AHIP Medicare Advantage (Part C) 2

Question 1

To enroll in a Medicare Advantage plan, a beneficiary must:

Accepted Answer

Have both Part A and Part B and live in the plan's service area

Answer

Have only Part A

Answer

Have Part B only

Answer

Be enrolled in a Medigap plan

Question 2

What is the Medicare Advantage Open Enrollment Period (MA OEP)?

Accepted Answer

January 1 – March 31

Answer

October 15 – December 7

Answer

April 1 – June 30

Answer

July 1 – September 30

Question 3

Risk adjustment in Medicare Advantage is used to:

Accepted Answer

Adjust payments based on enrollees' health status and diagnoses

Answer

Penalize plans with unhealthy members

Answer

Set uniform premiums across all plans

Answer

Limit enrollment to healthy beneficiaries

Question 4

Which star rating system does CMS use to evaluate Medicare Advantage plan quality?

Accepted Answer

1–5 star scale

Answer

A–F letter grades

Answer

Bronze/Silver/Gold tiers

Answer

Tier 1–4 ranking

Question 5

What happens to a beneficiary's Original Medicare coverage when they enroll in a Medicare Advantage plan?

Accepted Answer

It is suspended but retained; the MA plan provides benefits instead

Answer

It is permanently terminated

Answer

It remains fully active alongside the MA plan

Answer

It converts to Medicaid automatically

Question 6

A Medicare Advantage PFFS (Private Fee-for-Service) plan is characterized by:

Accepted Answer

Setting its own payment rates; any provider who accepts the terms can treat the member

Answer

Strict network requirements and mandatory referrals

Answer

Coverage only for preventive services

Answer

Requiring enrollment in a Part D drug plan