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AHIP Module 2 Continued... QUESTIONS WITH 100% VERIFIED ANSWERS 2024-2025/ A+ GRADE/ACTUAL, Exams of Nursing

AHIP Module 2 Continued... QUESTIONS WITH 100% VERIFIED ANSWERS 2024-2025/ A+ GRADE/ACTUAL EXA, EXAMS OF NURSING

Typology: Exams

2024/2025

Available from 12/04/2024

NURSINGGRADER01
NURSINGGRADER01 🇺🇸

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1.4K documents

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Download AHIP Module 2 Continued... QUESTIONS WITH 100% VERIFIED ANSWERS 2024-2025/ A+ GRADE/ACTUAL and more Exams Nursing in PDF only on Docsity!

AHIP Module 2 Continued... QUESTIONS

WITH 100% VERIFIED ANSWERS 2024-

2025/ A+ GRADE/ACTUAL EXA, EXAMS

OF NURSING

Which of the following statement is correct about a Medicare Savings Account (MSA) Plans? - CORRECT ANSWERS d. I, II, and IV only I. MSAs may have either a partial network, full network, or no network of providers. II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits. IV. Non-network providers must accept the same amount that Original Medicare would pay them as payment in full. 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? - CORRECT ANSWERS They are Medicare health plans such as HMOs, PPOs, PFFS, and MSAs. Mr. McTaggert notes that a Private Fee-for-Service (PFFS) plan available in his area has an attractive premium. He wants to know what makes them different from an HMO or a PPO. What should you tell him? - CORRECT ANSWERS Enrollees in a PFFS plan can obtain care from any provider in the U.S. who accepts Original Medicare, as long as the provider has a reasonable opportunity to access the plan's terms and conditions and agrees to accept them. Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can go to for her health care. What should you tell her? - CORRECT ANSWERS Mrs. Ramos can obtain care from any provider who participates in Original Medicare, but generally will have a higher cost-sharing amount if she sees a provider who/that is not a part of the PPO network. Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare. What should she be aware of when considering enrollment in a Medicare Advantage plan? - CORRECT ANSWERS She can enroll in any type of Medicare Advantage (MA) plan except an MA Medical Savings Account (MSA) plan. 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

AHIP Module 2 Continued... QUESTIONS

WITH 100% VERIFIED ANSWERS 2024-

2025/ A+ GRADE/ACTUAL EXA, EXAMS

OF NURSING

her? - CORRECT ANSWERS Medicaid may provide additional benefits, but Medicaid will coordinate benefits only with Medicaid participating providers. Mrs. Lee is discussing with you the possibility of enrolling in a Private Fee-for-Service (PFFS) plan. As part of that discussion, what should you be sure to tell her? - CORRECT ANSWERS PFFS plans may choose to offer Part D benefits but are not required to do so. Dr. Elizabeth Brennan does not contract with the 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 ANSWERS 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 percent of the Medicare rate. Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis, putting him at severe risk for pneumonia. Otherwise, he has no problems functioning. Which type of SNP is likely to be most appropriate for him? - CORRECT ANSWERS C-SNP Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage. What would be the correct description? - CORRECT ANSWERS Medicare Advantage is a way of covering all the Original Medicare benefits through private health insurance companies.