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AHIP module 1 Versions 1-5 Complete study set with verified answers
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AHIP module 1 Versions 1-5 Complete study set with verified answers
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payments. He is wondering whether he can obtain coverage under Medicare.AHIP module 1 Versions 1-5
What should you tell him? Correct Answer- d. After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare,
Complete study set with
regardless of age.
verified answers
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?
Correct Answer- a. He may sign-up for Medicare at any time however
AHIP module 1 Version 1 coverage usually begins on the fourth month after dialysis treatments start.
Correct
Ms. Henderson believes that she will qualify for Medicare coverage when she
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been turns 65, without paying any premiums, because she has been working for
employed full time, and paid taxes during that entire period. She is 40 years and paying Medicare taxes. What should you tell her?
concerned that she will not qualify for coverage under part A because she Correct Answer- a. In order to obtain Part B coverage, she must pay a
was not born in the United States. What should you tell her? standard
monthly premium, though it is higher for individuals with higher incomes.
Choose one answer. Correct
a. 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 Mr. Diaz continued working with his company and was insured under his
be covered as a result of paying monthly premiums. employer's group plan until he reached age 68. He has heard that there is a
b. Most individuals who are citizens and over age 65 and wish to be covered premium penalty for those who did not sign up for Part B when first eligible
under Part A must enroll in a Medicare Health Plan. and wants to know how much he will have to pay. What should you tell him?
c. Most individuals who are citizens and over age 65 and are covered under Correct Answer- b. Mr. Diaz will not pay any penalty because he had
Part A must pay a monthly premium for that coverage. continuous coverage under his employer's plan. Correct
d. All individuals who are citizens and over age 65 will be covered under Part
A. Correct Answer- a. Most individuals who are citizens and over age 65 are Mrs. Peňa is 66 years old, has coverage under an employer plan and will
covered under Part A by virtue of having paid Medicare taxes while working, retire next year. She heard she must enroll in Part B at the beginning of the
though some may be covered as a result of paying monthly premiums. year to ensure no gap in coverage. What can you tell her? Correct Answer- d.
She may enroll at any time while she is covered under her employer plan,
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled but she will have a special eight-month enrollment period that differs from
by the Social Security Administration and has been receiving disability the standard general enrollment period, during which she may enroll in
,Medicare Part B. Correct Mrs. Shields is covered by Original Medicare. She sustained a hip fracture
and is being successfully treated for that condition. However, she and her
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She physicians feel that after her lengthy hospital stay she will need a month or
is considering enrollment in a Medicare health plan (Part C). What should you two of nursing and rehabilitative care. What should you tell them about
advise her to do before she will be able to enroll into a Medicare health plan? Original Medicare's coverage of care in a skilled nursing facility? Correct
Correct Answer- Mrs. Kelly, age 65, is entitled to Part A, but has not yet Answer- b. Medicare will cover Mrs. Shields' skilled nursing services provided
enrolled in Part B. She is considering enrollment in a Medicare health plan during the first 20 days of her stay, after which she would have a
(Part C). What should you advise her to do before she will be able to enroll coinsurance until she has been in the facility for 100 days. Correct
into a Medicare health plan?
Mr. Rainey is experiencing paranoid delusions and his physician feels that he
Mrs. Park is an elderly retiree. She has a low, fixed income. What could you should be hospitalized. What should you tell Mr. Rainey (or his
tell Mrs. Park that might be of assistance? Correct Answer- d. She should representative) about the length of an inpatient psychiatric hospital stay that
contact her state Medicaid agency to see if she qualifies for one of several Medicare will cover? Correct Answer- a. Medicare will cover a total of 190
programs that can help with Medicare costs for which she is responsible. days of inpatient psychiatric care during Mr. Rainey's entire lifetime. Correct
Correct
Mrs. Quinn has recently turned 66 and decided after many years of work to
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn and
qualify for the Part D low-income subsidy. Where might he turn for help with received a letter informing her that she has been automatically enrolled in
his prescription drug costs? Correct Answer- a. Mr. Wu may still qualify for Medicare Part B. She wants to understand what this means. What should you
help in paying Part D costs through his State Pharmaceutical Assistance tell Mrs. Quinn? Correct Answer- a. Part B primarily covers physician services.
