AHIP Final Exam Questions AND ANSWERS ALL CORRECT
Types of Medicare Advantage Plans Correct Answer: PPO, HMO, MSA, Cost Plan, PFFS
Medicare-Medicaid plans Correct Answer: Serve both Medicare and Medicaid individuals. Include Part D
coverage. Individuals sometimes referred to as dual eligibles
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.
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.
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.
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.
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.
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.
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
Part C Medicare Advantage plans Correct Answer: Entiled to benefits under Part A AND enrolled in Part
B.
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 Correct 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.
Types of Medicare Advantage Plans Correct Answer: PPO, HMO, MSA, Cost Plan, PFFS
Medicare-Medicaid plans Correct Answer: Serve both Medicare and Medicaid individuals. Include Part D
coverage. Individuals sometimes referred to as dual eligibles
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.
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.
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.
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.
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.
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.
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
Part C Medicare Advantage plans Correct Answer: Entiled to benefits under Part A AND enrolled in Part
B.
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 Correct 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.
