AHIP Final Exam
2023
Types of Medicare Advantage Plans - ANS-PPO, HMO, MSA, Cost Plan, PFFS
Medicare-Medicaid plans - ANS-Serve both Medicare and
... [Show More] Medicaid individuals. Include
Part D coverage. Individuals sometimes referred to as dual eligibles
Medicare Cost Plan - ANS-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
coinsurances and deuctibles. Different enrollment/disenrollment periods apply. Can get
Part D Rx coverage if available, or apply for a separate PDP.
Medicare Entitlement/Enrollment - Part A & Part B - ANS-Individuals with ESRD may
sign up at anytime. Date on which coverage begins is the fourth month after dialysis
begins.
Medicare Enrollment Period - ANS-Individuals who do not enroll in Part B when first
eligible can enroll during a General Enrollment Period, Jan 1st to Mar 31st each year.
Coverage begins July 1st of that year.
Medicare Enrollment Period - Group Health Coverage - ANS-Individuals who have
group health coveage through employer may enroll in Part A and/or Part B anytime
while on group coverage during a Special Enrollment Period. Occurs during the 8 month
period following last month of group coverage.
Medicare Part A Premium - ANS-Free if worked 40 quarters of your life and paid
Medicare taxes. Premium is $240.00 for individuals or spouses who paid Medicare
taxes for 30 - 39 quarters. Premium is $437.00 for less than 30 quarters.
Medicare Part A Penalty - ANS-Don't enroll in Part A when fist eligible, will pay a late
penalty of up to 10% unless enroll during a Special Enrollment Period.
Medicare Part B Premium - ANS-In 2019, the standard monthly premium is $135.50 or
higher depending on income. Deducted from S.S. check or Railroad Retirement check.
Do not enroll when first eligible, premium is increased 10% for each 12 month period
not enrolled. Deductible for 2019 is $185.00
Part C Medicare Advantage plans - ANS-Entiled to benefits under Part A AND enrolled
in Part B.
Part D Prescription Drug benefits - ANS-Entitled to benefits under Part A but not
enrolled in Part B. Must be entitled to Part A AND/OR enrolled in Part B.
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