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AHIP Medicare Final Exam 2025 questions and answers 2024/2025
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AHIP Final Exam 2025What effect, if any, have current regulatory adjustments had on Medigap plans? - ANSThe
Part B deductible is no longer covered for individuals newly eligible for Medicare beginning
January 1, 2020.
Mr. Diaz endured operating together with his enterprise and was insured under his
enterprise's organization plan until he reached age 68. He has heard that there's a top rate
penalty for folks that did not sign on for Part B when first eligible and desires to recognize
how tons he's going to ought to pay. What need to you inform him? - ANSMr. Diaz will not
pay any penalty due to the fact he had non-stop coverage beneath his agency's plan.
Mrs. Shields is included by way of Original Medicare. She sustained a hip fracture and is
being correctly treated for that condition. However, she and her physicians experience that
after her lengthy health facility stay, she will want a month or of nursing and rehabilitative
care. What have to you tell them about Original Medicare's insurance of care in a skilled
nursing facility? - ANSMedicare will cover Mrs. Shield's skilled nursing services supplied at
some point of the first 20 days of her stay, and then she might have a copay till she has been
in the facility for a hundred days.
Mrs. Quinn recently grew to become sixty six and decided after many years of labor to retire
and start receiving Social Security blessings. Shortly thereafter Mrs. Quinn acquired a letter
informing her that she had been robotically enrolled in Medicare Part B. She desires to
recognize what this means. What need to you tell Mrs. Quinn? - ANSPart B commonly
covers physician offerings. She will be paying a month-to-month top class and, besides for
plenty preventive and screening exams, usually can have 20% co-payments for these
offerings, further to an annual deductible.
Mrs. Turner is evaluating her corporation's retiree coverage to Original Medicare and would
really like to recognize which of the subsequent offerings Original Medicare will cover if the
correct standards are met. What should you inform her? - ANSOriginal Medicare covers
ambulance offerings.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed profits. What should you tell Mrs.
Park that might be of assistance? - ANSShe must touch her state Medicaid employer to look
if she qualifies for certainly one of several packages which can assist with Medicare costs for
which she is responsible.
Mrs. West wears glasses and dentures and has enjoyed considerable pain comfort from
arthritis thru rubdown therapy. She is concerned about whether or not or no longer Medicare
will cover those items and services. What need to you tell her? - ANSMedicare does now not
cover rub down therapy, or, in wellknown, glasses or dentures.
Mrs. Chen will be sixty five quickly, has been a citizen for twelve years, has been hired
complete time, and paid taxes at some stage in that complete period. She is concerned that
, she will be able to no longer qualify for coverage under element A due to the fact she
become now not born within the United States. What need to you inform her? - ANSMost
folks that are citizens and age sixty five or over are blanketed below Part A by virtue of
getting paid Medicare taxes while running, although some may be covered because of
paying monthly charges.
Mr. Davis is 52 years antique and has these days been recognized with quit-degree renal
ailment (ESRD) and could quickly start dialysis. He is thinking if he can attain coverage
underneath Medicare. What ought to you tell him? - ANSHe may additionally signal-up for
Medicare at any time but insurance normally starts on the fourth month after dialysis
remedies start.
Mr. Lombardi is inquisitive about a Medicare Advantage (MA) PPO plan which you
represent. It is certainly one of three plans operated by means of the equal organisation in
Mr. Lombardi's location. The MA PPO plan does not consist of drug coverage, however the
different two plans do. Mr. Lombardi likes the PPO plan that doesn't include drug coverage
and intends to acquire his drug coverage via a stand-alone Medicare prescription drug plan.
What have to you tell him approximately this case? - ANSHe could sign up both in one of the
MA plans that include prescription drug insurance or Original Medicare with a Medigap plan
and standalone Part D prescription drug insurance, however he can not enroll in the
MA-handiest PPO plan and a stand-by myself prescription drug plan.
Mr. Lopez has heard that he can sign on for a product called "Medicare Advantage" but is
not sure approximately what kind of plan designs are available thru this software. What have
to you tell him approximately the styles of health plans which are available thru the Medicare
Advantage application? - ANSThere are Medicare health plans together with HMOs, PPOs,
PFFS, and MSAs.
Mr. Romero is 64, retiring soon, and considering enrollment in his organisation-backed
retiree group fitness plan that consists of drug insurance with nominal copays. He heard
about a neighbor's MA-PD plan which you constitute and because he is taking numerous
pharmaceuticals, he's considering signing up for it. What should you inform him? - ANSHe
should compare the blessings in his employer-sponsored retiree organization fitness plan
with the advantages in his neighbor's MA-PD plan to decide which one will provide enough
coverage for his prescription desires.
Mr. Barker enjoys a at ease retirement income. He these days had surgery and anticipated
that he might have sure services and items protected by using the plan with minimum
out-of-pocket prices because his MA-PD coverage has been excellent. However, while he
acquired the invoice, he become amazed to look huge charges in extra of his maximum
out-of-pocket restriction that covered a few services and items he idea would be absolutely
blanketed. He called you to invite what he ought to do? What could you inform him? -
ANSYou can provide to review the plans attraction technique to help him ask the plan to
study the insurance decision.
Mrs. Kelly, age 65, is entitled to Part A but has now not but enrolled in Part B. She is
considering enrollment in a Medicare Advantage plan (Part C). What must you propose her
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