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2023 AHIP/168 COMPLETE QUESTIONS AND ANSWERS/100% SOLVED!!!
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2023 AHIP/168 COMPLETE QUESTIONS AND ANSWERS/100% SOLVED!!!
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2023 AHIP/168 COMPLETE QUESTIONS ANDANSWERS/100% SOLVED!!!
Davis is 52 years old and has recently been diagnosed with end-stage renal
disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain
coverage under Medicare. What should you tell him? - -He may sign-up for
Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.
-Juan Perez, who is turning age 65 next month, intends to work for several
more years at Smallcap, Incorporated. Smallcap has a workforce of15
employees and offers employer-sponsored healthcare coverage. Juan is a
naturalized citizen and has contributed to the Medicare system for over 20
years. Juan asks you if he will be entitled to Medicare and if he enrolls how
that will impact his employer-sponsored healthcare coverage. How would
you respond? - -Juan is likely to be eligible for Medicare once he turns age
65 and if he enrolls Medicare would become the primary payor of his
healthcare claims and Smallcap does not have to continue to offer him
coverage comparable to those under age 65 under its employer-sponsored
group health plan.
-Moy's wife has a Medicare Advantage plan, but he wants to understand
what coverage Medicare Supplemental Insurance provides since his health
care needs are different from his wife's needs. What could you tell Mr. Moy? -
-Medicare Supplemental Insurance would help cover his Part A and Part B
deductibles or coinsurance in Original Fee-for-Service (FFS) Medicare as well
as possibly some services that Medicare does not cover.
-Peňa is 66 years old, has coverage under an employer plan, and will retire
next year. She heard she must enroll in Part B at the beginning of the year to
ensure no gap in coverage. What can you tell her? - -She may enroll at any
time while she is covered under her employer plan, but she will have a
special eight-month enrollment period after the last month on her employer
plan that differs from the standard general enrollment period, during which
she may enroll in Medicare Part B.
-Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is
concerned that she will not qualify for coverage under part A because she
was not born in the United States. What should you tell her? - -Most
individuals who are citizens and age 65 or over are covered under Part A by
virtue of having paid Medicare taxes while working, though some may be
covered as a result of paying monthly premiums.
, -Gonzalez is enrolled in Original Medicare and has a Medigap policy as well,
but it provides no drug coverage. She would like to keep the coverage she
has but replace her existing Medigap plan with one that provides drug
coverage. What should you tell her? - -Mrs. Gonzalez cannot purchase a
Medigap plan that covers drugs, but she could keep her Medigap policy and
enroll in a Part D prescription drug plan.
-West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through massage therapy. She is concerned about whether or
not Medicare will cover these items and services. What should you tell her? -
-Medicare does not cover massage therapy, or, in general, glasses or
dentures.
-Patel is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the health care costs
he might be exposed to under Medicare if he were to require hospitalization
as a result of an illness. In general terms, what could you tell him about his
costs for inpatient hospital services
under Original Medicare? - -Under Original Medicare, there is a single
deductible amount due for the first 60 days of any inpatient hospital stay,
after which it converts into a per-day coinsurance amount through day 90.
After day 90, he would pay a daily amount up to 60 days over his lifetime,
after which he would be responsible for all costs.
-Henderson believes that she will qualify for Medicare Coverage when she
turns 65, without paying any premiums, because she has been working for
40 years and paying Medicare taxes. What should you tell her? - -To obtain
Part B coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher incomes.
-Alonso receives some help paying for his two generic prescription drugs
from his employer's retiree coverage, but he wants to compare it to a Part D
prescription drug plan. He asks you what costs he would generally expect to
encounter when enrolling into a standard MedicarePart D prescription drug
plan. What should you tell him? - -He generally would pay a monthly
premium, annual deductible, and per-prescription cost-sharing.
-Moore plans to retire when she turns 65 in a few months. She is in excellent
health and will have considerable income when she retires. She is concerned
that her income will make it impossible for her to qualify for Medicare. What
could you tell her to address her concern? - -Medicare is a program for
people age 65 or older and those under age 65 with certain disabilities, end-
stage renal disease, and Lou Gehrig's disease so she will be eligible for
Medicare.
, -Xi will soon turn age 65 and has come to you for advice as to what services
are provided under Original Medicare. What should you tell Mr. Xi that best
describes the health coverage provided to Medicare beneficiaries? - -
Beneficiaries under Original Medicare have no cost-sharing for most
preventive services which include immunizations such as annual flu shots.
-Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a
determination that partially denied one of her claims for services. What
advice would you give her? - -Mrs. Duarte should file an appeal of this initial
determination within 120 days of the date she received the MSN in the mail.
-Capadona would like to purchase a Medicare Advantage (MA) plan and a
Medigap plan to pick up costs not covered by that plan.
What should you tell him? - -It is illegal for you to sell Mr. Capadona a
Medigap plan if he is enrolled in an MA plan, and besides, Medigap only
works with Original Medicare.
-Park is an elderly retiree. Mrs. Park has a low fixed income. What could you
tell Mrs. Park that might be of assistance? - -She should contact her state
Medicaid agency to see if she qualifies for one of several programs that can
help with Medicare costs for which she is responsible.
-Rainey is experiencing paranoid delusions and his physician feels that he
should be hospitalized. What should you tell Mr. Rainey (or his
representative) about the length of an inpatient psychiatric hospital stay that
Medicare will cover? - -Medicare will cover a total of 190 days of inpatient
psychiatric care during Mr. Rainey's entire lifetime.
-Schmidt would like to plan for retirement and has asked you what is
covered under Original Fee-for-Service (FFS) Medicare? What could you tell
him? - -Part A, which covers hospital, skilled nursing facility, hospice, and
home health services and Part B, which covers professional services such as
those provided by a doctor are covered under Original Medicare.
-Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is
currently enrolled in Medicare Parts A and B. Jerry has also purchased a
Medicare Supplement (Medigap) plan which he has had for several years.
However, the plan does not provide drug benefits. How would you advise
Agent John Miller to proceed? - -Tell prospect Jerry Smith that he should
consider adding a standalone Part D prescription drug coverage policy to his
present coverage.
-Bauer is 49 years old, but eighteen months ago he was declared disabled
by the Social Security Administration and has been receiving disability
payments. He is wondering whether he can obtain coverage under Medicare.
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