AHIP - 2 | 2025-2026 LATEST UPDATED|ACTUAL EXAM COMPLETE
QUESTIONS AND ANSWERS | 100% RATED CORRECT | 100% VERFIED |
ALREADY GRADED A+
1. Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage.
What would be the correct description?: Medicare Advantage is a way of covering all the Original
Medicare benefits through private health insurance companies.
2. 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?: They are
Medicare health plans such as HMOs, PPOs, PFFS, and MSAs.
3. Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access
providers. What should you tell him?: In most Medicare Advantage HMOs, Mr. Kumar must generally
obtain his services only from providers who have a contractual relationship with the plan (except in
an emergency or where care is unavailable within the network).
4. 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?: He is not eligible to
enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B.
5. Mrs. Walters is enrolled in her state's Medicaid program in addition to
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, Medicare. What should she be aware of when considering enrollment in a Medicare Advantage (MA)
plan?: She cannot enroll in an MA Medical Savings Account (MSA) plan.
6. 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?: C-SNP 7. Mrs. Burton is a retiree with substantial income. She is enrolled in an
MA-PD plan and was disappointed with the service she received from her primary care physician
because she was told she would have to wait five weeks to get an appointment when she was feeling
ill. She called you to ask what she could do so she would not have to put up with such poor access to
care. What could you tell her?: She could file a grievance with her plan to complain about the lack of
timeliness in getting an appointment.
8. Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from his
investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His friend has
mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would like to join that
plan. What should you tell him?: SNPs limit enrollment to certain subpopulations of beneficiaries. Given
his current situation, he is unlikely to qualify and would not be able to enroll in the SNP.
9. Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll
in a PPO that does not include drug coverage. What should you tell her about obtaining drug coverage?:
She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare Part D prescription
drug plan.
10. Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan
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QUESTIONS AND ANSWERS | 100% RATED CORRECT | 100% VERFIED |
ALREADY GRADED A+
1. Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage.
What would be the correct description?: Medicare Advantage is a way of covering all the Original
Medicare benefits through private health insurance companies.
2. 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?: They are
Medicare health plans such as HMOs, PPOs, PFFS, and MSAs.
3. Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access
providers. What should you tell him?: In most Medicare Advantage HMOs, Mr. Kumar must generally
obtain his services only from providers who have a contractual relationship with the plan (except in
an emergency or where care is unavailable within the network).
4. 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?: He is not eligible to
enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B.
5. Mrs. Walters is enrolled in her state's Medicaid program in addition to
1/8
, Medicare. What should she be aware of when considering enrollment in a Medicare Advantage (MA)
plan?: She cannot enroll in an MA Medical Savings Account (MSA) plan.
6. 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?: C-SNP 7. Mrs. Burton is a retiree with substantial income. She is enrolled in an
MA-PD plan and was disappointed with the service she received from her primary care physician
because she was told she would have to wait five weeks to get an appointment when she was feeling
ill. She called you to ask what she could do so she would not have to put up with such poor access to
care. What could you tell her?: She could file a grievance with her plan to complain about the lack of
timeliness in getting an appointment.
8. Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from his
investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His friend has
mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would like to join that
plan. What should you tell him?: SNPs limit enrollment to certain subpopulations of beneficiaries. Given
his current situation, he is unlikely to qualify and would not be able to enroll in the SNP.
9. Ms. Gibson recently lost her employer group health and drug coverage and now she wants to enroll
in a PPO that does not include drug coverage. What should you tell her about obtaining drug coverage?:
She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare Part D prescription
drug plan.
10. Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and
conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan
2/8
