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AHIP Final Exam questions and answers 2024/2025
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AHIP MEDICARE Final Exam questions and answers 2024/2025
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2025 AHIP Final ExamMrs. Shields is included through Original Medicare. She sustained a hip fracture and is being
correctly treated for that circumstance. However, she and her physicians feel that after her
lengthy medical institution live, she will be able to want a month or of nursing and
rehabilitative care. What should you tell them approximately Original Medicare's coverage of
care in a skilled nursing facility? - ANSMedicare will cover Mrs. Shield's professional nursing
offerings supplied in the course of the first 20 days of her stay, after which she might have a
copay till she has been inside the facility for 100 days.
Mrs. West wears glasses and dentures and has enjoyed good sized ache relief from arthritis
via rubdown therapy. She is involved about whether or not or no longer Medicare will cowl
those gadgets and offerings. What must you inform her? - ANSMedicare does no longer
cowl massage therapy, or, in popular, glasses or dentures.
Mrs. Park is an aged retiree. Mrs. Park has a low fixed profits. What may want to you tell
Mrs. Park that is probably of help? - ANSShe have to contact her state Medicaid business
enterprise to look if she qualifies for one in every of numerous packages which could assist
with Medicare fees for which she is responsible.
Mr. Alonso receives some assist buying his two typical pharmaceuticals from his employer's
retiree insurance, however he desires to examine it to a Part D prescription drug plan. He
asks you what charges he would normally anticipate to come upon when enrolling into a
preferred Medicare Part D prescription drug plan. What have to you tell him? - ANSHe
normally might pay a monthly premium, annual deductible, and in keeping with-prescription
cost-sharing.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as properly,
however it presents no drug coverage. She would like to preserve the coverage she has but
update her current Medigap plan with one that offers drug insurance. What should you
inform her? - ANSMrs. Gonzalez can't buy a Medigap plan that covers pills, however she
should preserve her Medigap coverage and join in a Part D prescription drug plan.
Mr. Davis is fifty two years old and has lately been recognized with end-level renal disorder
(ESRD) and will soon start dialysis. He is questioning if he can gain coverage below
Medicare. What must you inform him? - ANSHe may sign-up for Medicare at any time
however insurance generally begins on the fourth month after dialysis treatments start.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has these days reviewed her
Medicare Summary Notice (MSN) and disagrees with a determination that partially denied
one in all her claims for services. What advice would you provide her? - ANSMrs. Duarte
ought to record an attraction of this initial determination inside 120 days of the date she
received the MSN within the mail.
,Mrs. Geisler's neighbor informed her she must study her Part D options for the duration of
the yearly Medicare enrollment duration because the functions of Part D would possibly have
modified. Mrs. Geisler can not recall what Part D is so she called you to invite what her
neighbor became talking approximately. What could you inform her? - ANSPart D covers
pharmaceuticals and she have to study her charges, formulary, and cost-sharing among
different elements to peer if they have changed.
Mr. Rainey is experiencing paranoid delusions and his medical doctor feels that he ought to
be hospitalized. What ought to you tell Mr. Rainey (or his consultant) approximately the
length of an inpatient psychiatric clinic stay that Medicare will cowl? - ANSMedicare will
cover a complete of 190 days of inpatient psychiatric care at some point of Mr. Rainey's
entire lifetime.
Mr. Xi will quickly turn age 65 and has come to you for recommendation as to what services
are provided under Original Medicare. What ought to you tell Mr. Xi that exceptional
describes the health insurance provided to Medicare beneficiaries? - ANSBeneficiaries
beneath Original Medicare don't have any price-sharing for most preventive offerings.
Mr. Singh would love drug coverage however does not need to be enrolled in a Medicare
Advantage plan. What ought to you tell him? - ANSMr. Singh can sign up in a stand-by
myself prescription drug plan and stay protected for Part A and Part B offerings through
Original Fee-for-Service Medicare.
