AHIP Final Exam Practice Test
(200 Questions and Answers 100% Correct)
Latest () (Verified Answers)
1. Mr. Lopez has heard that he can sign up for a product called "Medicare
Advantage" but is not sure about what type of plan designs are available
through this program. What should you tell him about the types of health
plans that are available through the Medicare Advantage program ANS
They are Medicare health plans such as HMOs, PPOs, PFFS, SNPs, and
MSAs
2. (W) Mr. Wells is trying to understand the difference between Original
Medicare and Medicare Advantage. What would be a correct
description?-
: Medicare Advantage is a way of covering all of the Original
Medicare benefits through private health insurance companies.
3. During a sales presentation in Ms. Sullivan's home, she tells you that she
has heard about a type of Medicare health plan known as Private Fee-for-
Ser- vice (PFFS). She wants to know if this would be available to her. What
,should you tell her about PFFS plans ANS A PFFS plan is one of various
types of Medicare Advantage plans offered by private entities and she
may enroll in one if it is available in her area.
4. (W) Mrs. Radford asks whether there are any special eligibility
requirements for Medicare Advantage. What should you tell her ANS Mrs.
Radford must be entitled to Part A and enrolled in Part B to enroll in
Medicare Advantage
5. Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B
but has recently stopped paying his Part B premium. He would like to enroll
in a Medicare Advantage (MA) plan and is still covered by Part A. What
should you tell him ANS He is not eligible to enroll in a Medicare
Advantage plan until he re-enrolls in Medicare Part B
6. (W) Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan
several years ago. Her doctor recently confirmed a diagnosis of end-stage
renal disease (ESRD). What options does Mrs. Billings have in regard to her
MA plan during the next open enrollment season ANS She may remain in
her ABC MA plan or enroll in a Special Needs Plan (SNP) for individuals
suffering from ESRD if one is available in her area
7. Mr. Kumar is considering a Medicare Advantage HMO and has questions
about his ability to access providers. What should you tell him ANS In most
,Medicare Advantage HMOs, Mr. Kumar must obtain his services only
from providers who have a contractual relationship with the plan
(except in an emergency).
8. Mrs. Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should you
tell her ANS Mrs. Ramos can obtain care from any provider who
participates in Original Medicare, but generally will be charged a lower
co-payment if she goes to one of the plan's preferred providers.
, 9. Mr. Sinclair has diabetes and heart trouble and is generally satisfied with
the care he has received under Original Medicare, but he would like to know
more about Medicare Advantage Special Needs Plans (SNPs). What could
you tell him ANS SNPs have special programs for enrollees with chronic
conditions, like Mr. Sinclair, and they provide prescription drug coverage
that could be very helpful as well
10.(W) Mr. Greco is in excellent health, lives in his own home, and has a
sizeable income from his investments. He has a friend enrolled in a
Medicare Advantage Special Needs Plan (SNP). His friend has mentioned
that the SNP charges very low cost-sharing amounts and Mr. Greco would
like to join that plan. What should you tell him ANS SNPs limit enrollment
to certain sub-populations of beneficiaries. Given his current situation,
he is unlikely to qualify and would not be able to enroll in the SNP.
11.(W) Mrs. Chen will be 65 soon, has been a citizen for twelve years, has
been employed full time, and paid taxes during that entire period. She is
concerned that she will not qualify for coverage under part A because she
was not born in the United States. What should you tell her ANS Most
individuals who are citizens and over age 65 are covered under Part A
by virtue of having paid Medicare taxes while working, though some
may be covered as a result of paying monthly premiums.
12.(W) Mr. Bauer is 49 years old, but eighteen months ago he was declared
(200 Questions and Answers 100% Correct)
Latest () (Verified Answers)
1. Mr. Lopez has heard that he can sign up for a product called "Medicare
Advantage" but is not sure about what type of plan designs are available
through this program. What should you tell him about the types of health
plans that are available through the Medicare Advantage program ANS
They are Medicare health plans such as HMOs, PPOs, PFFS, SNPs, and
MSAs
2. (W) Mr. Wells is trying to understand the difference between Original
Medicare and Medicare Advantage. What would be a correct
description?-
: Medicare Advantage is a way of covering all of the Original
Medicare benefits through private health insurance companies.
3. During a sales presentation in Ms. Sullivan's home, she tells you that she
has heard about a type of Medicare health plan known as Private Fee-for-
Ser- vice (PFFS). She wants to know if this would be available to her. What
,should you tell her about PFFS plans ANS A PFFS plan is one of various
types of Medicare Advantage plans offered by private entities and she
may enroll in one if it is available in her area.
4. (W) Mrs. Radford asks whether there are any special eligibility
requirements for Medicare Advantage. What should you tell her ANS Mrs.
Radford must be entitled to Part A and enrolled in Part B to enroll in
Medicare Advantage
5. Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B
but has recently stopped paying his Part B premium. He would like to enroll
in a Medicare Advantage (MA) plan and is still covered by Part A. What
should you tell him ANS He is not eligible to enroll in a Medicare
Advantage plan until he re-enrolls in Medicare Part B
6. (W) Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan
several years ago. Her doctor recently confirmed a diagnosis of end-stage
renal disease (ESRD). What options does Mrs. Billings have in regard to her
MA plan during the next open enrollment season ANS She may remain in
her ABC MA plan or enroll in a Special Needs Plan (SNP) for individuals
suffering from ESRD if one is available in her area
7. Mr. Kumar is considering a Medicare Advantage HMO and has questions
about his ability to access providers. What should you tell him ANS In most
,Medicare Advantage HMOs, Mr. Kumar must obtain his services only
from providers who have a contractual relationship with the plan
(except in an emergency).
8. Mrs. Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should you
tell her ANS Mrs. Ramos can obtain care from any provider who
participates in Original Medicare, but generally will be charged a lower
co-payment if she goes to one of the plan's preferred providers.
, 9. Mr. Sinclair has diabetes and heart trouble and is generally satisfied with
the care he has received under Original Medicare, but he would like to know
more about Medicare Advantage Special Needs Plans (SNPs). What could
you tell him ANS SNPs have special programs for enrollees with chronic
conditions, like Mr. Sinclair, and they provide prescription drug coverage
that could be very helpful as well
10.(W) Mr. Greco is in excellent health, lives in his own home, and has a
sizeable income from his investments. He has a friend enrolled in a
Medicare Advantage Special Needs Plan (SNP). His friend has mentioned
that the SNP charges very low cost-sharing amounts and Mr. Greco would
like to join that plan. What should you tell him ANS SNPs limit enrollment
to certain sub-populations of beneficiaries. Given his current situation,
he is unlikely to qualify and would not be able to enroll in the SNP.
11.(W) Mrs. Chen will be 65 soon, has been a citizen for twelve years, has
been employed full time, and paid taxes during that entire period. She is
concerned that she will not qualify for coverage under part A because she
was not born in the United States. What should you tell her ANS Most
individuals who are citizens and over age 65 are covered under Part A
by virtue of having paid Medicare taxes while working, though some
may be covered as a result of paying monthly premiums.
12.(W) Mr. Bauer is 49 years old, but eighteen months ago he was declared
