AHIP 2025 MODULE 2 QUESTIONS AND ANSWERS 2025
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What
should you tell her? - (ANSWER)Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll
in Medicare Advantage.
Which of the following statement(s) is/are correct about a 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 enrolled in an MSA plan is responsible for a minimal deductible of $500 indexed
for inflation.
IV. Non-network providers must accept the same amount that Original Medicare would pay them as
payment in full.
Question 2Answer - (ANSWER)I, II, and IV only
Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan and was disappointed
with the service she received from her primary care physician because she was told she would have to
wait five weeks to get an appointment when she was feeling ill. She called you to ask what she could do
so she would not have to put up with such poor access to care. What could you tell her? - (ANSWER)She
could file a grievance with her plan to complain about the lack of timeliness in getting an appointment.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It is one of three
plans operated by the same organization in Mr. Lombardi's area. The MA PPO plan does not include
drug coverage, but the other two plans do. Mr. Lombardi likes the PPO plan that does not include drug
coverage and intends to obtain his drug coverage through a stand-alone Medicare prescription drug
plan. What should you tell him about this situation? - (ANSWER)He could enroll either in one of the MA
plans that include prescription drug coverage or Original Medicare with a Medigap plan and standalone
Part D prescription drug coverage, but he cannot enroll in the MA-only PPO plan and a stand-alone
prescription drug plan.
Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a
PPO that does not include drug coverage. What should you tell her about obtaining drug coverage? -
(ANSWER)She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare Part D
prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What
should you tell her? - (ANSWER)Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll
in Medicare Advantage.
Which of the following statement(s) is/are correct about a 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 enrolled in an MSA plan is responsible for a minimal deductible of $500 indexed
for inflation.
IV. Non-network providers must accept the same amount that Original Medicare would pay them as
payment in full.
Question 2Answer - (ANSWER)I, II, and IV only
Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan and was disappointed
with the service she received from her primary care physician because she was told she would have to
wait five weeks to get an appointment when she was feeling ill. She called you to ask what she could do
so she would not have to put up with such poor access to care. What could you tell her? - (ANSWER)She
could file a grievance with her plan to complain about the lack of timeliness in getting an appointment.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It is one of three
plans operated by the same organization in Mr. Lombardi's area. The MA PPO plan does not include
drug coverage, but the other two plans do. Mr. Lombardi likes the PPO plan that does not include drug
coverage and intends to obtain his drug coverage through a stand-alone Medicare prescription drug
plan. What should you tell him about this situation? - (ANSWER)He could enroll either in one of the MA
plans that include prescription drug coverage or Original Medicare with a Medigap plan and standalone
Part D prescription drug coverage, but he cannot enroll in the MA-only PPO plan and a stand-alone
prescription drug plan.
Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll in a
PPO that does not include drug coverage. What should you tell her about obtaining drug coverage? -
(ANSWER)She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare Part D
prescription drug plan.
