Exam (elaborations)
AHIP module 1 Versions 1-6 Complete study set with verified answers (VERIFIED!!)
AHIP module 1 Versions 1-6
Complete study set with verified
answers (VERIFIED!!)
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AHIPmodule1Versions1-6
Completestudysetwithverified
answers(VERIFIED!!)
AHIPmodule1Version1
Mrs.Chenwillbe65soon,hasbeenacitizenfortwelveyears,hasbeenemployed
fulltime,andpaidtaxesduringthatentireperiod.Sheisconcernedthatshewillnot
qualifyforcoverageunderpartAbecauseshewasnotbornintheUnitedStates.
Whatshouldyoutellher?
Chooseoneanswer.
a.Mostindividualswhoarecitizensandoverage65arecoveredunderPartAby
virtueofhavingpaidMedicaretaxeswhileworking,thoughsomemaybecoveredas
aresultofpayingmonthlypremiums.
b.Mostindividualswhoarecitizensandoverage65andwishtobecoveredunderPart
AmustenrollinaMedicareHealthPlan.
c.Mostindividualswhoarecitizensandoverage65andarecoveredunderPartAmust
payamonthlypremiumforthatcoverage.
d.Allindividualswhoarecitizensandoverage65willbecoveredunderPart
A.CorrectAnswer-a.Mostindividualswhoarecitizensandoverage65arecovered
underPartAbyvirtueofhavingpaidMedicaretaxeswhileworking,thoughsomemay
becoveredasaresultofpayingmonthlypremiums.
Mr.Baueris49yearsold,buteighteenmonthsagohewasdeclareddisabledbythe
SocialSecurityAdministrationandhasbeenreceivingdisabilitypayments.Heis
wonderingwhetherhecanobtaincoverageunderMedicare.Whatshouldyoutellhim?
CorrectAnswer-d.Afterreceivingsuchdisabilitypaymentsfor24months,hewillbe
automaticallyenrolledinMedicare,regardlessofage.
Mr.Dentonis52yearsoldandhasrecentlybeendiagnosedwithend-stagerenal
disease(ESRD)andwillsoonbegindialysis.Heiswonderingifhecanobtain
coverageunderMedicare.Whatshouldyoutellhim?CorrectAnswer-
a.Hemaysign-upforMedicareatanytimehowevercoverageusuallybeginsonthe
fourthmonthafterdialysistreatmentsstart.Correct
Ms.HendersonbelievesthatshewillqualifyforMedicarecoveragewhensheturns65,
withoutpayinganypremiums,becauseshehasbeenworkingfor40yearsand
payingMedicaretaxes.Whatshouldyoutellher?CorrectAnswer-a.Inorderto
obtainPartBcoverage,shemustpayastandard monthlypremium,thoughitishigherforindividualswithhigherincomes.Correct
Mr.Diazcontinuedworkingwithhiscompanyandwasinsuredunderhis
employer'sgroupplanuntilhereachedage68.Hehasheardthatthereisapremium
penaltyforthosewhodidnotsignupforPartBwhenfirsteligibleandwantstoknow
howmuchhewillhavetopay.Whatshouldyoutellhim?CorrectAnswer-b.Mr.
Diazwillnotpayanypenaltybecausehehadcontinuouscoverageunderhis
employer'splan.Correct
Mrs.Peňais66yearsold,hascoverageunderanemployerplanandwillretirenext
year.SheheardshemustenrollinPartBatthebeginningoftheyeartoensurenogap
incoverage.Whatcanyoutellher?CorrectAnswer-d.Shemayenrollatanytime
whilesheiscoveredunderheremployerplan,butshewillhaveaspecialeight-month
enrollmentperiodthatdiffersfromthestandardgeneralenrollmentperiod,during
whichshemayenrollinMedicarePartB.Correct
Mrs.Kelly,age65,isentitledtoPartA,buthasnotyetenrolledinPartB.Sheis
consideringenrollmentinaMedicarehealthplan(PartC).Whatshouldyouadviseher
todobeforeshewillbeabletoenrollintoaMedicarehealthplan?CorrectAnswer-
Mrs.Kelly,age65,isentitledtoPartA,buthasnotyetenrolledinPartB.Sheis
consideringenrollmentinaMedicarehealthplan(PartC).Whatshouldyouadviseher
todobeforeshewillbeabletoenrollintoaMedicarehealthplan?
