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AHIP FINAL EXAM TEST LATEST 2023/2024 WITH 100% CORRECT ANSWERS GRADED A+
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AHIP FINAL EXAM TEST LATEST 2023/2024 WITH 100% CORRECT ANSWERS GRADED A+
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AHIP FINAL EXAM TESTLATEST 2023/2024 WITH 100%
CORRECT ANSWERS GRADED A+
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.
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 willbe 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
tocontinue to offer him coverage comparable to those under age 65 under its
employer-sponsored group health 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 someservices that Medicare does not cover.
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.
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.
Mrs. 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 butreplace 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.
Mrs. 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.
Mr. 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
mightbe exposed to under Medicare if he were to require hospitalization as a
result of anillness. 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
wouldbe responsible for all costs.
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
yearsand 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.
Mr. Alonso receives some help paying for his two generic prescription drugs
fromhis employer's retiree coverage, but he wants to compare it to a Part D
prescriptiondrug plan. He asks you what costs he would generally expect to
encounter when enrolling into a standard MedicarePart D prescription drug
plan. What should youtell him? ✓✓He generally would pay a monthly
premium, annual deductible, and per-prescription cost-sharing.
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. Xi will soon turn age 65 and has come to you for advice as to what services
areprovided 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. 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.
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
Medigapplan 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
youtell 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. 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.
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
adoctor 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
plandoes not provide drug benefits. How would you advise Agent John Miller to
proceed? ✓✓Tell prospect Jerry Smith that he should consider adding a
standalonePart D prescription drug coverage policy to his present coverage.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by
theSocial Security Administration and has been receiving disability payments. He
is wondering whether he can obtain coverage under Medicare. What should you
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