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2023 AHIP Final Exam Quiz Bank| Questions and Verified Answers| 100% Correct| Latest Update| Complete Guide
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2023 AHIP Final Exam Quiz Bank| Questions and Verified Answers| 100% Correct| Latest Update| Complete Guide 1. 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 li...

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  • May 18, 2023
  • 71
  • 2022/2023
  • Exam (elaborations)
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2023 A HIP Final Exam Quiz Bank| Questions and Verified Answers| 100% Correct| Latest Update 1. Daniel iisiaimiddle -
income iMedicare ibeneficiary. iHeihasichronic ibronchitis, iputting ihimiatisevere iriskiforip
neumonia. iOtherwise, iheihasinoiproblems ifunctioning. iWhich itypeiofiSNPiisilikely itoib
eimost iappropriate iforihim? ~ Answer: iC-SNP 2. Mrs.iBurton iisiairetiree iwithisubstantial iincome. iSheiisienrolled iinianiMA-
PDiplaniandiwasidisappointed iwithitheiservice isheireceived ifrom iheriprimary icareiphysi
cianibecause isheiwasitoldisheiwould ihave itoiwaitifiveiweeks itoigetianiappointment iwhe
nisheiwasifeeling iill.iSheicalled iyouitoiaskiwhat isheicould idoisoisheiwould inotihave itoip
utiupiwithisuchipooriaccess itoicare. iWhat icould iyouitelliher? ~ Answer: iSheicould ifileiaigrievance iwithiheriplanitoicomplain iabout ithe
ilackiofitimel iness iinigetting ianiappointment. 3. Mr.iGreco iisiiniexcellent ihealth, ilives iinihisiownihome, iandihasiaisizeable iincome ifrom i
hisiinvestments. iHeihasiaifriend ienrolled iiniaiMedicare iAdvantage iSpecial iNeeds iPlani(
SNP). iHisifriend ihasimentioned ithatitheiSNPicharges iveryilowicost-
sharing iamounts iandiMr.iGreco iwould ilikeitoijoinithatiplan. iWhat ishould iyouitellihim? ~ Answer: iSNPs ilimit ienrollment itoicertain isubpopulations iofibeneficiari
es.iGiven ihisicurrent isituation, iheiisiunlikely itoiqualify iandiwould inotib
eiableitoienroll iinitheiSNP. 4. Mrs.iRadford iasksiwhether ithere iareianyispecial ieligibility irequirements iforiMedicare iA
dvantage. iWhat ishould iyouitelliher? ~ Answer: iMrs.iRadford imust ibeientitled itoiPartiAiandienrolled iiniPartiB
itoienroll iiniMedicare iAdvantage. 5. Mrs.iAndrews iasked ihowiaiPrivate iFee-for-
Service i(PFFS) iplanimight iaffect iheriaccess itoiservices isince isheireceives isome iassistanc
eiforiherihealth icareicosts ifrom itheiState. iWhat ishould iyouitelliher? ~ Answer: iMedicaid imayiprovide iadditional ibenefits, ibutiMedicaid iwillic
oordinate ibenefits ionlyiwithiMedicaid iparticipating iproviders. 6. Mr.iCastillo, iainaturalized icitizen, ipreviously ienrolled iiniMedicare iPartiBibutihasirecentl
yistopped ipaying ihisiPartiBipremium. iMr.iCastillo iisistillicovered ibyiPartiA.iHeiwould il
ikeitoienroll iiniaiMedicare iAdvantage i(MA) iplaniandiisistillicovered ibyiPartiA.iWhat ish
ouldiyouitellihim? ~ Answer: iHeiisinotieligible itoienroll iiniaiMedicare iAdvantage iplaniuntil
iheire-enrolls iiniMedicare iPartiB. 7. Mrs.iDavenport ienrolled iinitheiABC iMedicare iAdvantage i(MA) iplaniseveral iyears iago.i
Inimid-February iofi2021, iheridoctor iconfirms iaidiagnosis iofiend-
stage irenal idisease i(ESRD). iWhat ioptions iwilliMrs.iDavenport ihave iregarding iheriMAip
