2024 AHIP MEDICARE MODULE 2
PLANS EXAM WITH CORRECT
ANSWERS
Which statement best describes PACE plans?
Choose one answer.
a. It is an all-inclusive Medicare plan widely available throughout the United
States.
b. It includes comprehensive medical and social service delivery systems
using an interdisciplinary team approach in an adult day health center,
supplemented by in-home and referral services.
c. It is an all-inclusive publicly sponsored Medicaid plan for the elderly.
d. It allows enrollees to choose whether to receive Medicare service by going
to plan network providers and paying plan cost-sharing, or receiving services
from non-network providers and paying cost-sharing due under Original
Medicare. - CORRECT-ANSWERSb. It includes comprehensive medical and
social service delivery systems using an interdisciplinary team approach in
an adult day health center, supplemented by in-home and referral services.
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?
Choose one answer.
a. They are long-term care plans for people with Medicare.
b. They are Medicare health plans such as HMOs, PPOs, PFFS, and MSAs.
c. They are major medical policies, but are only for low-income beneficiaries
with Medicare.
d. They are Medigap Supplemental plans that fill in the gaps not covered by
Medicare. - CORRECT-ANSWERSb. They are Medicare health plans such as
HMOs, PPOs, PFFS, and MSAs.
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 plan?
Choose one answer.
a. State Medicaid programs do not coordinate any of their coverage with
Medicare Advantage plans.
, b. She can submit any bills she has for co-payments under Medicare to the
state's Medicaid program and they will always be fully covered.
c. She can enroll in any type of Medicare Advantage (MA) plan except an MA
Medical Savings Account (MSA) plan.
d. If a provider accepts her Medicare Advantage plan coverage, that
provider is legally obligated to also accept her Medicaid coverage, so she
does not need to worry about finding providers who participate in both
Medicare and Medicaid. - CORRECT-ANSWERSc. She can enroll in any type of
Medicare Advantage (MA) plan except an MA Medical Savings Account (MSA)
plan.
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?
Choose one answer.
a. Beneficiaries should check with their employer or union group benefits
administrator before changing plans to avoid losing the coverage they want
to keep.
b. Generally, employers prefer retirees to enroll in a stand-alone PDP, so he
should consider that instead of the MA-PD.
c. Generally, employers prefer retirees to have both the retiree group plan
and the MA-PD plan to fill in the gaps, but he would be better off with just the
MA-PD plan.
d. When possible, it is always the best option to have both the employer's
plan and the MA-PD, so he would have no out-of-p - CORRECT-ANSWERSa.
Beneficiaries should check with their employer or union group benefits
administrator before changing plans to avoid losing the coverage they want
to keep.
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?
Choose one answer.
a. SNPs do not provide Part D prescription drug coverage, so if he does
enroll, he should be aware that he will not have coverage for any
medications he may need now or in the future.
b. SNPs only serve individuals eligible for both Medicaid and Medicare, so he
cannot enroll.
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