AHIP – 2 COMPLETE SOLUTION

Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage. What would be the correct description?: Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies. 1. 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?: They are Medicare health plans such as HMOs, PPOs, PFFS, and MSAs. 2. Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access providers. What should you tell him?: In most Medicare Advantage HMOs, Mr. Kumar must generally obtain his services only from providers who have a contractual relationship with the plan (except in an emergency or where care is unavailable within the network). 3. 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?: He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B. 4. Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare. What should she be aware of when considering enrollment in a Medicare Advantage (MA) plan?: She cannot enroll in an MA Medical Savings Account (MSA) plan