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AHIP 2025 final exam with correct answers
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AHIP 2025 final exam with correct answers
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AHIP 2025 final exam with correct answersMrs. |Park |is |an |elderly |retiree. |Mrs. |Park |has |a |low |fixed |income. |What |could |you |tell |Mrs. |Park |
that |might |be |of |assistance? |- |correct |answer-She |should |contact |her |state |Medicaid |agency |to |see
|if |she |qualifies |forprograms |that |can |help |with |Medicare |costs |for |which |she |is |responsible.
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? |- |correct |answer-You |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.
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 |- |correct |answer-After |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? |- |correct |answer-Part |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.
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? |- |correct |answer-She |may |enroll |at |any |time |while |she |is |covered |under |her |
employer |plan, |but |she |will |have |a |special |eight |month |enrollment |period |that |differs |from |the |
standard |general |enrollment |period, |during |which |she |may |enroll |in |Medicare |Part |B.
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? |- |correct |answer-Tell |prospect |Jerry |Smith |that |he |should |
consider |adding |a |standalone |Part |D |prescription |drug |coverage |policy |to |his |present |coverage.
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? |- |correct |answer-The |penalty |will |be |a |permanent |10% |increase |in |his |Part |B
|premium |for |every |12-month |period |that |passed |during |which |he |could |have |enrolled |and |did |
not.
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? |- |
correct |answer-Medicare |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.
Mildred |Savage |enrolled |in |Allcare |Medicare |Advantage |plan |several |years |ago. |Mildred |recently |
learned |that |she |is |suffering |from |inoperable |cancer |and |has |just |a |few |months |to |live. |She |would
|like |to |spend |these |final |months |in |hospice |care. |Mildred's |family |asks |you |whether |hospice |
benefits |will |be |paid |for |under |the |Allcare |Medicare |Advantage |plan. |What |should |you |say? |- |
correct |answer-Mildred |may |remain |enrolled |in |Allcare |and |make |a |hospice |election. |Hospice |
benefits |will |be |paid |for |by |Original |Medicare |under |Part |A |and |Allcare |will |continue |to |pay |for |
any |non-hospice |services.
Mr. |Gomez |notes |that |a |Private |Fee-for-Service |(PFFS) |plan |available |in |his |area |has |an |attractive |
premium. |He |wants |to |know |if |he |must |use |doctors |in |a |network |as |his |current |HMO |plan |
requires |him |to |do. |What |should |you |tell |him? |- |correct |answer-He |may |receive |health |care |
services |from |any |doctor |allowed |to |bill |Medicare, |as |long |as |he |shows |the |doctor |the |plan's |
identification |card |and |the |doctor |agrees |to |accept |the |PFFS |plan's |payment |terms |and |conditions,
|which |could |include |balance |billing.
Mr. |Kelly |wants |to |know |whether |he |is |eligible |to |sign |up |for |a |Private |fee-for-service |(PFFS) |plan. |
What |questions |would |you |need |to |ask |to |determine |his |eligibility? |- |correct |answer-You |would |
need |to |ask |Mr. |Kelly |if |he |is |enrolled |in |Part |A |and |Part |B |and |if |he |lives |in |the |PFFS |plan's |
service |area.
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