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AHIP 2024 Exam With 100%
Correct And
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You are mailing invitations to new Medicare beneficiaries for a marketing
event. You want an idea of how many people to expect, so you would like to
request RSVPs. What should you keep in mind? - Correct Answer-ou may
request RSVPs, but you are not permitted to require contact information.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
qualify for the Part D low-income subsidy. Where might he turn for help with
his prescription drug costs? - Correct Answer-Mr. Wu may still qualify for help
in paying Part D costs through his State Pharmaceutical Assistance Program.
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 likely to be most appropriate for him? -
Correct Answer-C-SNP
Dr. Elizabeth Brennan does not contract with the 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 Answer-Dr. 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 percent of the Medicare rate.
Mrs. Lee is discussing with you the possibility of enrolling in a Private Fee-
for-Service
(PFFS) plan. As part of that discussion, what should you be sure to tell her?
- Correct
Answer-PFFS plans may choose to offer Part D benefits but are not required
to do so.
Which of the following statement is correct about 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 eligible for health care benefits
through the Veteran's Administration may enroll in an MSA.
AHIP 2024 Exam With 100% Correct And Verified Answers
, AHIP
IV. Non-network providers must accept the same amount that Original
Medicare would pay them as payment in full. - Correct Answer-I, II, and IV
only
For which of the following individuals would a Cost Plan be most appropriate?
- Correct Answer-Ms. Baker who is enrolled in Medicare Part B and is willing to
continue paying Part B premiums plus any plan premiums.
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 Health Plan? - Correct Answer-She can enroll in any type of
Medicare Advantage (MA) plan except an MA Medical Savings Account (MSA)
plan.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus
covered by both Medicare and Medicaid. He decides to enroll in a Medicare
Advantage (MA) PPO plan. Later he sees an out-of-network doctor to receive
a Medicare covered service. How much may the doctor collect from Mr.
Rivera? - Correct Answer-The doctor may only collect from Mr. Rivera the cost
sharing allowable under the state's Medicaid program.
Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless
of health status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy
network but may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may
only obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through
a standalone PDP or through their plan. - Correct Answer-I, II, and III only
All plans must cover at least the standard Part D coverage or its actuarial
equivalent. What costs would a beneficiary incur for prescription drugs in
2019 under the standard coverage? - Correct Answer-Standard Part D
coverage would require payment of an annual deductible, 25% cost-sharing
up to the coverage gap, a portion of costs for both generics and brand-name
drugs in the coverage gap, and co-pays or co-insurance after the coverage
gap.
Mrs. Andrews was preparing a budget for next year because she takes quite
a few prescription drugs, she will reach the coverage gap, and wants to be
sure she has enough money set aside for those months. She received
assistance calculating her projected expenses from her daughter who is a
pharmacist, but she doesn't think the calculations are correct because her
out-of-pocket expenses would be lower than last year. She calls to ask if you
can help. What might you tell her? - Correct Answer-It would not be unusual
AHIP 2024 Exam With 100% Correct And Verified Answers
AHIP 2024 Exam With 100%
Correct And
Verified
Answers
You are mailing invitations to new Medicare beneficiaries for a marketing
event. You want an idea of how many people to expect, so you would like to
request RSVPs. What should you keep in mind? - Correct Answer-ou may
request RSVPs, but you are not permitted to require contact information.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
qualify for the Part D low-income subsidy. Where might he turn for help with
his prescription drug costs? - Correct Answer-Mr. Wu may still qualify for help
in paying Part D costs through his State Pharmaceutical Assistance Program.
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 likely to be most appropriate for him? -
Correct Answer-C-SNP
Dr. Elizabeth Brennan does not contract with the 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 Answer-Dr. 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 percent of the Medicare rate.
Mrs. Lee is discussing with you the possibility of enrolling in a Private Fee-
for-Service
(PFFS) plan. As part of that discussion, what should you be sure to tell her?
- Correct
Answer-PFFS plans may choose to offer Part D benefits but are not required
to do so.
Which of the following statement is correct about 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 eligible for health care benefits
through the Veteran's Administration may enroll in an MSA.
AHIP 2024 Exam With 100% Correct And Verified Answers
, AHIP
IV. Non-network providers must accept the same amount that Original
Medicare would pay them as payment in full. - Correct Answer-I, II, and IV
only
For which of the following individuals would a Cost Plan be most appropriate?
- Correct Answer-Ms. Baker who is enrolled in Medicare Part B and is willing to
continue paying Part B premiums plus any plan premiums.
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 Health Plan? - Correct Answer-She can enroll in any type of
Medicare Advantage (MA) plan except an MA Medical Savings Account (MSA)
plan.
Mr. Rivera has Qualified Medicare Beneficiary (QMB) eligibility and is thus
covered by both Medicare and Medicaid. He decides to enroll in a Medicare
Advantage (MA) PPO plan. Later he sees an out-of-network doctor to receive
a Medicare covered service. How much may the doctor collect from Mr.
Rivera? - Correct Answer-The doctor may only collect from Mr. Rivera the cost
sharing allowable under the state's Medicaid program.
Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless
of health status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy
network but may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may
only obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through
a standalone PDP or through their plan. - Correct Answer-I, II, and III only
All plans must cover at least the standard Part D coverage or its actuarial
equivalent. What costs would a beneficiary incur for prescription drugs in
2019 under the standard coverage? - Correct Answer-Standard Part D
coverage would require payment of an annual deductible, 25% cost-sharing
up to the coverage gap, a portion of costs for both generics and brand-name
drugs in the coverage gap, and co-pays or co-insurance after the coverage
gap.
Mrs. Andrews was preparing a budget for next year because she takes quite
a few prescription drugs, she will reach the coverage gap, and wants to be
sure she has enough money set aside for those months. She received
assistance calculating her projected expenses from her daughter who is a
pharmacist, but she doesn't think the calculations are correct because her
out-of-pocket expenses would be lower than last year. She calls to ask if you
can help. What might you tell her? - Correct Answer-It would not be unusual
AHIP 2024 Exam With 100% Correct And Verified Answers
