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AHIP Questions & Answers correct Mr. Shapiro gets by on a very small amount of fixed income. He has heard there may be extra help paying for Part D prescription drugs for Medicare beneficiaries with limited income. He wants to know whether he might qualify. What should you tell him? c. The extra ...

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  • March 26, 2025
  • 8
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • ahip questions answers correct
  • mr shapiro gets by on a very small amount of fixe
  • during a sales presentation you client ask you wh

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AHIP Questions & Answers correct
Mr. Shapiro gets by on a very small amount of fixed income. He has heard there may be
extra help paying for Part D prescription drugs for Medicare beneficiaries with limited
income. He wants to know whether he might qualify. What should you tell him? - answer
c. The extra help is available to beneficiaries whose income and assets do not exceed
annual limits specified by the government.

During a sales presentation, you client ask you whether the Medicare agency
recommends that she sign up for your plan or stay in Original Medicare. - answer
Tell her that the Medicare agency does not endorse or recommend any plan

Ms. Levi often travels to visit relatives and is concerned that she may need emergency
care outside of her plan's service area. What should you tell her about coverage of
emergency care? - answer Cover the following services even when
provided by non-network providers:
• emergency services;
• out-of-area urgently needed services; and
• out-of-area renal dialysis.
Have access to doctors, specialists and hospitals:
Get emergency care when and where

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 US. What should you tell her?
Module 1 - answer Most individuals who are citizens and over age 65 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. Chen is enrolled in his employer's group health plan and will be retiring soon. He
would like to know his options since he has decided to drop his retiree coverage and is
eligible for Medicare. What should you tell him? - answer . Mr. Chen can disenroll
from his employer-sponsored coverage to elect a Medicare Advantage or Part D plan
within 2 months of his disenrollment, but he should revaluate if he really wants to drop
his employer coverage. Correct

Ms. Gates is dually eligible for Medicare and Medicaid. She is very concerned about
being locked into a specific Medicare prescription drug plan for the entire year. What
should you tell her? - answer I would recommend ms.gates check with each plan to
see what they offer and if the meds and services she needs will be covered. she will
also need to ask about how long coverage is and if there is any kind of coverage gap.

Mr. Lopez takes several high cost prescription drugs. He would like to enroll in a
standalone Part D prescription drug plan that is available in his area. In what type of

, Medicare Health Plan can he enroll? - answer Private Fee-for-Service (PFFS) plan
that does not include drug coverage.

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? - answer 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.

Ms. Stuart has heard about a special needs plan (SNP) that one of her friends is
enrolled in and is interested in that product. She wants to be sure she also has
coverage for prescription drugs. Would she be able to obtain drug coverage if she
enrolled in the SNP? - answer Yes. All SNPs are required to provide Part D
coverage for prescription drugs.

Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being
successfully treated for that condition. However, she and her physicians feel that after
her lengthy hospital stay she will need a month or two of nursing and rehabilitative care.
What should you tell them about Original Medicare's coverage of care in a skilled
nursing facility? - answer Medicare will cover Mrs. Schmidt's skilled nursing services
provided during the first 20 days of her stay, after which she would have a coinsurance
until she has been in the facility for 100 days

Mrs. Park is an elderly retiree. She has a low, fixed income. What could you tell Mrs.
Park that might be of assistance? - answer 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.

Mrs. Fiore was in the Army for 35 years and is now retired. She has drug coverage
through the VA. What issues might she consider with regard to whether to enroll in a
Medicare prescription drug plan? - answer She could compare the coverage to see if
the Medicare Part D plan offers better benefits and coverage than the VA for the
specific medications she needs and whether any additional benefits are worth the Part
D premium costs.

Mrs. Wolf wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through acupuncture. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her? - answer Medicare does
not cover acupuncture, or, in general, glasses or dentures.

Willard works as a representative focused on the senior marketplace. What would be
considered prohibited activity by Willard? - answer Implying that only seniors can
enroll in a Medicare Advantage plan when meeting with Mr. Hernandez, who is 58 but
qualifies for Medicare because she is disabled. Correct

Mr. Bickford did not quite qualify for the extra help low-income subsidy under the
Medicare Part D Prescription Drug program and he is wondering if there is any other

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