Ahip 2025 module 2 certification study guide
Which of the following statement(s) is/are correct about a Medicare Savings Account (MSA)
Plans? - answers✔✔MSAs may have either a partial network, full network, or no network of
providers. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.
Non-network providers must accept the same amount that Original Medicare would pay them
as payment in full.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to
enroll in a MA MSA plan that she heard about from her neighbor. She also wants to have
prescription drug coverage since her doctor recently prescribed several expensive medications.
Currently, she is enrolled in Original Medicare and a standalone Part D plan. How would you
advise Mrs. Chi? - answers✔✔Mrs. Chi may enroll in a MA MSA plan and remain in her current
standalone Part D prescription drug plan.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms
and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr.
Brennan charge? - answers✔✔Dr. Brennan can charge Mary Rogers no more than the cost
sharing specified in the PFFS plan's terms and condition of payment which may include balance
billing up to 15%of the Medicare rate.
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to
access providers. What should you tell him? - answers✔✔In most Medicare Advantage HMOs,
Mr. Kumar must generally obtain his services only from providers within the plan's network
(except in an emergency or where care is unavailable within the network).
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree
group health plan that includes drug coverage with nominal copays. He heard about a
neighbor's MA-PD plan that you represent and because he takes numerous prescription drugs,
he is considering signing up for it. What should you tell him? - answers✔✔An individual cannot
Which of the following statement(s) is/are correct about a Medicare Savings Account (MSA)
Plans? - answers✔✔MSAs may have either a partial network, full network, or no network of
providers. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.
Non-network providers must accept the same amount that Original Medicare would pay them
as payment in full.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to
enroll in a MA MSA plan that she heard about from her neighbor. She also wants to have
prescription drug coverage since her doctor recently prescribed several expensive medications.
Currently, she is enrolled in Original Medicare and a standalone Part D plan. How would you
advise Mrs. Chi? - answers✔✔Mrs. Chi may enroll in a MA MSA plan and remain in her current
standalone Part D prescription drug plan.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms
and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr.
Brennan charge? - answers✔✔Dr. Brennan can charge Mary Rogers no more than the cost
sharing specified in the PFFS plan's terms and condition of payment which may include balance
billing up to 15%of the Medicare rate.
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to
access providers. What should you tell him? - answers✔✔In most Medicare Advantage HMOs,
Mr. Kumar must generally obtain his services only from providers within the plan's network
(except in an emergency or where care is unavailable within the network).
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree
group health plan that includes drug coverage with nominal copays. He heard about a
neighbor's MA-PD plan that you represent and because he takes numerous prescription drugs,
he is considering signing up for it. What should you tell him? - answers✔✔An individual cannot
