AHIP BUNDLED EXAMS FULL SOLUTION
TESTED QUESTIONS AND ANSWERS
◉ Mrs. Joy, age 65, is entitled to Part A but has not yet enrolled in Part
B. She is considering enrolling in a Medicare Advantage plan (Part C).
What should you advise her to do before she can enroll in a Medicare
Advantage plan? ANSWER: To join a Medicare Advantage plan, she
also must enroll in Part B.
◉ Mr. Kumar is considering a Medicare Advantage HMO and has
questions about his ability to access providers. What should you tell
him? ANSWER: In 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).
◉ Mrs. Robles 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? ANSWER: Mrs. Robles 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.
◉ Mrs. Lester is age 75 and enjoys a comfortable but not
extremely high-income level. She wishes to enroll in an MA MSA plan
that she heard about from her neighbor. She also wants to have
prescription drug coverage since her doctor recently prescribed several
expensive medications. Currently, she is enrolled in Original Medicare
, and a standalone Part D plan. How would you advise Mrs. Lester?
ANSWER: Mrs. Lester may enroll in an MA MSA plan and remain in
her current standalone Part D prescription drug plan.
◉ Mr. Dalton 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.
Dalton would like to join that plan. What should you tell him?
ANSWER: 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. Anderson wants to know whether he is eligible to sign up
for a Private fee-for-service (PFFS) plan. What questions would you
need to ask to determine his eligibility? ANSWER: You would need to
ask Mr. Anderson if he is entitled to Part A, enrolled in Part B, and if he
lives in the PFFS plan's service area.
◉ Herber Noble is turning 65 next month, Herber legally entered
the United States over twenty years ago but is not a citizen. Since his
entry into the country, Herber has worked at Smallcap Incorporated and
contributed to the Medicare system. Herber suffers from diabetes. He
will soon retire and asks you if he can enroll in a Medicare Advantage
plan that you represent. How would you respond? ANSWER: Herber is
eligible to enroll in Medicare Advantage as long as he is entitled to Part
A and enrolled in Part B. Herber should go to the Social Security
website to enroll in Medicare Part A and B if he has not done so already.
Once he is enrolled, he can choose a Medicare Advantage plan.
TESTED QUESTIONS AND ANSWERS
◉ Mrs. Joy, age 65, is entitled to Part A but has not yet enrolled in Part
B. She is considering enrolling in a Medicare Advantage plan (Part C).
What should you advise her to do before she can enroll in a Medicare
Advantage plan? ANSWER: To join a Medicare Advantage plan, she
also must enroll in Part B.
◉ Mr. Kumar is considering a Medicare Advantage HMO and has
questions about his ability to access providers. What should you tell
him? ANSWER: In 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).
◉ Mrs. Robles 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? ANSWER: Mrs. Robles 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.
◉ Mrs. Lester is age 75 and enjoys a comfortable but not
extremely high-income level. She wishes to enroll in an MA MSA plan
that she heard about from her neighbor. She also wants to have
prescription drug coverage since her doctor recently prescribed several
expensive medications. Currently, she is enrolled in Original Medicare
, and a standalone Part D plan. How would you advise Mrs. Lester?
ANSWER: Mrs. Lester may enroll in an MA MSA plan and remain in
her current standalone Part D prescription drug plan.
◉ Mr. Dalton 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.
Dalton would like to join that plan. What should you tell him?
ANSWER: 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. Anderson wants to know whether he is eligible to sign up
for a Private fee-for-service (PFFS) plan. What questions would you
need to ask to determine his eligibility? ANSWER: You would need to
ask Mr. Anderson if he is entitled to Part A, enrolled in Part B, and if he
lives in the PFFS plan's service area.
◉ Herber Noble is turning 65 next month, Herber legally entered
the United States over twenty years ago but is not a citizen. Since his
entry into the country, Herber has worked at Smallcap Incorporated and
contributed to the Medicare system. Herber suffers from diabetes. He
will soon retire and asks you if he can enroll in a Medicare Advantage
plan that you represent. How would you respond? ANSWER: Herber is
eligible to enroll in Medicare Advantage as long as he is entitled to Part
A and enrolled in Part B. Herber should go to the Social Security
website to enroll in Medicare Part A and B if he has not done so already.
Once he is enrolled, he can choose a Medicare Advantage plan.
