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AHIP Module 2 Verified Solutions

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AHIP Module 2 Verified Solutions Question 1: What types of Medicare Advantage plans are available? a. Medicare health plans such as HMOs, PPOs, PFFS, and MSAs. Correct answer: a. Medicare health plans such as HMOs, PPOs, PFFS, and MSAs. Question 2: What is the main difference between Original Medicare and Medicare Advantage? a. Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies. Correct answer: a. Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies. Question 3: Who is eligible to enroll in Medicare Advantage? a. Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage. Correct answer: a. Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage. Question 4: Can Mr. Castillo enroll in a Medicare Advantage plan if he has stopped paying his Part B premium? a. He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B. Correct answer: a. He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B. Question 5: What options does Mrs. Billings have regarding her MA plan after being diagnosed with end stage renal disease (ESRD)? d. 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. Correct answer: d. 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. Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own home. She is attracted by the idea of maintaining control over a Medical Savings Account (MSA), but is not sure if the plan associated with the account will fit her needs. What specific piece of information about a Medicare MSA plan would it be important for her to know, prior to enrolling in such a plan? ️a. All MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits, which could be obtained by also enrolling in a separate prescription drug plan. Correct Which of the following statement is correct about Medicare Savings Account (MSA) Plans? I. MSAs may have not have a network or may have a full or partial network of providers. II. MSA plans must cover preventive services that have no cost sharing before the enrollee has met the deductible. III. An individual who is eligible for health care benefits through the Veteran's Administration may enroll in an MSA. IV. Non-network providers must accept the same amount that Original Medicare would pay them as payment in full. ️b. I, II, and IV only Correct Mr. Davies is turning 65 next month. He would like to enroll in a Medicare health plan, but does not want to be limited in terms of where he obtains his care. What should you tell him about how a Medicare Cost Plan might fit his needs? ️c. Cost plan enrollees can choose to receive Medicare covered services under the plan's benefits by going to plan network providers and paying plan cost sharing, or may receive services from non-network providers and pay cost-sharing due under Original Medicare. Correct

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AHIP Module 2 Verified Solutions


Question 1: What types of Medicare Advantage plans are available?



a. Medicare health plans such as HMOs, PPOs, PFFS, and MSAs.



Correct answer: a. Medicare health plans such as HMOs, PPOs, PFFS, and MSAs.



Question 2: What is the main difference between Original Medicare and Medicare Advantage?



a. Medicare Advantage is a way of covering all the Original Medicare benefits through private health
insurance companies.



Correct answer: a. Medicare Advantage is a way of covering all the Original Medicare benefits through
private health insurance companies.



Question 3: Who is eligible to enroll in Medicare Advantage?



a. Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage.



Correct answer: a. Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare
Advantage.



Question 4: Can Mr. Castillo enroll in a Medicare Advantage plan if he has stopped paying his Part B
premium?



a. He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B.



Correct answer: a. He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in
Medicare Part B.

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