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Medicare Supplement (Medigap) Plans Flashcards

7 cards from real AHIP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Medicare Supplement (Medigap) Plans flashcards as text

  1. What does 'guaranteed issue' mean in the context of Medigap insurance?

    Answer: The insurer must sell a Medigap policy regardless of health status without charging extra for pre-existing conditions

    Guaranteed issue means an insurer cannot deny you a Medigap policy or charge higher premiums based on pre-existing health conditions during qualifying periods.

  2. A Medicare beneficiary involuntarily loses their employer-sponsored retiree health coverage. What Medigap right does this qualifying event trigger?

    Answer: They have a guaranteed issue right to purchase certain Medigap plans without medical underwriting

    Losing employer-sponsored coverage is a qualifying event that grants guaranteed issue rights, allowing purchase of specific Medigap plans without medical underwriting.

  3. Which statement BEST describes medical underwriting as it applies to Medigap?

    Answer: A process where insurers evaluate health status to decide whether to sell a policy and at what premium

    Medical underwriting allows Medigap insurers to review health status outside of guaranteed issue periods, potentially resulting in denial or higher premiums.

  4. Under Medigap Plan N, a beneficiary may be required to pay which of the following cost-sharing amounts?

    Answer: Copayments of up to $20 for some office visits and up to $50 for emergency room visits

    Plan N requires copayments of up to $20 for certain office visits and up to $50 for ER visits that don't result in hospital admission, in exchange for lower premiums.

  5. How do Medigap insurers structure their premium pricing methodologies?

    Answer: Community-rated, issue-age-rated, and attained-age-rated are the three recognized methods

    Medigap premiums may be community-rated (same for everyone), issue-age-rated (based on age at purchase), or attained-age-rated (increases as you age).

  6. Can a Medigap insurer cancel a beneficiary's policy because the beneficiary develops a serious illness?

    Answer: No — Medigap policies are guaranteed renewable as long as premiums are paid on time

    Medigap policies are guaranteed renewable, meaning the insurer cannot cancel coverage due to health status as long as premiums continue to be paid.

  7. Which Medigap plans cover skilled nursing facility (SNF) coinsurance?

    Answer: Plans C, D, F, G, M, and N at 100%; Plans K and L at reduced percentages

    Plans C, D, F, G, M, and N cover 100% of SNF coinsurance; Plans K and L cover it at partial percentages; Plans A and B do not cover SNF coinsurance.