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AHIP Module 2 2022 with Verfied Answers

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AHIP Module 2 2022 with Verfied Answers 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 ne... twork as his current HMO plan requires him to do. What should you tell him? CORRECT ANSWERHe 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? CORRECT ANSWERINCORRECT- She can enroll in the PPO and purchase drug coverage through a stand-alone Medicare Part D prescription drug plan. Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What should you tell her? CORRECT ANSWERMrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage. 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 ANSWERHe will have to enroll in Part B. Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own home. She is attracted by the idea of maintaining control over a Medical Savings Account (MSA) but is not sure if the plan associated with the account will fit her needs. What specific piece of information about a Medicare MSA plan would it be important for her to know, prior to enrolling in such a plan? CORRECT ANSWER Mr. Sinclair has diabetes and heart trouble and is generally satisfied with the care he has received under Original Medicare, but he would like to know more about Medicare Advantage Special Needs Plans (SNPs). What could you tell him? CORRECT ANSWERSNPs have special programs for enrollees with chronic conditions, like Mr. Sinclair, and they provide prescription drug coverage that could be very helpful as well. 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? CORRECT ANSWERMedicaid may provide additional benefits, but Medicaid will only pay for these services if they are furnished by Medicaid participating providers. [Show More]

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