AHIP 2021-2022 Module 2 EXAM QUESTIONS
AND ANSWERS WITH COMPLETE TOP SOLUTION
RATED A.
Mr. Lopez has heard that he can sign up for a product called "Medicare
Advantage" but is not sure about what type of plan designs are available
through this program. What should you tell him about the types of health
plans that are available through the Medicare Advantage program? -
ANSWER--a. They are Medicare health plans such as HMOs, PPOs,
PFFS, and MSAs. Correct
Mr. Wells is trying to understand the difference between Original
Medicare and Medicare Advantage. What would be a correct
description? - ANSWER--b. Medicare Advantage is a way of covering
all the Original Medicare benefits through private health insurance
companies. Correct
Mrs. Radford asks whether there are any special eligibility requirements
for Medicare Advantage. What should you tell her? - ANSWER--d. Mrs.
Radford must be entitled to Part A and enrolled in Part B to enroll in
Medicare Advantage. Correct
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part
B but has recently stopped paying his Part B premium. Mr. Castillo is
still covered by Part A. He would like to enroll in a Medicare Advantage
(MA) plan and is still covered by Part A. What should you tell him? -
ANSWER--a. He is not eligible to enroll in a Medicare Advantage plan
until he re-enrolls in Medicare Part B. Correct
, AHIP 2021-2022 Module 2 EXAM QUESTIONS
AND ANSWERS WITH COMPLETE TOP SOLUTION
RATED A.
Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan
several years ago. Her doctor recently confirmed a diagnosis of end-
stage renal disease (ESRD). What options does Mrs. Billings have in
regard to her MA plan during the next open enrollment season? -
ANSWER--d. She may remain in her ABC MA plan or enroll in a
Special Needs Plan (SNP) for individuals suffering from ESRD if one is
available in her area. Correct
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? - ANSWER--b. C-SNP Correct
Mr. Kumar is considering a Medicare Advantage HMO and has
questions about his ability to access providers. What should you tell
him? - ANSWER--a. In most Medicare Advantage HMOs, Mr. Kumar
must obtain his services only from providers who have a contractual
relationship with the plan (except in an emergency). Correct
Mrs. Ramos 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--d. Mrs. Ramos 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
part of the PPO network. Correct
AND ANSWERS WITH COMPLETE TOP SOLUTION
RATED A.
Mr. Lopez has heard that he can sign up for a product called "Medicare
Advantage" but is not sure about what type of plan designs are available
through this program. What should you tell him about the types of health
plans that are available through the Medicare Advantage program? -
ANSWER--a. They are Medicare health plans such as HMOs, PPOs,
PFFS, and MSAs. Correct
Mr. Wells is trying to understand the difference between Original
Medicare and Medicare Advantage. What would be a correct
description? - ANSWER--b. Medicare Advantage is a way of covering
all the Original Medicare benefits through private health insurance
companies. Correct
Mrs. Radford asks whether there are any special eligibility requirements
for Medicare Advantage. What should you tell her? - ANSWER--d. Mrs.
Radford must be entitled to Part A and enrolled in Part B to enroll in
Medicare Advantage. Correct
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part
B but has recently stopped paying his Part B premium. Mr. Castillo is
still covered by Part A. He would like to enroll in a Medicare Advantage
(MA) plan and is still covered by Part A. What should you tell him? -
ANSWER--a. He is not eligible to enroll in a Medicare Advantage plan
until he re-enrolls in Medicare Part B. Correct
, AHIP 2021-2022 Module 2 EXAM QUESTIONS
AND ANSWERS WITH COMPLETE TOP SOLUTION
RATED A.
Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan
several years ago. Her doctor recently confirmed a diagnosis of end-
stage renal disease (ESRD). What options does Mrs. Billings have in
regard to her MA plan during the next open enrollment season? -
ANSWER--d. She may remain in her ABC MA plan or enroll in a
Special Needs Plan (SNP) for individuals suffering from ESRD if one is
available in her area. Correct
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? - ANSWER--b. C-SNP Correct
Mr. Kumar is considering a Medicare Advantage HMO and has
questions about his ability to access providers. What should you tell
him? - ANSWER--a. In most Medicare Advantage HMOs, Mr. Kumar
must obtain his services only from providers who have a contractual
relationship with the plan (except in an emergency). Correct
Mrs. Ramos 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--d. Mrs. Ramos 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
part of the PPO network. Correct
