AHIP 2023 Final Exam Answers/28
Questions and answers
Types of Medicare Advantage Plans - -PPO, HMO, MSA, Cost Plan, PFFS
-Medicare-Medicaid plans - -Serve both Medicare and Medicaid individuals.
Include Part D coverage. Individuals sometimes referred to as dual eligibles
-Medicare Cost Plan - -Type of Medicare health plan. Have Part B to enroll.
Can join anytime plan is accepting new members. A non network provider
will can charge higher coinsurances and deuctibles. Different
enrollment/disenrollment periods apply. Can get Part D Rx coverage if
available, or apply for a separate PDP.
-Medicare Entitlement/Enrollment - Part A & Part B - -Individuals with ESRD
may sign up at anytime. Date on which coverage begins is the fourth month
after dialysis begins.
-Medicare Enrollment Period - -Individuals who do not enroll in Part B when
first eligible can enroll during a General Enrollment Period, Jan 1st to Mar
31st each year. Coverage begins July 1st of that year.
-Medicare Enrollment Period - Group Health Coverage - -Individuals who
have group health coveage through employer may enroll in Part A and/or
Part B anytime while on group coverage during a Special Enrollment Period.
Occurs during the 8 month period following last month of group coverage.
-Medicare Part A Premium - -Free if worked 40 quarters of your life and paid
Medicare taxes. Premium is $240.00 for individuals or spouses who paid
Medicare taxes for 30 - 39 quarters. Premium is $437.00 for less than 30
quarters.
-Medicare Part A Penalty - -Don't enroll in Part A when fist eligible, will pay a
late penalty of up to 10% unless enroll during a Special Enrollment Period.
-Medicare Part B Premium - -In 2019, the standard monthly premium is
$135.50 or higher depending on income. Deducted from S.S. check or
Railroad Retirement check. Do not enroll when first eligible, premium is
increased 10% for each 12 month period not enrolled. Deductible for 2019 is
$185.00
-Part C Medicare Advantage plans - -Entiled to benefits under Part A AND
enrolled in Part B.
Questions and answers
Types of Medicare Advantage Plans - -PPO, HMO, MSA, Cost Plan, PFFS
-Medicare-Medicaid plans - -Serve both Medicare and Medicaid individuals.
Include Part D coverage. Individuals sometimes referred to as dual eligibles
-Medicare Cost Plan - -Type of Medicare health plan. Have Part B to enroll.
Can join anytime plan is accepting new members. A non network provider
will can charge higher coinsurances and deuctibles. Different
enrollment/disenrollment periods apply. Can get Part D Rx coverage if
available, or apply for a separate PDP.
-Medicare Entitlement/Enrollment - Part A & Part B - -Individuals with ESRD
may sign up at anytime. Date on which coverage begins is the fourth month
after dialysis begins.
-Medicare Enrollment Period - -Individuals who do not enroll in Part B when
first eligible can enroll during a General Enrollment Period, Jan 1st to Mar
31st each year. Coverage begins July 1st of that year.
-Medicare Enrollment Period - Group Health Coverage - -Individuals who
have group health coveage through employer may enroll in Part A and/or
Part B anytime while on group coverage during a Special Enrollment Period.
Occurs during the 8 month period following last month of group coverage.
-Medicare Part A Premium - -Free if worked 40 quarters of your life and paid
Medicare taxes. Premium is $240.00 for individuals or spouses who paid
Medicare taxes for 30 - 39 quarters. Premium is $437.00 for less than 30
quarters.
-Medicare Part A Penalty - -Don't enroll in Part A when fist eligible, will pay a
late penalty of up to 10% unless enroll during a Special Enrollment Period.
-Medicare Part B Premium - -In 2019, the standard monthly premium is
$135.50 or higher depending on income. Deducted from S.S. check or
Railroad Retirement check. Do not enroll when first eligible, premium is
increased 10% for each 12 month period not enrolled. Deductible for 2019 is
$185.00
-Part C Medicare Advantage plans - -Entiled to benefits under Part A AND
enrolled in Part B.
