AHIP Practice Exam

A Medicare Advantage plan is a type of health insurance plan that is offered by private companies and approved by Medicare. It provides an alternative to Original Medicare (Part A and Part B) and often includes additional benefits. Health Maintenance Organizations (HMOs) are a common example of Medicare Advantage plans, as they typically require members to choose a primary care physician and get referrals for specialist care, while coordinating overall healthcare services within the network.

In Medicare Advantage, plans like HMOs usually offer lower out-of-pocket costs when members use network providers. They often include additional benefits such as vision, dental, and wellness programs, which are not available through Original Medicare alone.

Other options listed, while they are types of health insurance plans, do not fit the definition of a Medicare Advantage plan in the same way an HMO does. Fee-for-service plans traditionally let individuals receive care from any provider, imposing higher costs without the cost-saving benefits seen in managed care approaches like HMOs. Exclusive Provider Organizations (EPOs) may limit members to network providers but, similar to fee-for-service, do not provide the full range of benefits typical of Medicare Advantage plans.

Thus, the Health Maintenance Organization is the best example of a Medicare Advantage plan, highlighting its role in providing coordinated