Exam (elaborations)
2024 AHIP MODULE 2 EXAM WITH CORRECT ANSWERS
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2024 AHIP MODULE 2 EXAM WITH CORRECT ANSWERS
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2024 AHIP MODULE 2 EXAM WITHCORRECT ANSWERS
Ms. Gibson recently lost her employer group health and drug coverage and
now she wants to enroll in a PPO that does not include drug coverage. What
should you tell her about obtaining drug coverage? - CORRECT-ANSWERSShe
can enroll in the PPO, but she will not be able to purchase a stand-alone
Medicare Part D prescription drug plan
Mr. Kumar is considering a Medicare Advantage HMO and has questions
about his ability to access providers. What should you tell him? - CORRECT-
ANSWERSIn most Medicare Advantage HMOs, Mr. Kumar must generally
obtain his services only from providers within the plan's network (except in
an emergency or where care is unavailable within the network)
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you
represent. It is one of three plans operated by the same organization in Mr.
Lombardi's area. The MA PPO plan does not include drug coverage, but the
other two plans do. Mr. Lombardi likes the PPO plan that does not include
drug coverage and intends to obtain his drug coverage through a stand-
alone Medicare prescription drug plan. What should you tell him about this
situation? - CORRECT-ANSWERSHe could enroll either in one of the MA plans
that include prescription drug coverage or Original Medicare with a Medigap
plan and standalone Part D prescription drug coverage, but he cannot enroll
in the MA-only PPO plan and a stand-alone prescription drug plan
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts
the plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan
for treatment. How much may Dr. Brennan charge? - CORRECT-ANSWERSDr.
Brennan can charge Mary Rogers no more than the cost sharing specified in
the PFFS plan's terms and condition of payment which may include balance
billing up to 15%of the Medicare rate.
Juan Perez, who is turning age 65 next month, intends to work for several
more years at Smallcap, Incorporated. Smallcap has a workforce of 15
employees and offers employer-sponsored healthcare coverage. Juan is a
naturalized citizen and has contributed to the Medicare system for over 20
years. Juan asks you if he will be entitled to Medicare and if he enrolls how
that will impact his employer-sponsored healthcare coverage. How would
you respond? - CORRECT-ANSWERSJuan is likely to be eligible for Medicare
once he turns age 65 and if he enrolls Medicare would become the primary
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