AHIP Final Exam Questions
Study online at https://quizlet.com/_h4skus
1. PPO, HMO, MSA, Cost Plan, PFFS Types of Medicare Advan-
tage Plans
2. Serve both Medicare and Medicaid individuals. Include Medicare-Medicaid plans
Part D coverage. Individuals sometimes referred to as
dual eligibles
3. Type of Medicare health plan. Have Part B to enroll. Medicare Cost Plan
Can join anytime plan is accepting new members. A
non network provider will can charge higher coinsur-
ances and deuctibles. Different enrollment/disenroll-
ment periods apply. Can get Part D Rx coverage if
available, or apply for a separate PDP.
4. Individuals with ESRD may sign up at anytime. Date Medicare Entitlement/En-
on which coverage begins is the fourth month after rollment - Part A & Part B
dialysis begins.
5. Individuals who do not enroll in Part B when first eligi- Medicare Enrollment Peri-
ble can enroll during a General Enrollment Period, Jan od
1st to Mar 31st each year. Coverage begins July 1st of
that year.
6. Individuals who have group health coveage through Medicare Enrollment Peri-
employer may enroll in Part A and/or Part B anytime od - Group Health Cover-
while on group coverage during a Special Enrollment age
Period. Occurs during the 8 month period following
last month of group coverage.
7. Free if worked 40 quarters of your life and paid Medicare Part A Premium
Medicare taxes. Premium is $240.00 for individuals or
spouses who paid Medicare taxes for 30 - 39 quarters.
Premium is $437.00 for less than 30 quarters.
1/5
, AHIP Final Exam Questions
Study online at https://quizlet.com/_h4skus
8. Don't enroll in Part A when fist eligible, will pay a late Medicare Part A Penalty
penalty of up to 10% unless enroll during a Special
Enrollment Period.
9. In 2019, the standard monthly premium is $135.50 Medicare Part B Premium
or higher depending on income. Deducted from S.S.
check or Railroad Retirement check. Do not enroll
when first eligible, premium is increased 10% for each
12 month period not enrolled. Deductible for 2019 is
$185.00
10. Entiled to benefits under Part A AND enrolled in Part B. Part C Medicare Advan-
tage plans
11. Entitled to benefits under Part A but not enrolled in Part D Prescription Drug
Part B. Must be entitled to Part A AND/OR enrolled in benefits
Part B.
12. Do not qualify for Part D Low Income Subsidy, but are Part D Low Income Sub-
of limited means, may qualify for help in Part D costs sidy
through State Pharmaceutical Assistance Program.
13. $1364.00 deductible for each benefit period. Days 1 - Part A Benefits
60: $0 coinsurance. Days 61 - 90: $341.00 coinsurance
per day. days 91 and beyond: $682.00 coinsurance per
each "lifetime reserve day" after day 90 for each ben-
efit period (up to 60 days over a beneficiarys lifetime.
Beyond lifetime reserve days, all costs.
14. Blood, hospice, home health care, skilled nursing and Part A Benefits
rehabilitative care only after a 3 day hospital stay up to
100 days in a benefit period. In 2019, will pay $170.50
2/5
Study online at https://quizlet.com/_h4skus
1. PPO, HMO, MSA, Cost Plan, PFFS Types of Medicare Advan-
tage Plans
2. Serve both Medicare and Medicaid individuals. Include Medicare-Medicaid plans
Part D coverage. Individuals sometimes referred to as
dual eligibles
3. Type of Medicare health plan. Have Part B to enroll. Medicare Cost Plan
Can join anytime plan is accepting new members. A
non network provider will can charge higher coinsur-
ances and deuctibles. Different enrollment/disenroll-
ment periods apply. Can get Part D Rx coverage if
available, or apply for a separate PDP.
4. Individuals with ESRD may sign up at anytime. Date Medicare Entitlement/En-
on which coverage begins is the fourth month after rollment - Part A & Part B
dialysis begins.
5. Individuals who do not enroll in Part B when first eligi- Medicare Enrollment Peri-
ble can enroll during a General Enrollment Period, Jan od
1st to Mar 31st each year. Coverage begins July 1st of
that year.
6. Individuals who have group health coveage through Medicare Enrollment Peri-
employer may enroll in Part A and/or Part B anytime od - Group Health Cover-
while on group coverage during a Special Enrollment age
Period. Occurs during the 8 month period following
last month of group coverage.
7. Free if worked 40 quarters of your life and paid Medicare Part A Premium
Medicare taxes. Premium is $240.00 for individuals or
spouses who paid Medicare taxes for 30 - 39 quarters.
Premium is $437.00 for less than 30 quarters.
1/5
, AHIP Final Exam Questions
Study online at https://quizlet.com/_h4skus
8. Don't enroll in Part A when fist eligible, will pay a late Medicare Part A Penalty
penalty of up to 10% unless enroll during a Special
Enrollment Period.
9. In 2019, the standard monthly premium is $135.50 Medicare Part B Premium
or higher depending on income. Deducted from S.S.
check or Railroad Retirement check. Do not enroll
when first eligible, premium is increased 10% for each
12 month period not enrolled. Deductible for 2019 is
$185.00
10. Entiled to benefits under Part A AND enrolled in Part B. Part C Medicare Advan-
tage plans
11. Entitled to benefits under Part A but not enrolled in Part D Prescription Drug
Part B. Must be entitled to Part A AND/OR enrolled in benefits
Part B.
12. Do not qualify for Part D Low Income Subsidy, but are Part D Low Income Sub-
of limited means, may qualify for help in Part D costs sidy
through State Pharmaceutical Assistance Program.
13. $1364.00 deductible for each benefit period. Days 1 - Part A Benefits
60: $0 coinsurance. Days 61 - 90: $341.00 coinsurance
per day. days 91 and beyond: $682.00 coinsurance per
each "lifetime reserve day" after day 90 for each ben-
efit period (up to 60 days over a beneficiarys lifetime.
Beyond lifetime reserve days, all costs.
14. Blood, hospice, home health care, skilled nursing and Part A Benefits
rehabilitative care only after a 3 day hospital stay up to
100 days in a benefit period. In 2019, will pay $170.50
2/5
