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AHIP 2025 Updated Final Exam | Qs & As| 100% Correct| Grade A (Verified Answers)
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AHIP 2025 Updated Final Exam | Qs & As| 100% Correct| Grade A (Verified Answers) Q: Mrs. Velasquez cares for her frail elderly mother, Maria, who lives in North Carolina. She is worried that without additional support, her mother will need to go into a nursing home. Mrs. Velasquez asks you if th...

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  • October 14, 2024
  • 32
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

Subjects

  • ahip 2025
  • ahip 2025 updated final exam qs as 100 corre
  • ms gibson recently lost her employer group health
  • mrs velasquez cares for her frail elderly mother

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  • AHIP 2025
  • AHIP 2025

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AHIPI2025IUpdatedIFinalIExamI|IQsI&IAs|I
100%ICorrect|IGradeIAI(VerifiedIAnswers)

Q:IMrs.IVelasquezIcaresIforIherIfrailIelderlyImother,IMaria,IwhoIlivesIinINorthICarolina.ISh
eIisIworriedIthatIwithoutIadditionalIsupport,IherImotherIwillIneedItoIgoIintoIaInursingIhome.I
Mrs.IVelasquezIasksIyouIifIthereIisIanyIMedicareIplanIthatImightIallowIherImotherItoIremainI
inItheIcommunityIratherIthanIgoingIintoIaInursingIhome.IHowIshouldIyouIadviseIMrs.IVelasq
uez?


Answer:
ThereIareIProgramsIofIAll-
InclusiveICareIforItheIElderlyI(PACE)IforIfrailIelderlyIbeneficiariesIcertifiedIasIneedingIaInurs
ingIhomeIlevelIofIcareIbutIareIableItoIliveIsafelyIinItheIcommunityIatItheItimeIofIenrolment.




Q:IWhichIofItheIfollowingIstatement(s)Iis/areIcorrectIaboutIaIMedicareISavingsIAccountI(M
SA)IPlans?
I.IMSAsImayIhaveIeitherIaIpartialInetwork,IfullInetwork,IorInoInetworkIofIproviders.
II.IMSAIplansIcoverIPartIAIandIPartIBIbenefitsIbutInotIPartIDIprescriptionIdrugIbenefits.
III.IAnIindividualIwhoIisIenrolledIinIanIMSAIplanIisIresponsibleIforIaIminimalIdeductibleIofI
$500IindexedIforIinflation.
IV.INon-
networkIprovidersImustIacceptItheIsameIamountIthatIOriginalIMedicareIwouldIpayIthemIasIpa
ymentIinIfull.


Answer:
I,III,IandIIVIonly




Q:IMrs.IChiIisIageI75IandIenjoysIaIcomfortableIbutInotIextremelyIhigh-
incomeIlevel.ISheIwishesItoIenrollIinIaIMAIMSAIplanIthatIsheIheardIaboutIfromIherIneighbor
.ISheIalsoIwantsItoIhaveIprescriptionIdrugIcoverageIsinceIherIdoctorIrecentlyIprescribedIsever
alIexpensiveImedications.ICurrently,IsheIisIenrolledIinIOriginalIMedicareIandIaIstandaloneIPar
tIDIplan.IHowIwouldIyouIadviseIMrs.IChi?

,Answer:
Mrs.IChiImayIenrollIinIaIMAIMSAIplanIandIremainIinIherIcurrentIstandaloneIPartIDIprescript
ionIdrugIplan.




Q:IMrs.ILyonsIisIinIgoodIhealth,IusesIaIsingleIprescription,IandIlivesIindependentlyIinIherIo
wnIhome.ISheIisIattractedIbyItheIideaIofImaintainingIcontrolIoverIaIMedicalISavingsIAccount
I(MSA)IbutIisInotIsureIifItheIplanIassociatedIwithItheIaccountIwillIfitIherIneeds.IWhatIspecifi
cIpieceIofIinformationIaboutIaIMedicareIMSAIplanIwouldIitIbeIimportantIforIherItoIknow,Ipri
orItoIenrollingIinIsuchIaIplan?


Answer:
AllIMSAsIcoverIPartIAIandIPartIBIbenefits,IbutInotIPartIDIprescriptionIdrugIbenefits,IwhichIc
ouldIbeIobtainedIbyIalsoIenrollingIinIaIseparateIprescriptionIdrugIplan.




Q:IMrs.IBurtonIisIaIretireeIwithIsubstantialIincome.ISheIisIenrolledIinIanIMA-
PDIplanIandIwasIdisappointedIwithItheIserviceIsheIreceivedIfromIherIprimaryIcareIphysicianI
becauseIsheIwasItoldIsheIwouldIhaveItoIwaitIfiveIweeksItoIgetIanIappointmentIwhenIsheIwasI
feelingIill.ISheIcalledIyouItoIaskIwhatIsheIcouldIdoIsoIsheIwouldInotIhaveItoIputIupIwithIsuc
hIpoorIaccessItoIcare.IWhatIcouldIyouItellIher?


