AHIP Medicare Supplement (Medigap) Plans 2

Question 1

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

Accepted Answer

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

Answer

The insurer guarantees the lowest premium available in the market

Answer

The federal government guarantees payment of all Medigap claims

Answer

The policy is guaranteed to automatically renew without premium increases

Question 2

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

Accepted Answer

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

Answer

They must wait until the next Annual Enrollment Period to apply for Medigap

Answer

They must wait 6 months before applying for any Medigap plan

Answer

They automatically qualify for Medicaid as a secondary payer

Question 3

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

Accepted Answer

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

Answer

A process where insurers review a beneficiary's financial history before issuing a policy

Answer

A federal mandate requiring all Medigap plans to accept pre-existing conditions at any time

Answer

A process that applies only to beneficiaries under age 65 with disabilities

Question 4

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

Accepted Answer

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

Answer

The full Medicare Part B monthly premium

Answer

A 50% coinsurance for all Medicare Part B services

Answer

The full Medicare Part A inpatient deductible

Question 5

How do Medigap insurers structure their premium pricing methodologies?

Accepted Answer

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

Answer

All insurers are federally required to use only community-rated (same premium for all) pricing

Answer

Premiums are set uniformly by CMS and must be identical across all private insurers

Answer

Premiums are based solely on the beneficiary's income and Social Security benefit amount

Question 6

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

Accepted Answer

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

Answer

Yes, if the illness was a pre-existing condition at the time of enrollment

Answer

Yes, after a mandatory 90-day notice period

Answer

No, but the insurer can increase premiums based on the beneficiary's deteriorating health

Question 7

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

Accepted Answer

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

Answer

Plans A and B only

Answer

All 10 standardized Medigap plans cover 100% of SNF coinsurance

Answer

No standardized Medigap plan covers skilled nursing facility coinsurance