100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
AHIP2024 MODULE 2 Study Guide Rated A $14.99   Add to cart

Exam (elaborations)

AHIP2024 MODULE 2 Study Guide Rated A

 0 view  0 purchase
  • Course
  • Institution

AHIP2024 MODULE 2 Study Guide Rated A+ Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an attractive premium. He wants to know if he must use doctors in a network as his current HMO plan requires him to do. What should you tell him? Juan Hernandez is turning 6...

[Show more]

Preview 1 out of 4  pages

  • February 20, 2024
  • 4
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
avatar-seller
AHIP2024 MODULE 2 Study Guide Rated A+

1). Mr. gomez notes that a private fee-for-service (pffs) plan available in his area has an
attractive premium. he wants to know if he must use doctors in a network as his current
hmo plan requires him to do. what should you tell him?

 Ans: He may receive health care services from any doctor allowed to bill Medicare, as
long as he shows the doctor the plan's identification card and the doctor agrees to accept
the PFFS plan's payment terms and conditions, which could include balance billing.


2). Juan hernandez is turning 65 next month, juan legally entered the united states over twenty
years ago but is not a citizen. since his entry into the country, juan has worked at smallcap
incorporated and contributed to the medicare system. juan suffers from diabetes. he will
soon retire and asks you if he can enroll in a medicare advantage plan that you represent.
how would you respond?

 Ans: Juan is eligible to enroll in a Medicare Advantage as long as he is entitled to Part
A and enrolled in Part B. Juan should go to the Social Security website to enroll in
Medicare Part A and B if he has not done so already. Once he is enrolled, he can choose a
Medicare Advantage plan.


3). 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?

 Ans: He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in
Medicare Part B.


4). 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?

 Ans: B. 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


5). Mr. kumar is considering a medicare advantage hmo and has questions about his ability to
access providers. what should you tell him?




PaperStoc.com Page 1 of 4

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller Academik001. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $14.99. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

72042 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling
$14.99
  • (0)
  Add to cart