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AHIP Module 2 Question and Answers (Latest 2022/2023) 100% Correct Answers
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AHIP Module 2 Question and Answers (Latest 2022/2023) 100% Correct Answers
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AHIP Module 2 Question and Answers (Latest2022/2023) 100% Correct Answers
Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about
what type of plan designs are available through this program. What should you tell him about the types
of health plans that are available through the Medicare Advantage program? Correct Answer: c. They
are Medicare health plans such as HMOs, PPOs, PFFS, and MSAs. Correct
Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage.
What would be a correct description? Correct Answer: a. Medicare Advantage is a way of covering all
the Original Medicare benefits through private health insurance companies. Correct
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What
should you tell her? Correct Answer: b. Mrs. Radford must be entitled to Part A and enrolled in Part B to
enroll in Medicare Advantage. Correct
Mr. Castillo, a naturalized citizen, previously enrolled 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? Correct Answer: a. He is
not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B. Correct
Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan several years ago. Her doctor recently
confirmed a diagnosis of end-stage renal disease (ESRD). What options does Mrs. Billings have in regard
to her MA plan during the next open enrollment season? Correct Answer: a. She may remain in her ABC
MA plan or enroll in a Special Needs Plan (SNP) for individuals suffering from ESRD if one is available in
her area. Correct
Daniel is a middle-income 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? Correct Answer: a. C-SNP Correct
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access
providers. What should you tell him? Correct Answer: d. In most Medicare Advantage HMOs, Mr. Kumar
must obtain his services only from providers who have a contractual relationship with the plan (except
in an emergency). Correct
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can
go to for her health care. What should you tell her? Correct Answer: b. Mrs. Ramos can obtain care
from any provider who participates in Original Medicare, but generally will have a higher cost-sharing
amount if she sees a provider who/that is not part of the PPO network. Correct
Mr. Sinclair has diabetes and heart trouble and is generally satisfied with the care he has received under
Original Medicare, but he would like to know more about Medicare Advantage Special Needs Plans
(SNPs). What could you tell him? Correct Answer: b. SNPs have special programs for enrollees with
chronic conditions, like Mr. Sinclair, and they provide prescription drug coverage that could be very
helpful as well. Correct
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