Pffs - Study guides, Class notes & Summaries

AHIP 2025 Final Exam Questions and Answers (2024 / 2025) (Verified Answers).1. PPO, HMO, MSA, Cost Plan, PFFS ANS Types of Medicare Advantage Plans 2. Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals sometimes referred to as dual eligibles ANS Medicare-Medicaid plans 3. Type of Medicare health plan. Have Part B to enroll. Can join anytime plan is accepting new members. A non network provider will can charge higher coin- surances and deuctibles. Different enr...

UHC 2024 Ethics & Compliance Assessment 100%Clarification Annual Election Period (AEP) is a time when. . . - Consumers can elect to switch to a different plan or join a Medicare Advantage plan or Prescription Drug Plan. Aries is currently a member of a stand-alone PDP. Aries would like to have additional medical coverage. A thorough needs analysis indicates a Medicare Advantage Plan would be a good fit, there are plans available in his area, and he is in a valid election period. Which o...

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...

A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - Answer-You must have her sign a scope of appointment form, indicating which products she wishes to discuss. You may then proceed with the discussion. Agent Harriet Walker has recently begun marketing Medicare Advantage and related products aimed at meeting the needs of senior citi...

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...

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 answersDr. 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. Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an at...

Ahip 2024 module 3 Practice Questions and Answers 100% Pass Which of the following statements about Medicare Part D are correct? - Correct Answer ️️ -I, II, and III only -I. Part D plans must enroll any eligible beneficiary who applies regardless of health status except in limited circumstances. II. Private fee-for-service (PFFS) plans are not required to use a pharmacy network but may choose to have one. III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may only...

AHIP - Final Examination (Latest Update 2022) Mr. Zachow has a condition for which three drugs are available. He has tried two but had an allergic reaction to them. Only the third drug works for him and it is not on his Part D plan's formulary. What could you tell him to do? - Mr. Zachow has a right to request a formulary exception to obtain coverage for his Part D drug. He or his physician could obtain the standardized request form on the plan's website, fill it out, and submit it to his ...

AHIP 2024 Certification Version 2 All New Qs & As for A++ Exam - Guaranteed Pass! 1. Mrs. Mulcahy, age 65, is concerned that she may not qualify for enrollmentin a Medicare prescription drug plan because, although she is entitled to PartA, she is not enrolled under Medicare Part B. What should you tell her? Answer: An individual who is entitled to Part A or enrolled under Part B is eligible to enroll in a Medicare prescription drug plan. As long as Mrs. Mulcahy is entitled to Part A, ...

AHIP LATEST FINAL EXAM 2023 /2024 GRADED A+ Question1 Marks: 1 Mrs. Roberts has Original Medicare and would like to enroll in a Private Fee-for-Service (PFFS) plan. All types of PFFS plans are available in her area. Which options could Mrs. Roberts consider before selecting a PFFS plan? n Drug (MA-PD) Choose one answer

Medicare - Answer - Federal health insurance program Medicare is administered by whom? - Answer - CMS ( Centers for medicare and medicaid services) Parts A & B of medicare are - Answer - federal health insurance program referred to as original medicare Part A? - Answer - Hospital insurance Part B? - Answer - Medical insurance What doesnt medicare cover? - Answer - routine dental, eye care hearing exam,deductibles, coinsurance and copayments Part C? - Answer - Medicare Advantage...