AHIP 2025 Module 2 Study
Questions and Answers
[COMPANY NAME] [Company address]
, AHIP 2025 Module 2 Study Questions
and Answers
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.
Question 2Answer - 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.
Questions and Answers
[COMPANY NAME] [Company address]
, AHIP 2025 Module 2 Study Questions
and Answers
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.
Question 2Answer - 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.
