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AHIP 2022 Module 2 Questions And Answers Latest Quiz
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AHIP 2022 Module 2 Questions And AnswersLatest Quiz
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? Correct Answer: 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.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to
enroll in a MA MSA plan that she heard about from her neighbor. She also wants to have prescription
drug coverage since her doctor recently prescribed several expensive medications. Currently, she is
enrolled in Original Medicare and a standalone Part D plan. How would you advise Mrs. Chi? Correct
Answer: Mrs. Chi may enroll in a MA MSA plan and remain in her current standalone Part D
prescription drug plan.MA MSA plans are prohibited from offering prescription drug coverage. If an
MSA member wants prescription drug coverage, the member must enroll in a standalone PDP.
Mrs. Davenport enrolled in the ABC Medicare Advantage (MA) plan several years ago. In mid-
February of 2021, her doctor confirms a diagnosis of end-stage renal disease (ESRD). What options
will Mrs. Davenport have regarding her MA plan during the next open enrollment season? Correct
Answer: Mrs. Davenport has three clear choices: (1) remain in the ABC MA plan, (2) enroll in another
MA plan in her service area, or (3) enroll in a Special Needs Plan (SPN) for persons suffering from
ESRD if one is available in her area.
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage.
What should you tell her? Correct Answer: To be eligible to enroll in Medicare Advantage, an
individual must be entitled (not enrolled) to Part A and enrolled in Part B.
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? Correct Answer: Mr. Gomez may receive health care services from
any doctor allowed to bill Medicare, provided he shows the doctor the plan's identification card, and
the doctor accepts the PFFS's payment terms and conditions. These terms may include balance
billing up to 15% of the Medicare rate.
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? Correct Answer: Dr. Brennan cannot charge any PFFS plan enrollee more than the cost-
sharing specified in that PFFS plan's terms and conditions.
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? Correct Answer: He will have to 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
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