laniduring itheinextiopen ienrollment iseason? ~ Answer: iSheimayiremain iiniheriABC iMAiplan, ienroll iinianother iMAip
laniiniheriservice iarea, iorienroll iiniaiSpecial iNeeds iPlani(SNP) iforiindiv
iduals isuffering ifrom iESRD iifioneiisiavailable iiniheriarea. 8. Mr.iKumar iisiconsidering iaiMedicare iAdvantage iHMO iandihasiquestions iabout ihisiabili
tyitoiaccessiproviders. iWhat ishould iyouitellihim? ~ Answer: iInimost iMedicare iAdvantage iHMOs, iMr.iKumar imust igeneral
lyiobtain ihisiservices ionlyifrom iproviders iwithin itheiplan's inetwork i(ex
ceptiinianiemergency ioriwhere icareiisiunavailabl eiwithin itheinetwork).u
riclients, iLauren iNichols, ihasiheard iabout iaiMedica 9. Mr.iBarker ienjoys iaicomfortable iretirement iincome. iHeirecently ihadisurgery iandiexpect
edithatiheiwould ihave icertain iservices iandiitems icovered ibyitheiplaniwithiminimal iout-
of-pock eticosts ibecause ihisiMA-
PDicoverage ihasibeen iveryigood. iHowever, iwhen iheireceived itheibill,iheiwasisurprised it
oiseeilarge icharges iiniexcess iofihisimaximum iout-of-
pocket ilimit ithatiincluded isome iservices iandiitems iheithought iwould ibeifully icovered. iH
eicalle diyouitoiaskiwhat iheicould ido?iWhat icould iyouitellihim? ~ Answer: iYouicanioffer itoireview itheiplans iappeal iprocess itoihelpihimia
skitheiplanitoireview itheicoverage idecision. 10. Mr.iSinclair ihasidiabetes iandiheart itrouble iandiisigenerally isatisfied iwithitheicareiheihas
ireceived iunder iOriginal iMedicare, ibutiheiwould ilikeitoiknow imore iabout iMedicare iAdv
antage iSpecial iNeeds iPlans i(SNPs). iWhat icould iyouitellihim? ~ Answer: iSNPs ihave ispecial iprograms iforienrollees iwithichronic iconditi
ons,ilikeiMr.iSinclair, ianditheyiprovide iprescription idrugicoverage ithati
could ibeiveryihelpful iasiwell. 11. Mr.iLopez ihasiheard ithatiheicanisigniupiforiaiproduct icalled i"Medicare iAdvantage" ibutii
sinotisureiabout iwhat itypeiofiplanidesigns iareiavailable ithrough ithisiprogram. iWhat isho
uldiyouitellihimiabout itheitypes iofihealth iplans ithatiareiavailable ithrough itheiMedicare i
Advantage iprogram? ~ Answer: iThey iareiMedicare ihealth iplans isuchiasiHMOs, iPPOs, iPFFS, i
andiMSAs. 12. Mr.iSanchez ihasijustiturned i65iandiisientitled itoiPartiAibutihasinotienrolled iiniPartiBibe
cause iheihasicoverage ithrough ianiemployer iplan. iIfiheiwants itoienroll iiniaiMedicare iAd
vantage iplan, iwhatiwilliheihave itoido? ~ Answer: iHeiwillihave itoienroll iiniPartiB. 13. Mr.iZachow ihasiaicondition iforiwhich ithree idrugs iareiavailable. iHeihasitrieditwoibutiha
dianiallergic ireaction itoithem. iOnly itheithird idrugiworks iforihimiandiitiisinotionihisiPart
iDiplan's iformulary. iWhat icould iyouitellihimitoido? ~ Answer: iMr.iZachow ihasiairight itoirequest iaiformulary iexception itoiob
tainicoverage iforihisiPartiDidrug. iHeiorihisiphysician icould iobtain itheis
tandardiz edirequest iform ionitheiplan's iwebsite, ifilliitiout,iandisubmit iitit
oihisiplan. 14. Mr.iBickford ididinotiquite iqualify iforitheiextra ihelpilow-
income isubsidy iunder itheiMedicare iPartiDiPrescription iDrug iprogram iandiheiisiwonderi
ngiifithere iisianyiother ioption iheihasiforiobtaining ihelpiwithihisiconsiderable idrugicosts.
iWhat ishould iyouitellihim?

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