AHIP Final UPDATED ACTUAL Exam Questions and CORRECT
Answers | Verified
Question 1.
Types of Medicare Advantage Plans
Correct Answer: PPO, HMO, MSA, Cost Plan, PFFS
Question 2.
Medicare-Medicaid plans
Correct Answer: Serve both Medicare and Medicaid individuals. Include Part D
coverage. Individuals sometimes referred to as dual eligibles
Question 3.
Medicare Cost Plan
Correct 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
Correct 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
Correct 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.
Question 6.
Medicare Enrollment Period - Group Health Coverage
Correct 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 7.
Medicare Part A Premium
Correct 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 8.
Medicare Part A Penalty
Correct 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 9.
Medicare Part B Premium
Correct 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 10.
Part C Medicare Advantage plans
Correct Answer: Entiled to benefits under Part A AND enrolled in Part B.
Question 11.
Part D Prescription Drug benefits
Correct 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 -✓✓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 12.
Part A Benefits
Correct 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.
Answers | Verified
Question 1.
Types of Medicare Advantage Plans
Correct Answer: PPO, HMO, MSA, Cost Plan, PFFS
Question 2.
Medicare-Medicaid plans
Correct Answer: Serve both Medicare and Medicaid individuals. Include Part D
coverage. Individuals sometimes referred to as dual eligibles
Question 3.
Medicare Cost Plan
Correct 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
Correct 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
Correct 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.
Question 6.
Medicare Enrollment Period - Group Health Coverage
Correct 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 7.
Medicare Part A Premium
Correct 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 8.
Medicare Part A Penalty
Correct 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 9.
Medicare Part B Premium
Correct 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 10.
Part C Medicare Advantage plans
Correct Answer: Entiled to benefits under Part A AND enrolled in Part B.
Question 11.
Part D Prescription Drug benefits
Correct 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 -✓✓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 12.
Part A Benefits
Correct 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.