Mrs.Parkisanelderlyretiree.Shehasalow,fixedincome.WhatcouldyoutellMrs.
Parkthatmightbeofassistance?CorrectAnswer-d.Sheshouldcontactherstate
Medicaidagencytoseeifshequalifiesforoneofseveralprogramsthatcanhelpwith
Medicarecostsforwhichsheisresponsible.
Correct
Mr.WuiseligibleforMedicare.Hehaslimitedfinancialresourcesbutfailedtoqualify
forthePartDlow-incomesubsidy.Wheremightheturnforhelpwithhisprescription
drugcosts?CorrectAnswer-a.Mr.WumaystillqualifyforhelpinpayingPartDcosts
throughhisStatePharmaceuticalAssistanceProgram.Correct
Mr.Patelisingoodhealthandispreparingabudgetinanticipationofhisretirement
whenheturns66.Hewantstounderstandthehealthcarecostshemightbeexposedto
underMedicareifheweretorequirehospitalizationasaresultofanillness.Ingeneral
terms,whatcouldyoutellhimabouthiscostsforinpatienthospitalservicesunder
OriginalMedicare?CorrectAnswer-
d.UnderOriginalMedicare,thereisasingledeductibleamountdueforthefirst60
daysofanyinpatienthospitalstay,afterwhichitconvertsintoaper-daycoinsurance
amountthroughday90.Afterday90,hewouldpayadaily amountupto60daysoverhislifetime,afterwhichhewouldberesponsibleforall
costsCorrect
Mrs.ShieldsiscoveredbyOriginalMedicare.Shesustainedahipfractureandis
beingsuccessfullytreatedforthatcondition.However,sheandherphysiciansfeelthat
afterherlengthyhospitalstayshewillneedamonthortwoofnursingand
rehabilitativecare.WhatshouldyoutellthemaboutOriginalMedicare'scoverageof
careinaskillednursingfacility?CorrectAnswer-b.MedicarewillcoverMrs.Shields'
skillednursingservicesprovidedduringthefirst20daysofherstay,afterwhichshe
wouldhaveacoinsuranceuntilshehasbeeninthefacilityfor100days.Correct
Mr.Raineyisexperiencingparanoiddelusionsandhisphysicianfeelsthatheshouldbe
hospitalized.WhatshouldyoutellMr.Rainey(orhisrepresentative)aboutthelength
ofaninpatientpsychiatrichospitalstaythatMedicarewillcover?CorrectAnswer-a.
Medicarewillcoveratotalof190daysofinpatientpsychiatriccareduringMr.
Rainey'sentirelifetime.Correct
Mrs.Quinnhasrecentlyturned66anddecidedaftermanyyearsofworktobegin
receivingSocialSecuritybenefits.ShortlythereafterMrs.Quinnandreceivedaletter
informingherthatshehasbeenautomaticallyenrolledinMedicarePartB.Shewants
tounderstandwhatthismeans.WhatshouldyoutellMrs.Quinn?CorrectAnswer-a.
PartBprimarilycoversphysicianservices.Shewillbepayingamonthlypremiumand,
withtheexceptionofmanypreventiveandscreeningtests,generallywillhave20%
co-paymentsfortheseservices,inadditiontoanannualdeductible.Correct
Mr.Buckhasseveralfamilymemberswhodiedfromdifferentcancers.Hewantsto
knowifMedicarecoverscancerscreening.Whatshouldyoutellhim?Correct
Answer-c.Medicarecoversperiodicperformanceofarangeofscreeningteststhat
aremeanttoprovideearlydetectionofdisease.Mr.
Buckwillneedtocheckspecifictestsbeforeobtainingthemtoseeiftheywillbe
covered.Correct
Mrs.Turneriscomparingheremployer'sretireeinsurancetoOriginalMedicareand
wouldliketoknowwhichofthefollowingservicesOriginalMedicarewillcoverifthe
appropriatecriteriaaremet?Whatcouldyoutellher?CorrectAnswer-a.Original
Medicarecoversambulanceservices.
Correct
Mrs.Wolfwearsglassesanddenturesandhasenjoyedconsiderablepainrelieffrom
arthritisthroughacupuncture.SheisconcernedaboutwhetherornotMedicarewill
covertheseitemsandservices.Whatshouldyoutellher?CorrectAnswer-c.
Medicaredoesnotcoveracupuncture,or,ingeneral,glassesordentures.Correct