECT ANSWERS I, II, and IV only
For which of the following individuals would a Cost Plan be most appropriate? -
CORRECT ANSWERS Ms. Baker who is enrolled in Medicare Part B and is
willing to continue paying Part B premiums plus any plan premiums.
Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare.
What should she be aware of when considering enrollment in a Medicare Health
Plan? - CORRECT ANSWERS She can enroll in any type of Medicare
Advantage (MA) plan except an MA Medical Savings Account (MSA) plan.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus covered
by both Medicare and Medicaid. He decides to enroll in a Medicare Advantage (MA)
PPO plan. Later he sees an out-of-network doctor to receive a Medicare covered
service. How much may the doctor collect from Mr. Rivera? - CORRECT ANSWERS
The doctor may only collect from Mr. Rivera the cost sharing allowable under the
state's Medicaid program.
Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of health
status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network
but may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only
obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a
standalone PDP or through their plan. - CORRECT ANSWERS I, II, and III only
All plans must cover at least the standard Part D coverage or its actuarial
equivalent. What costs would a beneficiary incur for prescription drugs in 2019
under the standard coverage? - CORRECT ANSWERS Standard Part D
coverage would require payment of an annual deductible, 25% cost-sharing up to
the coverage gap, a portion of costs for both generics and brand-name drugs in the
coverage gap, and co-pays or co-insurance after the coverage gap.
