Medicare advantage plan - Study guides, Class notes & Summaries

AHIP Practice Exam Updated Questions and Answers (2024 / 2025) (Verified Answers). 1. Mr. Carlini has heard that Medicare prescription drug plans are only offered through private companies under a program known as Medicare Advantage (MA), not by the government. He likes Original Medicare and does not want to sign up for an MA product, but he also wants prescription drug coverage. What should you tell him ANS Mr. Carlini can stay with Original Medicare and also enroll in a Medicare prescription...

AHIP 2023/2024 TEST BANK 200 QUESTIONS WITH ANSWERS 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? - ANSWER They are Medicare health plans such as HMOs, PPOs, PFFS, SNPs, and MSAs (W) Mr...

CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 Steps used to control costs of managed care include: Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage HMO Conventional PPO and POS H...

UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS Version 2 |A+ GRADE Q: John has Power of Attorney to act on behalf of his mother. What does that mean when it comes to his mother enrolling in a Medicare Advantage Plan? Answer: John may sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indicates his authority under state law to enroll his mother. Q: In which of the...

LA Life, Health & Accident Insurance Series 103 Practice Exam Questions and Answers Already Passed Under which situation must insurable interest exist between the applicant and insured at the time of application? When a third-party applicant names themselves beneficiary. Which of the following is true about a decreasing term life policy? The face amount reaches zero at policy expiration. Which of the following occurs immediately after the application is submitted and the initial premium paid?...

AHIP 2024 FINAL EXAM/ 50+ QUESTIONS AND ANSWERS ALL CORRECT/ 2023/2024. AHIP 2024 final exam 1. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might be of assistance?: She should contact her state Medicaid agency to see if she qualifies forprograms that can help with Medicare costs for which she is responsible. 2. Madeline Martinez was widowed several years ago. Her husband worked for many years and contributed into the Medicare sy...

Lisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits. How does she enroll in Original Medicare? Correct Answer: Her enrollment in Medicare Parts A and B is generally automatic if she meets all eligibility requirements. Which statement is true about a member of a Medicare Advantage (MA) Plan who wants to enroll in a Medicare Supplement Insurance Plan? Correct Answer: When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not auto...

Pharmacotherapeutics for Advanced Practice Nurse Prescribers 5th Edition Woo & Robinson Test Bank UNIT I. THE FOUNDATION Chapter 1. The Role of the Nurse Practitioner as Prescriber Chapter 2. Review of the Basic Principles of Pharmacology Chapter 3. Rational Drug Selection Chapter 4. Legal and Professional Issues in Prescribing Chapter 5. Adverse Drug Reactions Chapter 6. An Introduction to Pharmacogenetics Chapter 7. Nutrition and Neutraceuticals Chapter 8. Herbal Therapies and Cannabis Chapter...

Dual special needs plans are defined as? Medicare advantage plans uniquely designed for consumers enrolled in both Medicare and Medicaid. Meredith a d- snp member loses Medicaid eligibility. What impact does this have on her D-SNP enrollment? She will enter a grace period during which she is responsible for plan, cost sharing and she will be disenrolled at the end of the grace. If she does not re-establish Medicaid eligibility. Brainpower Read More Previous Play Next Rewin...

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...