AHIP Final Exam Questions and
Answers 100% Pass
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.
Answers 100% Pass
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.
