AHIP FINAL EXAM Multiple Choice Verified Questions & Answers
- Types of Medicare Advantage Plans
Question: Which of the following is NOT a type of Medicare Advantage plan?
A) PPO
B) HMO
C) MSA
D) Medigap
Answer: D) Medigap
Rationale: Medigap is supplemental insurance, not a Medicare Advantage plan. MA plans include PPO, HMO, MSA, Cost Plans, and PFFS.
- Medicare-Medicaid Plans (Dual Eligibles)
Question: Who qualifies for a Medicare-Medicaid Plan (MMP)?
A) Only Medicare beneficiaries B) Only Medicaid recipients C) Individuals eligible for both Medicare and Medicaid D) Veterans with TRICARE
Answer: C) Individuals eligible for both Medicare and Medicaid
Rationale: Dual eligibles qualify for MMPs, which combine Medicare and Medicaid benefits, including Part D.
- Medicare Cost Plans
Question: What is a key feature of Medicare Cost Plans?
A) Require enrollment in Part D 1 / 2
B) Allow beneficiaries to use non-network providers at higher costs C) Only available to ESRD patients D) Replace Medigap policies
Answer: B) Allow beneficiaries to use non-network providers at higher costs
Rationale: Cost Plans let beneficiaries see out-of-network providers but with higher coinsurance/deductibles.
- Medicare Entitlement for ESRD Patients
Question: When does Medicare coverage begin for someone with ESRD?
A) Immediately after diagnosis B) The fourth month after dialysis starts C) After a 12-month waiting period D) Only if enrolled in Part B
Answer: B) The fourth month after dialysis starts
Rationale: ESRD patients become eligible the 4th month of dialysis (or immediately if they undergo a kidney transplant).
- General Enrollment Period (GEP)
Question: If someone misses their Initial Enrollment Period for Part B, when can they enroll?A) Anytime B) January 1–March 31 annually C) During the Annual Election Period (AEP) D) Only if they have employer coverage
Answer: B) January 1–March 31 annually
Rationale: The GEP runs Jan 1–Mar 31 each year, with coverage starting July 1.
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