AHIP module 1 2024/2025 Questions and Answers with complete solution
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Module
AHIP module 1
Institution
AHIP Module 1
Mr. Alonso receives some help paying for his two generic prescription drugs from his employer's retiree
coverage, but he wants to compare it to a Part D prescription drug plan. He asks you what costs he
would generally expect to encounter when enrolling into a standard Medicare Part D prescriptio...
AHIP module 1 Mr. Alonso receives some help paying for his two generic prescription drugs from his employer's retiree coverage, but he wants to compare it to a Part D prescription drug plan. He asks you what costs he would generally expect to encounter when enrolling in to a standard Medicare Part D prescription drug plan. What should you tell him? - Answer -b. He generally would pay a monthly premium, annual deductible, and per -prescription cost sharing. Correct 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? - Answer -d. After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of age. Mr. Buck has several family members who died from different cancers. He wants to know if Medicare covers cancer screening. What should you tell him? - Answer -c. Medicare covers periodic performance of a range of screening tests that are meant to provide ea rly detection of disease. Mr. Buck will need to check specific tests before obtaining them to see if they will be covered. Correct 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 -b. 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. Correct Mr. Denton 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? - Answer -a. He may sign -up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. Correct 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 wil l have to pay. What should you tell him? - Answer -
b. Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan. Correct Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan may, at some time in the future, reduce his benefits below what is available in Original Medicare. What should you tell him about his concern? - Answer -a. Medicare health plans must cover all benefits available under Medicare Part A and Part B. Many also cover Part D prescription drugs. Correct Mr. Kelly has substantial financial means. He enrolled in Original Medicare and purchased a Medigap policy many years ago that offered prescription drug coverage. The prescription drug coverage has not been comparable to that offered by Medicare Part D for several years and despite notification, Mr. Kelly took no action. Which of the following statements best describes what will occur if Mr. Kelly now decides to enroll in Medicare Part D? - Answer -a. He will incur a late enrollment penalty. Correct 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 might be exposed to under Medicare if he were to require hospitalization as a result of an illness. In general terms, what could you tell him about his costs for inpatient hospital services under Original Medicare? - Answer -d. 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 would be responsible for all costs Correct 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? - Answer -a. M edicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime. Correct 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? - Answer -d. Part A, which covers hospital, skilled nursing facility, hospice and home health services an d Part B, which covers professional services such as those provided by a doctor are covered under Original Medicare. Correct Mr. Singh would like drug coverage, but does not want to be enrolled into a health plan. What should you tell him? - Answer -b. Mr. Singh can enroll in a stand -alone prescription drug plan and continue to be covered for Part A and Part B services through Or iginal Fee -for-Service Medicare. Correct 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? - Answer -a. Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program. Correct
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