Mrs. Chen might be sixty five quickly, has been a citizen for twelve years, has been
employed full time, and paid taxes all through that complete length. She is concerned that
she will be able to no longer qualify for coverage underneath component A because she
changed into no longer born within the United States. What have to you tell her? - ANSMost
individuals who are residents and age 65 or over are covered beneath Part A with the aid of
virtue of getting paid Medicare taxes whilst running, even though some may be protected as
a result of paying monthly premiums.
Mrs. Quinn these days turned sixty six and decided after a few years of work to retire and
begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn obtained a letter
informing her that she had been mechanically enrolled in Medicare Part B. She wants to
apprehend what this indicates. What ought to you inform Mrs. Quinn? - ANSPart B by and
large covers doctor services. She may be paying a month-to-month top class and, besides
for plenty preventive and screening assessments, commonly could have 20% co-bills for
those offerings, further to an annual deductible.
Mr. Patel is in proper fitness and is making ready a finances in anticipation of his retirement
while he turns sixty six. He desires to recognize the fitness care fees he is probably
uncovered to beneath Medicare if he were to require hospitalization because of an
contamination. In wellknown terms, what should you inform him approximately his prices for
inpatient health center offerings below Original Medicare? - ANSUnder Original Medicare,
there may be a single deductible quantity due for the primary 60 days of any inpatient clinic
live, and then it converts into a in step with-day coinsurance amount thru day ninety. After
day 90, he might pay a daily amount up to 60 days over his lifetime, after which he could be
liable for all expenses.
, What impact, if any, have latest regulatory changes had on Medigap plans? - ANSThe Part B
deductible is now not protected for people newly eligible for Medicare starting January 1,
2020.
Mrs. Paterson is concerned about the deductibles and co-payments related to Original
Medicare. What can you inform her approximately Medigap as an choice to cope with this
problem? - ANSMedigap plans do no longer cowl Original Medicare advantages, but they
coordinate with Original Medicare coverage.
Mrs. Turner is evaluating her corporation's retiree coverage to Original Medicare and would
really like to recognize which of the following services Original Medicare will cowl if the
perfect criteria are met. What may want to you inform her? - ANSOriginal Medicare covers
ambulance services.
Ms. Brooks has aggressive most cancers and would like to recognise if Medicare will cover
hospice services in case she desires them. What should you tell her? - ANSMedicare covers
hospice offerings, and they'll be to be had for her.
Mr. Diaz persevered running with his enterprise and become insured below his employer's
institution plan until he reached age sixty eight. He has heard that there's a top rate penalty
for people who did no longer sign up for Part B whilst first eligible and desires to realize how
much he's going to ought to pay. What ought to you tell him? - ANSMr. Diaz will no longer
pay any penalty due to the fact he had non-stop coverage below his organisation's plan.
Anita Magri will flip age 65 in August 2023. Anita intends to sign up for Original Medicare
Part A and Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan.
Anita's older neighbor Mel has instructed her about the Medigap Plan F in which he's
enrolled. It not most effective offers overseas journey emergency benefits however also
covers his Medicare Part B deductible. Anita comes to you for advice. What should you
inform her? - ANSYou are sorry to disappoint Anita, but a Medigap F plan is now not to be
had to folks that flip age 65 after January 1, 2020. Anita might as an alternative recollect
other Medigap plans that provide foreign journey benefits however do not cowl the Part B
deductible.
Hank's Fish Store, Inc. Is a small business enterprise with just 15 employees placed in
Florida. Hank, the shop owner, has provided awesome health blessings to the shop's
personnel. William, one in every of the shop's lengthy-time personnel, will soon be reaching
age sixty five and eligible for Medicare. William is in suitable health. He intends to stay an
lively full-time worker, working numerous years after becoming eligible for Medicare. What
type(s) of retiree fitness advantage will Hank's Fish Store be able to offer William? -
ANSHank's can maintain to offer William the equal worker health advantage plan, or, if
William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan this is
provided to the general public.
Mr. Sanchez has just turned 65 and is entitled to Part A but has no longer enrolled in Part B
because he has coverage via an company plan. If he desires to join in a Medicare
Advantage plan, what's going to he should do? - ANSHe will should enroll in Part B.
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