AHIP Final & Module 1–5 Test Bank | Practice UPDATED ACTUAL
Exam Questions and CORRECT Answers for Certification
Graded A+
Question 1.
Types of Medicare Advantage Plans .
Answer: PPO, HMO, MSA, Cost Plan, PFFS
Question 2.
Medicare-Medicaid plans .
Answer: Serve both Medicare and Medicaid individuals. Include Part D
coverage. Individuals sometimes referred to as dual eligibles
Question 3.
Medicare Cost Plan .
Answer: Type of Medicare health plan. Have Part B to enroll. Can join anytime
plan is accepting new members. A non network provider will can charge
higher coinsurances and deuctibles. Different enrollment/disenrollment
periods apply. Can get Part D Rx coverage if available, or apply for a separate
PDP.
Question 4.
Medicare Entitlement/Enrollment - Part A & Part B .
Answer: Individuals with ESRD may sign up at anytime. Date on which
coverage begins is the fourth month after dialysis begins.
Question 5.
Medicare Enrollment Period .
Answer: Individuals who do not enroll in Part B when first eligible can enroll
during a General Enrollment Period, Jan 1st to Mar 31st each year. Coverage
begins July 1st of that year.
• Medicare Enrollment Period - Group Health Coverage . Answer: Individuals
who have group health coveage through employer may enroll in Part A and/or
Part B anytime while on group coverage during a Special Enrollment Period.
Occurs during the 8 month period following last month of group coverage.
Question 6.
Medicare Part A Premium .
, Answer: Free if worked 40 quarters of your life and paid 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.
Question 7.
Medicare Part A Penalty .
Answer: Don't enroll in Part A when fist eligible, will pay a late penalty of up
to 10% unless enroll during a Special Enrollment Period.
Question 8.
Medicare Part B Premium .
Answer: In 2019, the standard monthly premium is $135.50 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
Question 9.
Part C Medicare Advantage plans .
Answer: Entiled to benefits under Part A AND enrolled in Part B.
Question 10.
Part D Prescription Drug benefits .
Answer: Entitled to benefits under Part A but not enrolled in Part B. Must be
entitled to Part A AND/OR enrolled in Part B.
• Part D Low Income Subsidy . Answer: Do not qualify for Part D Low Income
Subsidy, but are of limited means, may qualify for help in Part D costs through
State Pharmaceutical Assistance Program.
Question 11.
Part A Benefits .
Answer: $1364.00 deductible for each benefit period. Days 1 - 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
benefit period (up to 60 days over a beneficiarys lifetime. Beyond lifetime
reserve days, all costs.
Question 12.
Part A Benefits .
Exam Questions and CORRECT Answers for Certification
Graded A+
Question 1.
Types of Medicare Advantage Plans .
Answer: PPO, HMO, MSA, Cost Plan, PFFS
Question 2.
Medicare-Medicaid plans .
Answer: Serve both Medicare and Medicaid individuals. Include Part D
coverage. Individuals sometimes referred to as dual eligibles
Question 3.
Medicare Cost Plan .
Answer: Type of Medicare health plan. Have Part B to enroll. Can join anytime
plan is accepting new members. A non network provider will can charge
higher coinsurances and deuctibles. Different enrollment/disenrollment
periods apply. Can get Part D Rx coverage if available, or apply for a separate
PDP.
Question 4.
Medicare Entitlement/Enrollment - Part A & Part B .
Answer: Individuals with ESRD may sign up at anytime. Date on which
coverage begins is the fourth month after dialysis begins.
Question 5.
Medicare Enrollment Period .
Answer: Individuals who do not enroll in Part B when first eligible can enroll
during a General Enrollment Period, Jan 1st to Mar 31st each year. Coverage
begins July 1st of that year.
• Medicare Enrollment Period - Group Health Coverage . Answer: Individuals
who have group health coveage through employer may enroll in Part A and/or
Part B anytime while on group coverage during a Special Enrollment Period.
Occurs during the 8 month period following last month of group coverage.
Question 6.
Medicare Part A Premium .
, Answer: Free if worked 40 quarters of your life and paid 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.
Question 7.
Medicare Part A Penalty .
Answer: Don't enroll in Part A when fist eligible, will pay a late penalty of up
to 10% unless enroll during a Special Enrollment Period.
Question 8.
Medicare Part B Premium .
Answer: In 2019, the standard monthly premium is $135.50 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
Question 9.
Part C Medicare Advantage plans .
Answer: Entiled to benefits under Part A AND enrolled in Part B.
Question 10.
Part D Prescription Drug benefits .
Answer: Entitled to benefits under Part A but not enrolled in Part B. Must be
entitled to Part A AND/OR enrolled in Part B.
• Part D Low Income Subsidy . Answer: Do not qualify for Part D Low Income
Subsidy, but are of limited means, may qualify for help in Part D costs through
State Pharmaceutical Assistance Program.
Question 11.
Part A Benefits .
Answer: $1364.00 deductible for each benefit period. Days 1 - 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
benefit period (up to 60 days over a beneficiarys lifetime. Beyond lifetime
reserve days, all costs.
Question 12.
Part A Benefits .
