AHIP MODULE 2 ACTUAL EXAM 2024-2025
COMPLETE 80 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+
Terms in this set (25)
Daniel is a middle-income b. C-SNP Correct
Medicare beneficiary. He
has chronic bronchitis,
putting him at severe risk for
pneumonia. Otherwise, he
has no problems
functioning. Which type of
SNP is likely to be most
appropriate for him?
Dr. Elizabeth Brennan does b. Dr. Brennan can charge Mary Rogers no more than
not contract with the PFFS the cost sharing specified in the PFFS plan's terms and
plan but accepts the plan's condition of payment which may include balance billing
terms and conditions for up to 15 percent of the Medicare rate. Correct
payment. Mary Rodgers
sees Dr. Brennan for
treatment. How much may
Dr. Brennan charge?
For which of the following b. Ms. Baker who is enrolled in Medicare Part B and is
individuals would a Cost willing to continue paying Part B premiums plus any plan
Plan be most appropriate? premiums. Correct
, Mr. Castillo, a naturalized a. He is not eligible to enroll in a Medicare Advantage
citizen, previously enrolled plan until he re-enrolls in Medicare Part B. Correct
in Medicare Part B but has
recently stopped paying his
Part B premium. Mr. Castillo
is still covered by Part A. He
would like to enroll in a
Medicare Advantage (MA)
plan and is still covered by
Part A. What should you tell
him?
Mr. Davies is turning 65 next c. Cost plan enrollees can choose to receive Medicare
month. He would like to covered services under the plan's benefits by going to
enroll in a Medicare health plan network providers and paying plan cost sharing, or
plan, but does not want to may receive services from non-network providers and
be limited in terms of where pay cost-sharing due under Original Medicare. Correct
he obtains his care. What
should you tell him about
how a Medicare Cost Plan
might fit his needs?
Mr. Gomez notes that a a. He may receive health care services from any doctor
Private Fee-for-Service allowed to bill Medicare, as long as he shows the doctor
(PFFS) plan available in his the plan's identification card and the doctor agrees to
area has an attractive accept the PFFS plan's payment terms and conditions,
premium. He wants to know which could include balance billing. Correct
if he must use doctors in a
network like his current
HMO plan requires him to
do. What should you tell
him?
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