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AHIP 2025 Module 2, AHIP 2025 Module 1, AHIP 2025 Module 3, AHIP 2025 module 4, AHHIP 2025 Module 5 Practice Questions and Answers $13.49   Add to cart

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AHIP 2025 Module 2, AHIP 2025 Module 1, AHIP 2025 Module 3, AHIP 2025 module 4, AHHIP 2025 Module 5 Practice Questions and Answers

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AHIP 2025 Module 2, AHIP 2025 Module 1, AHIP 2025 Module 3, AHIP 2025 module 4, AHHIP 2025 Module 5 Practice Questions and Answers Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he has coverage through an employer plan. If he wants to enroll in a...

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  • October 31, 2024
  • 28
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • 2025 AHIP
  • 2025 AHIP
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Emillect
©EMILLECT2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




AHIP 2025 Module 2, AHIP 2025 Module 1, AHIP 2025

Module 3, AHIP 2025 module 4, AHHIP 2025 Module 5

Practice Questions and Answers



Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he has

coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he

have to do? - ANSWER✔✔-He will have to enroll in Part B.


Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare. What should she be

aware of when considering enrollment in a Medicare Advantage (MA) plan? - ANSWER✔✔-She cannot

enroll in an MA Medical Savings Account (MSA) plan.


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? - ANSWER✔✔-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.


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? -




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, ©EMILLECT2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




ANSWER✔✔-She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare Part

D prescription drug plan.


Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She is considering enrollment in

a Medicare Advantage plan (Part C). What should you advise her to do before she will be able to enroll in

a Medicare Advantage plan? - ANSWER✔✔-To join a Medicare Advantage plan, she also must enroll in

Part B.


Mrs. Andrews asked how a Private Fee-for-Service (PFFS) plan might affect her access to services since

she receives some assistance for her health care costs from the State. What should you tell her? -

ANSWER✔✔-Medicaid may provide additional benefits, but Medicaid will only pay for these services if

they are furnished by Medicaid participating providers.


Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access

providers. What should you tell him? - ANSWER✔✔-In most Medicare Advantage HMOs, Mr. Kumar

must generally obtain his services only from providers within the plan's network (except in an emergency

or where care is unavailable within the network).


Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap,

Incorporated. Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare

coverage. Juan is a naturalized citizen and has contributed to the Medicare system for over 20 years.

Juan asks you if he will be entitled to Medicare and if he enrolls how that will impact his employer-

sponsored healthcare coverage. How would you respond? - ANSWER✔✔-Juan is likely to be eligible for


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, ©EMILLECT2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




Medicare once he turns age 65 and if he enrolls Medicare would become the primary payor of his

healthcare claims and Smallcap does not have to continue to offer him coverage comparable to those

under age 65 under its employer-sponsored group health plan.


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

charge? - ANSWER✔✔-Dr. Brennan can charge Mary Rogers no more than the cost sharing specified in

the PFFS plan's terms and condition of payment which may include balance billing up to 15%of the

Medicare rate.


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✔✔-C-SNP


Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent. It is one of three

plans operated by the same organization in Mr. Lombardi's area. The MA PPO plan does not include drug

coverage, but the other two plans do. Mr. Lombardi likes the PPO plan that does not include drug

coverage and intends to obtain his drug coverage through a stand-alone Medicare prescription drug

plan. What should you tell him about this situation? - ANSWER✔✔-He could enroll either in one of the

MA plans that include prescription drug coverage or Original Medicare with a Medigap plan and

standalone Part D prescription drug coverage, but he cannot enroll in the MA-only PPO plan and a stand-

alone prescription drug plan.




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