Exam (elaborations)
2024 AHIP FINAL EXAM QUESTIONS WITH CORRECT ANSWERS
- Course
- Institution
2024 AHIP FINAL EXAM QUESTIONS WITH CORRECT ANSWERS
[Show more]
Content preview
2024 AHIP FINAL EXAMQUESTIONS WITH CORRECT
ANSWERS
Types of Medicare Advantage Plans - CORRECT-ANSWERSPPO, HMO, MSA,
Cost Plan, PFFS
Medicare Advantage Eligibility - CORRECT-ANSWERSNot eligible if have ESRD
unless: MA Plan is a SNP plan for people with ESRD, OR person developed
ESRD after enrolling in MA plan.
Medicare Advantage Special Needs Plans - CORRECT-ANSWERSThree types.
Chronic Condition (CSNP) for specific severe or disabling conditions. Dual
Eligible (DSNP) for entitlement to both Medicare and Medicaid.
Institutionalized (ISNP) for individuals who need services in skilled nursing
facility for 90 days or longer. All SNP plans include prescription drug
coverage.
MA Plan Types - Coordinated Care Plans - HMO's - CORRECT-ANSWERSSome
HMO's offer Point Of Service option. Allows enrollees to go to no plan
doctors/hospitals without prior approval for sertain services. HMO-POS may
limit services out of network or put cap on out of network coverage. Cost
sharing is generally higher than from network providers
MA Plan Types - Coordinated Care Plans - PPO's - CORRECT-ANSWERSDo not
need referral for out of network providers. May pay higher cost sharing
amount.
MA Plan Types - Private Fee For Service plans - PFFS - CORRECT-
ANSWERSIndividuals in PFFS plan may receive covered services from any
provider who is eligible to provide Medicare services, and agrees to the plans
terms and conditions of payment. Enrollees must inform provider they are a
PFFS member, so the provider can decide whether to accept terms and
conditions. Not permitted to charge more than cost sharing specified in plan.
Cost sharing may include balance billing up to 15%.
MA Plan Types - Medical Savings Account - MSA plan - CORRECT-
ANSWERSHigh deductible plan. Medicare makes contribution to beneficiaries
savings account. Max deductible in 2019 is $12,650.00. In 2020, $13,400.00.
The benefits of buying summaries with Stuvia:
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
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
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 Elitaa. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.09. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
76669 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now