AHIP-2 ACTUAL EXAM WITH CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+||UPDATED 2024!

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?
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.
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?
She can enroll in the PPO, but she will not be able to purchase a stand-alone Medicare Part D
prescription drug plan.
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?
Dr. 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.
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that does not include
drug coverage. She wants to enroll in the plan and enroll in a stand-alone prescription drug plan.
What should you tell her?
She could enroll in a PFFS plan and a stand-alone Medicare prescription drug plan.
Mrs. Davenport enrolled in the ABC Medicare Advantage (MA) plan several years ago. In midFebruary 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?
She may remain in her ABC MA plan, enroll in another MA plan in her service area, or enroll in a
Special Needs Plan (SNP) for individuals 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?
Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he
would have certain services and items covered by the plan with minimal out-of-pocket costs
because his MA-PD coverage has been very good. However, when he received the bill, he was
surprised to see large charges in excess of his maximum out-of-pocket limit that included a
number of services and items he thought would be fully covered. He called you to ask what he
could do? What could you tell him?
You can offer to review the plans appeal process to help him ask the plan to review the coverage
decision.
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?
All MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits, which could be
obtained by also enrolling in a separate prescription drug p