AHIP Final Exam Questions And 100%
Verified Answers
\Q\.Types of Medicare Advantage Plans - ANSWERS✔-PPO, HMO, MSA, Cost Plan, PFFS
\Q\.Medicare-Medicaid plans - ANSWERS✔-Serve both Medicare and Medicaid individuals.
Include Part D coverage. Individuals sometimes referred to as dual eligibles
\Q\.Medicare Cost Plan - ANSWERS✔-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.
\Q\.Medicare Entitlement/Enrollment - Part A & Part B - ANSWERS✔-Individuals with ESRD may
sign up at anytime. Date on which coverage begins is the fourth month after dialysis begins.
\Q\.Medicare Enrollment Period - ANSWERS✔-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.
\Q\.Medicare Enrollment Period - Group Health Coverage - ANSWERS✔-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.
, \Q\.Medicare Part A Premium - ANSWERS✔-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.
\Q\.Medicare Part A Penalty - ANSWERS✔-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.
\Q\.Medicare Part B Premium - ANSWERS✔-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
\Q\.Part C Medicare Advantage plans - ANSWERS✔-Entiled to benefits under Part A AND
enrolled in Part B.
\Q\.Part D Prescription Drug benefits - ANSWERS✔-Entitled to benefits under Part A but not
enrolled in Part B. Must be entitled to Part A AND/OR enrolled in Part B.
\Q\.Part D Low Income Subsidy - ANSWERS✔-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.
\Q\.Part A Benefits - ANSWERS✔-$1364.00 deductible for each benefit period. Days 1 - 60: $0
coinsurance. Days 61 - 90: $341.00 coinsurance per day. days 91 and beyond: $682.00
coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days
over a beneficiarys lifetime. Beyond lifetime reserve days, all costs.
\Q\.Part A Benefits - ANSWERS✔-Blood, hospice, home health care, skilled nursing and
rehabilitative care only after a 3 day hospital stay up to 100 days in a benefit period. In 2019,
Verified Answers
\Q\.Types of Medicare Advantage Plans - ANSWERS✔-PPO, HMO, MSA, Cost Plan, PFFS
\Q\.Medicare-Medicaid plans - ANSWERS✔-Serve both Medicare and Medicaid individuals.
Include Part D coverage. Individuals sometimes referred to as dual eligibles
\Q\.Medicare Cost Plan - ANSWERS✔-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.
\Q\.Medicare Entitlement/Enrollment - Part A & Part B - ANSWERS✔-Individuals with ESRD may
sign up at anytime. Date on which coverage begins is the fourth month after dialysis begins.
\Q\.Medicare Enrollment Period - ANSWERS✔-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.
\Q\.Medicare Enrollment Period - Group Health Coverage - ANSWERS✔-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.
, \Q\.Medicare Part A Premium - ANSWERS✔-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.
\Q\.Medicare Part A Penalty - ANSWERS✔-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.
\Q\.Medicare Part B Premium - ANSWERS✔-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
\Q\.Part C Medicare Advantage plans - ANSWERS✔-Entiled to benefits under Part A AND
enrolled in Part B.
\Q\.Part D Prescription Drug benefits - ANSWERS✔-Entitled to benefits under Part A but not
enrolled in Part B. Must be entitled to Part A AND/OR enrolled in Part B.
\Q\.Part D Low Income Subsidy - ANSWERS✔-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.
\Q\.Part A Benefits - ANSWERS✔-$1364.00 deductible for each benefit period. Days 1 - 60: $0
coinsurance. Days 61 - 90: $341.00 coinsurance per day. days 91 and beyond: $682.00
coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days
over a beneficiarys lifetime. Beyond lifetime reserve days, all costs.
\Q\.Part A Benefits - ANSWERS✔-Blood, hospice, home health care, skilled nursing and
rehabilitative care only after a 3 day hospital stay up to 100 days in a benefit period. In 2019,
