AHIP 2025 MODULE 2 QUESTIONS
WITH 100% VERIFIED
SOLUTIONS.
Mrs. Radford asks whether there are any special eligibility requirements for
Medicare Advantage. What should you tell her? - Correct Answer-Mrs.
Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare
Advantage.
Which of the following statement(s) is/are correct about a Medicare Savings
Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no network of
providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription
drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal
deductible of $500 indexed for inflation.
IV. Non-network providers must accept the same amount that Original
Medicare would pay them as payment in full.- Correct Answer-I, II, and IV
only
Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD
plan and was disappointed with the service she received from her primary
care physician because she was told she would have to wait five weeks to
get an appointment when she was feeling ill. She called you to ask what she
could do so she would not have to put up with such poor access to care.
What could you tell her? - Correct Answer-She could file a grievance with her
plan to complain about the lack of timeliness in getting an appointment.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you
represent. It is one of three plans operated by the same organization in Mr.
Lombardi's area. The MA PPO plan does not include drug coverage, but the
other two plans do. Mr. Lombardi likes the PPO plan that does not include
drug coverage and intends to obtain his drug coverage through a stand-
, alone Medicare prescription drug plan. What should you tell him about this
situation? - Correct Answer-He could enroll either in one of the MA plans that
include prescription drug coverage or Original Medicare with a Medigap plan
and standalone Part D prescription drug coverage, but he cannot enroll in
the MA-only PPO plan and a stand-alone prescription drug plan.
Ms. Gibson recently lost her employer group health and drug coverage and
now she wants to enroll in a PPO that does not include drug coverage. What
should you tell her about obtaining drug coverage? - Correct Answer-She can
enroll in the PPO, but she will not be able to purchase a stand-alone Medicare
Part D prescription drug plan.
Mr. Kelly wants to know whether he is eligible to sign up for a private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility? - Correct Answer-You would need to ask Mr. Kelly if he is enrolled
in Part A and Part B and if his doctor will accept the terms and conditions of
payment of the PFFS plan.
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? - Correct
Answer-There are Medicare health plans such as HMOs, PPOs, PFFS, and
MSAs.
Mrs. Wang wants to know generally how the benefits under Original Medicare
might compare to the benefits package of a Medicare Advantage Plan before
she starts looking at specific plans. What could you tell her? - Correct
Answer-Medicare Advantage Plans may offer extra benefits that Original
Medicare does not offer such as vision, hearing, and dental services. It must
include a maximum out-of-pocket limit on Part A and Part B services.
Mr. Wells is trying to understand the difference between Original Medicare
and Medicare Advantage. What would be the correct description? - Correct
Answer-Medicare Advantage is a way of covering all the Original Medicare
benefits through private health insurance companies.
Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She
is considering enrollment in a Medicare Advantage plan (Part C). What should
you advise her to do before she can enroll in a Medicare Advantage plan? -
WITH 100% VERIFIED
SOLUTIONS.
Mrs. Radford asks whether there are any special eligibility requirements for
Medicare Advantage. What should you tell her? - Correct Answer-Mrs.
Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare
Advantage.
Which of the following statement(s) is/are correct about a Medicare Savings
Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no network of
providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription
drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal
deductible of $500 indexed for inflation.
IV. Non-network providers must accept the same amount that Original
Medicare would pay them as payment in full.- Correct Answer-I, II, and IV
only
Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD
plan and was disappointed with the service she received from her primary
care physician because she was told she would have to wait five weeks to
get an appointment when she was feeling ill. She called you to ask what she
could do so she would not have to put up with such poor access to care.
What could you tell her? - Correct Answer-She could file a grievance with her
plan to complain about the lack of timeliness in getting an appointment.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you
represent. It is one of three plans operated by the same organization in Mr.
Lombardi's area. The MA PPO plan does not include drug coverage, but the
other two plans do. Mr. Lombardi likes the PPO plan that does not include
drug coverage and intends to obtain his drug coverage through a stand-
, alone Medicare prescription drug plan. What should you tell him about this
situation? - Correct Answer-He could enroll either in one of the MA plans that
include prescription drug coverage or Original Medicare with a Medigap plan
and standalone Part D prescription drug coverage, but he cannot enroll in
the MA-only PPO plan and a stand-alone prescription drug plan.
Ms. Gibson recently lost her employer group health and drug coverage and
now she wants to enroll in a PPO that does not include drug coverage. What
should you tell her about obtaining drug coverage? - Correct Answer-She can
enroll in the PPO, but she will not be able to purchase a stand-alone Medicare
Part D prescription drug plan.
Mr. Kelly wants to know whether he is eligible to sign up for a private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility? - Correct Answer-You would need to ask Mr. Kelly if he is enrolled
in Part A and Part B and if his doctor will accept the terms and conditions of
payment of the PFFS plan.
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? - Correct
Answer-There are Medicare health plans such as HMOs, PPOs, PFFS, and
MSAs.
Mrs. Wang wants to know generally how the benefits under Original Medicare
might compare to the benefits package of a Medicare Advantage Plan before
she starts looking at specific plans. What could you tell her? - Correct
Answer-Medicare Advantage Plans may offer extra benefits that Original
Medicare does not offer such as vision, hearing, and dental services. It must
include a maximum out-of-pocket limit on Part A and Part B services.
Mr. Wells is trying to understand the difference between Original Medicare
and Medicare Advantage. What would be the correct description? - Correct
Answer-Medicare Advantage is a way of covering all the Original Medicare
benefits through private health insurance companies.
Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She
is considering enrollment in a Medicare Advantage plan (Part C). What should
you advise her to do before she can enroll in a Medicare Advantage plan? -