Program. Correct She will be paying a monthly premium and, with the exception of many
preventive and screening tests, generally will have 20% co-payments for
Mr. Patel is in good health and is preparing a budget in anticipation of his these services, in addition to an annual deductible. Correct
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 Mr. Buck has several family members who died from different cancers. He
as a result of an illness. In general terms, what could you tell him about his wants to know if Medicare covers cancer screening. What should you tell
costs for inpatient hospital services under Original Medicare? Correct Answer- him? Correct Answer- c. Medicare covers periodic performance of a range of
d. Under Original Medicare, there is a single deductible amount due for the screening tests that are meant to provide early detection of disease. Mr.
first 60 days of any inpatient hospital stay, after which it converts into a per- Buck will need to check specific tests before obtaining them to see if they
day coinsurance amount through day 90. After day 90, he would pay a daily will be covered. Correct
amount up to 60 days over his lifetime, after which he would be responsible
for all costs Correct 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? Correct Answer- a. Original Medicare covers ambulance services.
Correct Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as
well, but it provides no drug coverage. She would like to keep the coverage
Mrs. Wolf wears glasses and dentures and has enjoyed considerable pain she has, but replace her existing Medigap plan with one that provides drug
relief from arthritis through acupuncture. She is concerned about whether or coverage. What should you tell her? Correct Answer- a. Mrs. Gonzalez cannot
not Medicare will cover these items and services. What should you tell her? purchase a Medigap plan that covers drugs, but she could keep her Medigap
Correct Answer- c. Medicare does not cover acupuncture, or, in general, policy and enroll in a Part D prescription drug plan. Correct
glasses or dentures. Correct
Mr. Singh would like drug coverage, but does not want to be enrolled into a Mr. Kelly has substantial financial means. He enrolled in Original Medicare
health plan. What should you tell him? Correct Answer- b. Mr. Singh can and purchased a Medigap policy many years ago that offered prescription
enroll in a stand-alone prescription drug plan and continue to be covered for drug coverage. The prescription drug coverage has not been comparable to
Part A and Part B services through Original Fee-for-Service Medicare. Correct 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
Mr. Alonso receives some help paying for his two generic prescription drugs will occur if Mr. Kelly now decides to enroll in Medicare Part D? Correct
from his employer's retiree coverage, but he wants to compare it to a Part D Answer- a. He will incur a late enrollment penalty. Correct
prescription drug plan. He asks you what costs he would generally expect to
encounter when enrolling into a standard Medicare Part D prescription drug Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a
plan. What should you tell him? Correct Answer- b. He generally would pay a Medigap plan to pick up costs not covered by that plan. What should you tell
monthly premium, annual deductible, and per-prescription cost sharing. him? Correct Answer- b. It is illegal for you to sell Mr. Capadona a Medigap
Correct plan if he is enrolled in an MA plan, and besides, Medigap only works with
Original Medicare. Correct
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 What impact, if any, will the Medicare Access and CHIP Reauthorization Act of
have changed. Mrs. Geisler can't remember what Part D is so she called you 2015 (MACRA) have upon Medigap plans? Correct Answer- d. The Part B
to ask what her neighbor was talking about. What could you tell her? Correct deductible will no longer be covered for individuals newly eligible for
Answer- c. Part D covers prescription drugs and she should look at her Medicare starting January 1, 2020. Correct
premiums, formulary, and cost sharing among other factors to see if they
have changed. 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
Mrs. Paterson is concerned about the deductibles and co-payments him? Correct Answer- d. Part A, which covers hospital, skilled nursing facility,
associated with Original Medicare. What can you tell her about Medigap as hospice and home health services and Part B, which covers professional
an option to address this concern? Correct Answer- a. Medigap plans help services such as those provided by a doctor are covered under Original
beneficiaries cover coinsurance, co-payments, and/or deductibles for Medicare. Correct
medically necessary services. Correct
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