AHIP Final Exam Questions 100% Solved
Types of Medicare Advantage Plans -ANS-PPO, HMO, MSA, Cost Plan, PFFS
Medicare-Medicaid plans -ANS-Serve both Medicare and Medicaid individuals. Include Part D coverage.
Individuals sometimes referred to as dual eligibles
Medicare Cost Plan -ANS-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 -ANS-Individuals with ESRD may sign up at anytime.
Date on which coverage begins is the fourth month after dialysis begins.
Medicare Enrollment Period -ANS-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 -ANS-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 -ANS-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 -ANS-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 -ANS-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 -ANS-Entiled to benefits under Part A AND enrolled in Part B.
Types of Medicare Advantage Plans -ANS-PPO, HMO, MSA, Cost Plan, PFFS
Medicare-Medicaid plans -ANS-Serve both Medicare and Medicaid individuals. Include Part D coverage.
Individuals sometimes referred to as dual eligibles
Medicare Cost Plan -ANS-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 -ANS-Individuals with ESRD may sign up at anytime.
Date on which coverage begins is the fourth month after dialysis begins.
Medicare Enrollment Period -ANS-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 -ANS-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 -ANS-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 -ANS-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 -ANS-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 -ANS-Entiled to benefits under Part A AND enrolled in Part B.
