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AHIP Module Quizzes( With Complete Solution Rated A)
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AHIP 2021 - 2022 Module QuizzesMr. 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 obtaincoverage
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
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicareenrollment
period because features of Part D might have changed. Mrs. Geisler can't remember what Part D is so she
called you to ask what her neighbor was talking about. What could you tell her? - Part D covers prescription
drugs & she should look at her premiums, formulary, & cost sharing among other factors to see if they have
changed
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal diease (ESRD) andwill 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
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided underOriginal
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 inc. immunizations such as annual flu shots
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 w/an annual income of
approx. $130,000. Madeline, who has only worked part-time for the last 3 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 PartA w/out paying monthly premiums due to her
husband's long work record & 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 to her
substantial income
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 & those under age 65 w/ certain disabilities, end-stage renal disease, & Lou Gehrig's disease so
she will be eligible for Medicare
,Mrs. Quinn recently turned 66 and decided after Social Security benefits. Shortly thereafter,
Mrs. Quinn received a letter informing her she has been automatically enrolled in Medicare Part B. She wants
to understand what this means. What should you tell her? - Part B primarily covers physician services. She
will be paying a monthly premium &, with the exception ofmany preventive and screening tests, generally
will have 20% coinsurance for these services, in addition to an annual deductible
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for the Part Dlow
income subsidy. Where might he turn for help w/ his prescription drug costs? - He may still qualify for help in
paying Part D costs through his State Pharmaceutical Assistance Program
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 him? - Medicare Supplemental Insurance would help cover his Part A & B cost sharing
in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicaredoes not cover
Anita Magri will turn 65 in August 2020. Anita intends to enroll in Original Medicare Part A & B. Shewould
also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel had told her about
Medigap Part F plan in which he is enrolled. It not only provides foreign travel emergency benefits, but also
covers his Medicare Part B deductible. Anita comes to you for advice. What should you tell her? - You are
sorry to disappoint her but a Medigap Part F plan is no longer available to those who turn 65 after Jan. 1,
2020. Anita might instead consider other Medigap plans that offer foreign travel benefits but do not cover the
Part B deductible
Mr. Singh would like drug coverage, but does not want to be enrolled in a Medicare Advantage plan.What
should you tell him? - Mr. Singh can enroll in a stand alone prescription drug plan & continue to be covered
for Part A & B services through Original Fee-for-Service Medicare
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know
which of the following services Original Medicare will cover if the appropriate criteria are met? What could
you tell her? - Original Medicare covers ambulance services
, 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 stayshe 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? - Medicare will cover Mrs. Shieldsskill nursing services during the first 20
days of her stay, after which she would have a copay until she has been in the facility for 100 days
What impact, if any, will recent regulatory changes have upon Medigap plans? - The Part B deductible will no
longer be covered for individuals newly eligible for Medicare starting Jan. 1, 2020
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled in Medicare Parts A
& 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 adviseAgent 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
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paidtaxes
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 arecitizens & 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
Juan Perez, who is turning 65 next month, intends to work for several more years at Smallcap, Inc. Smallcap
has a workforce of 15 employees & offers employer sponsored healthcare coverage. Juan is a naturalized
citizen & has contributed to the Medicare system for over 20 years. Juans asks you ifhe will be entitled to
Medicare & if he enrolls how that impact his employer sponsored healthcare coverage. How would you
respond? - Juan is likely to be eligible for Medicare once he turns 65 & if he enrolls Medicare would become
the primary payor of his healthcare claims & Smallcap does not have to continue to offer him coverage
comparable to those under 65 under its employer sponsoredgroup health plan
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, & some home health services & part B, which covers professional servicessuch as those provided by
a doctor are covered under Original Medicare
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