AHIP FWA UPDATED Exam Questions and CORRECT Answers
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Course
AHIP FWA
Institution
AHIP FWA
AHIP FWA UPDATED Exam Questions
and CORRECT Answers
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 ANSWE...
AHIP FWA UPDATED Exam Questions
and CORRECT Answers
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- Original Medicare covers
ambulance services.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him? - CORRECT ANSWER- Mr. Singh can enroll in
a stand-alone prescription drug plan and continue to be covered for Part A and Part B services
through Original Fee-for-Service 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?
- CORRECT ANSWER- Medicare 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.
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.
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? - CORRECT ANSWER- Medicare does not
cover massage therapy, or, in general, glasses or dentures.
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? - CORRECT ANSWER- Part 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. 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? - CORRECT ANSWER- Part D covers prescription drugs and she
should look at her premiums, formulary, and cost-sharing among other factors to see if they
have changed.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed her
Medicare Summary Notice (MSN) and disagrees with a determination that partially denied
one of her claims for services. What advice would you give her? - CORRECT ANSWER-
Mrs. Duarte should file an appeal of this initial determination within 120 days of the date she
received the MSN in the mail.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be
hospitalized. What should you tell Mr. Rainey (or his representative) about the length of an
inpatient psychiatric hospital stay that Medicare will cover? - CORRECT ANSWER-
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's
entire lifetime.
Mrs. 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 for one of several programs that can help with
Medicare costs for which she is responsible.
Anita Magri will turn age 65 in August 2022. 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? - CORRECT
ANSWER- You 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.
, 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? - CORRECT ANSWER- 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
Medicare Part D prescription drug plan. What should you tell him? - CORRECT ANSWER-
He generally would pay a monthly premium, annual deductible, and per-prescription cost-
sharing.
Mr. Buck has several family members who died from different cancers. He wants to know if
Medicare covers cancer screening. What should you tell him? - CORRECT ANSWER-
Medicare covers the periodic performance of a range of screening tests that are meant to
provide early detection of disease. Mr. Buck will need to check specific tests before obtaining
them to see if they will be covered.
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- Mr. Diaz will not pay any penalty
because he had continuous coverage under his employer's plan.
What impact, if any, have recent regulatory changes had upon Medigap plans? - CORRECT
ANSWER- The Part B deductible is no longer covered for individuals newly eligible for
Medicare starting January 1, 2020.
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? -
CORRECT ANSWER- *** Medigap plans help beneficiaries cover Original Medicare
benefits, but they coordinate with Original Medicare coverage.
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? - CORRECT
ANSWER- 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
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