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

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

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

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

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

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

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

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.

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

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).

AHIP - America's Health Insurance Plans Practice Test

AHIP - America's Health Insurance Plans Practice Test

AHIP Medicare Supplement (Medigap) Plans 2