AHIP Final Exam Questions and Answers(2022 Frequently
tested questions)
Types of Medicare Advantage Plans
PPO, HMO, MSA, Cost Plan, PFFS
Medicare-Medicaid plans
Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals
sometimes referred to as dual eligibles
Medicare Cost Plan
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
Individuals with ESRD may sign up at anytime. Date on which coverage begins is the
fourth month after dialysis begins.
Medicare Enrollment Period
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
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
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
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
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
tested questions)
Types of Medicare Advantage Plans
PPO, HMO, MSA, Cost Plan, PFFS
Medicare-Medicaid plans
Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals
sometimes referred to as dual eligibles
Medicare Cost Plan
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
Individuals with ESRD may sign up at anytime. Date on which coverage begins is the
fourth month after dialysis begins.
Medicare Enrollment Period
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
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
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
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
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
