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Medicare AHIP Module 2 Exam 2024/2025 Questions With Completed & Verified Solutions.
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Medicare AHIP Module 2 Exam 2024/2025 Questions With Completed & Verified Solutions.
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Mrs. Wang wants to know generally how the benefits under Original Medicare might compare tothe benefits package of a Medicare Advantage Plan before she starts looking at specific plans.
What could you tell her? - ANS Medicare Advantage Plans may offer extra benefits that Original
Medicare does not offer such as vision, hearing, and dental services. It must include a maximum
out-of-pocket limit on Part A and Part B services.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that
he would have certain services and items covered by the plan with minimal out-of-pocket costs
because his MA-PD coverage has been very good. However, when he received the bill, he was
surprised to see large charges in excess of his maximum out-of-pocket limit that included some
services and items he thought would be fully covered. He called you to ask what he could do?
What could you tell him? - ANS You can offer to review the plans appeal process to help him
ask the plan to review the coverage decision.
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? - ANS 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 a part of the PPO network
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. - ANS I, II and IV only
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.
IV. Non-network providers must accept the same amount that Original Medicare would pay them
as payment in full.
Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from his
investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His
friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would
like to join that plan. What should you tell him? - ANS SNPs limit enrollment to certain
subpopulations of beneficiaries. Given his current situation, he is unlikely to qualify and would
not be able to enroll in the SNP.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree
group health plan that includes drug coverage with nominal copays. He heard about a
neighbor's MA-PD plan that you represent and because he takes numerous prescription drugs,
he is considering signing up for it. What should you tell him? - ANS He should compare the
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