Answer:
SheIcouldIfileIaIgrievanceIwithIherIplanItoIcomplainIaboutItheIlackIofItimelinessIinIgettingIan
Iappointment.




Q:IMrs.IRadfordIasksIwhetherIthereIareIanyIspecialIeligibilityIrequirementsIforIMedicareIAd
vantage.IWhatIshouldIyouItellIher?


Answer:
Mrs.IRadfordImustIbeIentitledItoIPartIAIandIenrolledIinIPartIBItoIenrollIinIMedicareIAdvanta
ge.

,Q:IMr.IKellyIwantsItoIknowIwhetherIheIisIeligibleItoIsignIupIforIaIprivateIfee-for-
serviceI(PFFS)Iplan.IWhatIquestionsIwouldIyouIneedItoIaskItoIdetermineIhisIeligibility?


Answer:
YouIwouldIneedItoIaskIMr.IKellyIifIheIisIentitledItoIPartIA,IenrolledIinIPartIB,IandIifIheIlives
IinItheIPFFSIplan'sIserviceIarea.




Q:IMr.IRomeroIisI64,IretiringIsoon,IandIconsideringIenrollmentIinIhisIemployer-
sponsoredIretireeIgroupIhealthIplanIthatIincludesIdrugIcoverageIwithInominalIcopays.IHeIhear
dIaboutIaIneighbor'sIMA-
PDIplanIthatIyouIrepresentIandIbecauseIheItakesInumerousIprescriptionIdrugs,IheIisIconsiderin
gIsigningIupIforIit.IWhatIshouldIyouItellIhim?


Answer:
HeIshouldIcompareItheIbenefitsIinIhisIemployer-
sponsoredIretireeIgroupIhealthIplanIwithItheIbenefitsIinIhisIneighbor'sIMA-
PDIplanItoIdetermineIwhichIoneIwillIprovideIsufficientIcoverageIforIhisIprescriptionIneeds.




Q:IMs.IGibsonIrecentlyIlostIherIemployerIgroupIhealthIandIdrugIcoverageIandInowIsheIwant
sItoIenrollIinIaIPPOIthatIdoesInotIincludeIdrugIcoverage.IWhatIshouldIyouItellIherIaboutIobtai
ningIdrugIcoverage?


Answer:
SheIcanIenrollIinItheIPPO,IbutIsheIwillInotIbeIableItoIpurchaseIaIstand-
aloneIMedicareIPartIDIprescriptionIdrugIplan.




Q:IDr.IElizabethIBrennanIdoesInotIcontractIwithItheIABCIPFFSIplanIbutIacceptsItheIplan'sIt
ermsIandIconditionsIforIpayment.IMaryIRodgersIseesIDr.IBrennanIforItreatment.IHowImuchI
mayIDr.IBrennanIcharge?

, Answer:
Dr.IBrennanIcanIchargeIMaryIRogersInoImoreIthanItheIcostIsharingIspecifiedIinItheIPFFSIpla
n'sItermsIandIconditionIofIpaymentIwhichImayIincludeIbalanceIbillingIupItoI15%ofItheIMedic
areIrate.




Q:IMrs.IKelly,IageI65,IisIentitledItoIPartIAIbutIhasInotIyetIenrolledIinIPartIB.ISheIisIconside
ringIenrollmentIinIaIMedicareIAdvantageIplanI(PartIC).IWhatIshouldIyouIadviseIherItoIdoIbef
oreIsheIcanIenrollIinIaIMedicareIAdvantageIplan?


Answer:
ToIjoinIaIMedicareIAdvantageIplan,IsheIalsoImustIenrollIinIPartIB.




Q:IMr.IWellsIisItryingItoIunderstandItheIdifferenceIbetweenIOriginalIMedicareIandIMedicare
IAdvantage.IWhatIwouldIbeItheIcorrectIdescription?


Answer:
MedicareIAdvantageIisIaIwayIofIcoveringIallItheIOriginalIMedicareIbenefitsIthroughIprivateIh
ealthIinsuranceIcompanies.




Q:IMr.ILombardiIisIinterestedIinIaIMedicareIAdvantageI(MA)IPPOIplanIthatIyouIrepresent.I
ItIisIoneIofIthreeIplansIoperatedIbyItheIsameIorganizationIinIMr.ILombardi'sIarea.ITheIMAIPP
OIplanIdoesInotIincludeIdrugIcoverage,IbutItheIotherItwoIplansIdo.IMr.ILombardiIlikesItheIPP
OIplanIthatIdoesInotIincludeIdrugIcoverageIandIintendsItoIobtainIhisIdrugIcoverageIthroughIaI
stand-aloneIMedicareIprescriptionIdrugIplan.IWhatIshouldIyouItellIhimIaboutIthisIsituation?


Answer:
HeIcouldIenrollIeitherIinIoneIofItheIMAIplansIthatIincludeIprescriptionIdrugIcoverageIorIOrigi
nalIMedicareIwithIaIMedigapIplanIandIstandaloneIPartIDIprescriptionIdrugIcoverage,IbutIheIc
annotIenrollIinItheIMA-onlyIPPOIplanIandIaIstand-aloneIprescriptionIdrugIplan.

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