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2022 AHIP QUESTIONS AND ANSWER | LATEST UPDATE

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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? ~~> He may sign-up for Medicare at any time however coverage usually begins on th...

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  • September 17, 2024
  • 56
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • AHIP
  • AHIP
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2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!




2022 AHIP QUESTIONS AND ANSWER |
LATEST UPDATE
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?


~~> He may sign-up for Medicare at any time however coverage usually

begins on the fourth month after dialysis treatments start.




Juan Perez, who is turning age 65 next month, intends to work for several more years at

Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers employer-

sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to the

Medicare system for over 20 years. Juan asks you if he will be entitled to Medicare and if he

enrolls how that will impact his employer-sponsored healthcare coverage. How would you

respond?


~~> Juan is likely to be eligible for Medicare once he turns age 65 and if he

enrolls Medicare would become the primary payor of his healthcare claims and

Smallcap does not have to continue to offer him coverage comparable to those

under age 65 under its employer -sponsored group health plan.




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?


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~~> Medicare Supplemental Insurance would help cover his Part A and Part

B deductibles or coinsurance in Original Fee -for-Service (FFS) Medicare as well

as possibly some services that Medicare does not cover.




Mrs. Peňa is 66 years old, has coverage under an employer plan, and will retire next year.

She heard she must enroll in Part B at the beginning of the year to ensure no gap in

coverage. What can you tell her?


~~> She may enroll at any time while she is covered under her employer

plan, but she will have a special eight-month enrollment period after the last

month on her employer plan that differs from the standard general enrollment

period, during which she may enroll in Medicare Part B.




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?


~~> Most 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.




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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 she has but replace her

existing Medigap plan with one that provides drug coverage. What should you tell her?


~~> Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but

she could keep her Medigap policy and enroll in a Part D prescription drug plan.




Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from

arthritis through massage therapy. She is concerned about whether or not Medicare will

cover these items and services. What should you tell her?


~~> Medicare does not cover massage therapy, or, in general, glasses or

dentures.




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?


~~> 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




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amount up to 60 days over his lifetime, after which he would be responsible for

all costs.




Ms. Henderson believes that she will qualify for Medicare Coverage when she turns 65,

without paying any premiums, because she has been working for 40 years and paying

Medicare taxes. What should you tell her?


~~> To obtain Part B coverage, she must pay a standard monthly premium,

though it is higher for individuals with higher incomes.




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 MedicarePart D prescription drug plan. What should you tell him?


~~> He generally would pay a monthly premium, annual deductible, and per -

prescription cost-sharing.




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?




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