Exam (elaborations)
2024 AHIP Questions with Solved Answers/ Updated/Verified.
- Course
- Institution
2024 AHIP Questions with Solved Answers/ Updated/Verified.
[Show more]
Seller
Follow
Nurselucy2023
Content preview
2024 AHIP Questions with SolvedAnswers/ Updated/Verified.
Edward IP suffered from serious kidney disease. As a result. Edward became eligible for
Medicare coverage due to end-stage renal disease (ESRD). A close relative donated their
kidney and Edward successfully underwent transplant surgery 12 months ago. Edward is
now age 50 and asks you if his Medicare coverage will continue, what should you say? - -
Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after
the month in which the individual receives a kidney transplant unless they are eligible for
Medicare on another basis such as age or disability. Edward may, however, remain
enrolled in Part B but solely for coverage of immunosuppressive drugs if he has no other
health care coverage that would cover the drugs.
-Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. Mildred
recently learned that she is suffering from inoperable cancer and has just a few months to
live. She would like to spend these final months in hospice care. Mildred's family asks you
whether hospice benefits will be paid for under the Allcare Medicare Advantage plan.
What should you say? - -Mildred may remain enrolled in Allcare and make a hospice
election. Hospice benefits will be paid for by Original Medicare under Part A and Allcare
will continue to pay for any non-hospice services.
-Mr. Diaz continued working with his company and was insured under his employer's
group plan until he reached age 68. He has heard that there is a premium penalty for those
who did not sign up for Part B when first eligible and wants to know how much he will
have to pay. What should you tell him? - -Mr. Diaz will not pay any penalty because he
had continuous coverage under his employer's plan.
-Mr. 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.
-Mrs. 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.
-Mr. 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. What should you tell him? - -
After receiving such disability payments for 24 months, he will be automatically enrolled
in Medicare, regardless of age.
, -Mr. 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.
-Mrs. 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.
-Mr. 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.
-Madeline Martinez was widowed several years ago. Her husband worked for many years
and contributed into the Medicare system. He also left a substantial estate which provides
Madeline with an annual income of approximately $130,000. Madeline, who has only
worked part-time for the last three years, will soon turn age 65 and hopes to enroll in
Original Medicare. She comes to you for advice. What should you tell her? - -You should
tell Madeline that she will be able to enroll in Medicare Part A without paying monthly
premiums due to her husband's long work record and participation in the Medicare system.
You should also tell Madeline that she will pay Part B premiums at more than the standard
lowest rate but less than the highest rate due her substantial income.
-Ms. 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.
-To obtain Part B coverage, she must pay a standard monthly premium, though it is higher
for individuals with higher incomes. - -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.
-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.
-Ms. 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.
-Mr. 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.
-Mrs. 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.
-Mr. 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.
-Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify
for the Part D low-income subsidy. Where might he turn for help with his prescription drug
costs? - -Mr. Wu may still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program.
-Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE).
This coverage has recently been terminated due to the end of the PHE. While Shirley was
enrolled in Medicaid, she missed an opportunity to enroll in Medicare and now wants Part
B. Which of the following statements best describes Shirley's ability to now enroll in
Medicare Part B? - -Shirley is eligible for a Special Enrollment Period (SEP) for up to six
months after the termination of her Medicaid coverage. Under this SEP, Shirley can choose
retroactive coverage back to the date of termination from Medicaid or coverage beginning
the month after the month of enrollment.
-Anthony Boniface turned 65 in 2023. He was not receiving Social Security or Railroad
Retirement Benefits on his 65th birthday. He was interested in obtaining Medicare
coverage and is eligible for premium-free Part A. Before he could enroll in Medicare, his
entire area was impacted by a hurricane causing massive flooding and severe wind
damage. The Federal government declared this to be a natural disaster which has recently
ended. During this period Anthony's initial enrollment period expired. Anthony asks you
how he can now obtain Medicare coverage. What should you say? - -Anthony is eligible
for a special enrollment period (SEP) because he missed an enrollment period due to the
impact of the Federally declared disaster. This SEP will allow Anthony to enroll in Part B
up to six months after the end of the emergency declaration. Anthony may enroll in
premium-free Part A at any time and his Part A coverage will be retroactive for up to 6
months.
-Mrs. Lyons is in good health, uses a single prescription, and lives independently in her
own home. She is attracted by the idea of maintaining control over a Medical Savings
Account (MSA) but is not sure if the plan associated with the account will fit her needs.
What specific piece of information about a Medicare MSA plan would it be important for
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Nurselucy2023. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79223 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now