AHIP Exam AHM-520 Topic 4 Question 95 Discussion

Actual exam question for AHIP's AHM-520 exam

Question #: 95
Topic #: 4

The Northwest Company offers its employees the option of choosing to receive their healthcare benefits from an HMO or from a traditional indemnity plan. The premiums for the HMO are lower than for the traditional indemnity plan. In this situation, it is correct to assume that:

1. Individual low utilizers are more likely to enroll in the traditional indemnity plan

2. Individual high utilizers are more likely to enroll in the HMO

ABoth 1 and 2

B1 only

C2 only

DNeither 1 nor 2

Show Suggested Answer

Suggested Answer: D

by Daniel at Aug 22, 2024, 08:59 PM

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Carmelina

7 months ago

D) Neither 1 nor 2? What kind of trick question is this? Of course individual risk profiles would determine their plan choice. I'm not falling for that one!

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Starr

7 months ago

Hey, if I'm a high utilizer, I'm definitely going for the traditional plan! Why would I willingly sign up for the HMO plan and have to jump through hoops to see a specialist? A) Both 1 and 2 is the way to go.

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Latrice

7 months ago

I see your point, Tegan. So, the answer could be both 1 and 2.

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Tegan

7 months ago

But wouldn't individual high utilizers benefit more from the comprehensive coverage of the HMO?

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Jestine

7 months ago

I'm going with C) 2 only. It just makes sense that people who expect to use more healthcare services would choose the HMO to get the lower premiums, even if it means more restrictions.

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Janey

7 months ago

I think I would go with A) Both 1 and 2, because low utilizers might prefer the traditional indemnity plan for more flexibility.

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Charlene

7 months ago

I agree with you, C) 2 only seems like the logical choice for high utilizers.

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Barrett

8 months ago

I agree with Tom, the lower premiums would be more attractive to low utilizers.

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Tom

8 months ago

I think individual low utilizers would prefer the traditional indemnity plan.

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Dwight

8 months ago

I think the correct answer is B) 1 only. Low utilizers would logically choose the cheaper HMO plan, while high utilizers would be more likely to opt for the traditional indemnity plan with its higher premiums but wider coverage.

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Truman

7 months ago

That makes sense, so the correct answer is B) 1 only.

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Nida

7 months ago

But wouldn't high utilizers want the wider coverage of the traditional plan?

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Dell

7 months ago

I agree with you, low utilizers would definitely go for the cheaper option.

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