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AHIP MEDICARE TRAINING 2021 latest update 2024/2025 A+ score assured
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AHIP MEDICARE TRAINING 2021 latest update 2024/2025 A+ score assured
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AHIP MEDICARE TRAINING 2021Ms. Jensen has heard about "Original Fee-for-Service Medicare" and "Private Fee-for-Service"
plans. She wants to know what the difference is if any. What should you tell her? - ANSPFFS
plans are a type of Medicare Advantage plan offered by private companies.
This year you decide to focus your efforts on marketing to employer and union groups. Which of
the following statements best describes what you can and cannot do in order to stay in
compliance? - ANSYou are not required to submit communication and marketing materials
specific only to those employer plans to CMS at the time of use, but CMS may request and
review copies if employee complaints occur.
Agent Suma has recently had several clients request his assistance in completing their paper
enrollment form. What advice would you give him? - ANSAgent Suma is only permitted to fill out
the applicant's name and contact information. The applicant must fill in the remaining
information in order to protect his or her privacy.
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social
Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What
should you tell Mrs. Quinn? - ANSPart B primarily covers physician services. She will be paying
a monthly premium and, with the exception of many preventive and screening tests, generally
will have 20% coinsurance for these services, in addition to an annual deductible.
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? - ANSOriginal Medicare covers ambulance services.
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 will have to pay. What
should you tell him? - ANSMr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in 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 told her about the 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 - ANSYou are sorry to disappoint Anita but a
Medigap Part F plan is no longer available to those who turn age 65 after January 1,2020. Anita
might instead consider other Medigap plans that offer foreign travel benefits but do not cover the
Part B deductible.
,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? - ANSMedicare Supplemental Insurance would help
cover his Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare as well as
possibly some services that Medicare does not cover.
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? - ANSAfter receiving such
disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of
age.
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? - ANSPart A, which covers hospital,
skilled nursing facility, hospice, and home health services and Part B, which covers professional
services such as those provided by a doctor are covered under Original Medicare.
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? -
ANSMedicare 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.
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? -
ANSMedicare will cover Mrs. Shield's skilled nursing services provided 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.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided
under Original Medicare. What should you tell Mr. Xi that best describes the health coverage
provided to Medicare beneficiaries? - ANSBeneficiaries under Original Medicare have no
cost-sharing for most preventive services which include immunizations such as annual flu shots.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual
Medicare enrollment 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? - ANSPart D covers prescription drugs and she should look at her premiums,
formulary, and cost-sharing among other factors to see if they have changed.
, What impact, if any, will recent regulatory changes have upon Medigap plans? - ANSThe Part B
deductible will no longer be covered for individuals newly eligible for Medicare starting January
1, 2020.
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? -
ANSMr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical
Assistance Program.
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
with an annual income of approximately $130,000. Madeline, who has only worked part-time for
the last three years, will soon turn age 65 and hopes to enroll in Original Medicare. She comes
to you for advice. What should you tell her? - ANSYou should tell Madeline that she will be able
to enroll in Medicare Part A without paying monthly premiums due to her husband's long work
record and 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 her
substantial income.
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 plan does not provide drug benefits. How
would you advise Agent John Miller to proceed? - ANSTell prospect Jerry Smith that he should
consider adding a standalone Part D prescription drug coverage policy to his present coverage.
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. What can you tell her about Medigap as an option to address this concern? -
ANSMedigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for
medically necessary services
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? - ANSHe may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
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? -
ANSMost 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.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him? - ANSMr. Singh can enroll in a stand-alone prescription drug
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