Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might be of assistance? - 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 Martine...
AHIP 2024 final exam|| 50 QUESTIONS ||
CORRECT ANSWERS|| LATEST UPDATE
2024
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might
be of assistance? - 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? - 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 - 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? - 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? -
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? - ANSWER Tell prospect Jerry Smith that he should consider adding a standalone Part
D prescription drug coverage policy to his present coverage.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery and expected that he would
have certain services and items covered by the plan with minimal out-of-pocket costs because his MA-PD
coverage has been very good. However, when he received the bill, he was surprised to see large charges
in excess of his maximum out-of-pocket limit that included some services and items he thought would be
fully covered. He called you to ask what he could do? What could you tell him? - ANSWER You can offer
to review the plans appeal process to help him ask the plan to review the coverage decision.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to enroll in
a MA MSA plan that she heard about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive medications. Currently, she is enrolled in
Original Medicare and a standalone Part D plan. How would you advise Mrs. Chi? - ANSWER Mrs. Chi
may enroll in a MA MSA plan and remain in her current standalone Part D prescription drug plan.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can
go to for her health care. What should you tell her? - ANSWER Mrs. Ramos can obtain care from any
provider who participates in Original Medicare, but generally will have a higher cost-sharing amount if
she sees a provider who/that is not a part of the PPO network.
Mr. Wells is trying to understand the difference between Original Medicare and Medicare Advantage.
What would be a correct description? - ANSWER Medicare Advantage is a way of covering all the Original
Medicare benefits through private health insurance companies.
Juan Hernandez is turning 65 next month, Juan legally entered the United States over twenty years ago
but is not a citizen. Since his entry into the country, Juan has worked at Smallcap Incorporated and
contributed to the Medicare system. Juan suffers from diabetes. He will soon retire and asks you if he
can enroll in a Medicare Advantage plan that you represent. How would you respond? - ANSWER Juan is
eligible to enroll in a Medicare Advantage as long as he is entitled to Part A and enrolled in Part B. Juan
should go to the Social Security website to enroll in Medicare Part A and B if he has not done so already.
Once he is enrolled, he can choose a Medicare Advantage plan.
Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is concerned about the
Part D premium penalty if he does not enroll in a Medicare prescription drug plan, but does not want to
purchase extra coverage that he will not need. What should you tell him? - ANSWER He will need to
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