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AHIP questions and answers rated A+ 2025/2026
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AHIP questions and answers rated A+ 2025/2026
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AHIPMrs. Burton is a retiree with vast earnings. She is enrolled in an MA-PD plan and was upset
with the carrier she obtained from her number one care physician due to the fact she
become informed she would need to wait five weeks to get an appointment when she was
feeling ill. She called you to ask what she should accomplish that she might not have to
positioned up with such negative get right of entry to to care. What should you tell her?
She may want to file a grievance with her plan to whinge about the dearth of timeliness in
getting an appointment.
Edward IP suffered from extreme kidney disease. As a result. Edward became eligible for
Medicare coverage due to give up-degree renal sickness (ESRD). A near relative donated
their kidney and Edward effectively underwent transplant surgical procedure 12 months ago.
Edward is now age 50 and asks you if his Medicare coverage will continue, what have to you
assert?
Individuals eligible for Medicare primarily based on ESRD typically lose eligibility 36 months
after the month in which the man or woman gets a kidney transplant until they are eligible for
Medicare on any other basis which include age or incapacity. Edward may, but, stay enrolled
in Part B but totally for insurance of immunosuppressive pills if he has no different health
care insurance that could cowl the medicine.
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Mildred Savage enrolled in Allcare Medicare Advantage plan numerous years ago. Mildred
these days discovered that she is laid low with inoperable cancer and has only a few months
to live. She would really like to spend those final months in hospice care. Mildred's circle of
relatives asks you whether hospice benefits might be paid for underneath the Allcare
Medicare Advantage plan. What have to you say?
Mildred can also continue to be enrolled in Allcare and make a hospice election. Hospice
advantages might be paid for with the aid of Original Medicare under Part A and Allcare will
keep to pay for any non-hospice offerings.
,Mr. Diaz persevered operating with his enterprise and turned into insured underneath his
enterprise's organization plan till he reached age sixty eight. He has heard that there may be
a top class penalty for people who did not sign up for Part B when first eligible and wants to
recognise how tons he's going to ought to pay. What need to you tell him?
Mr. Diaz will now not pay any penalty because he had non-stop coverage beneath his
organisation's plan.
Mr. Moy's spouse has a Medicare Advantage plan, but he desires to apprehend what
insurance Medicare Supplemental Insurance affords considering the fact that his fitness care
wishes are different from his wife's needs. What should you tell Mr. Moy?
Medicare Supplemental Insurance might assist cowl his Part A and Part B deductibles or
coinsurance in Original Fee-for-Service (FFS) Medicare in addition to probably some
services that Medicare does no longer cover.
We have an professional-written solution to this trouble!
Mrs. Chen will be sixty five quickly, has been a citizen for twelve years, has been employed
complete time, and paid taxes during that entire duration. She is concerned that she can no
longer qualify for coverage below element A due to the fact she turned into not born within
the United States. What should you tell her?
Most folks who are citizens and age 65 or over are blanketed below Part A with the aid of
virtue of getting paid Medicare taxes whilst working, even though a few may be included as a
result of paying monthly charges.
Mr. Bauer is 49 years old, however eighteen months ago he become declared disabled with
the aid of the Social Security Administration and has been receiving disability bills. He is
thinking whether or not he can acquire insurance below Medicare. What must you tell him?
After receiving such disability bills for 24 months, he may be mechanically enrolled in
Medicare, no matter age.
Mr. Xi will soon flip age 65 and has come to you for advice as to what offerings are provided
under Original Medicare. What have to you inform Mr. Xi that great describes the fitness
insurance furnished to Medicare beneficiaries?
Beneficiaries under Original Medicare don't have any fee-sharing for most preventive
offerings which include immunizations which include annual flu pictures.
Mrs. Peňa is sixty six years antique, has coverage underneath an organisation plan, and
could retire subsequent year. She heard she have to join in Part B at the start of the yr to
make certain no hole in coverage. What can you inform her?
She may additionally sign up at any time at the same time as she is included underneath her
enterprise plan, but she can have a unique eight-month enrollment period after the closing
,month on her business enterprise plan that differs from the same old wellknown enrollment
period, at some point of which she might also sign up in Medicare Part B.
Mr. Davis is fifty two years old and has these days been identified with quit-degree renal
ailment (ESRD) and will quickly begin dialysis. He is questioning if he can reap insurance
beneath Medicare. What ought to you tell him?
He can also signal-up for Medicare at any time but insurance normally starts on the fourth
month after dialysis remedies begin.
Madeline Martinez was widowed numerous years ago. Her husband worked for many years
and contributed into the Medicare gadget. He additionally left a full-size estate which affords
Madeline with an annual income of about $one hundred thirty,000. Madeline, who has
simplest worked part-time for the closing 3 years, will soon flip age 65 and hopes to enroll in
Original Medicare. She involves you for advice. What should you inform her?
You must tell Madeline that she may be capable of sign up in Medicare Part A without paying
month-to-month charges due to her husband's long paintings report and participation within
the Medicare gadget. You have to additionally tell Madeline that she will pay Part B rates at
greater than the standard lowest charge however much less than the very best price due her
massive profits.
Ms. Henderson believes that she will qualify for Medicare Coverage while she turns sixty
five, with out paying any rates, due to the fact she has been operating for 40 years and
paying Medicare taxes. What need to you inform her?
To reap Part B insurance, she have to pay a fashionable month-to-month top rate, though it's
far better for individuals with higher earning.
We have an expert-written solution to this trouble!
To reap Part B coverage, she must pay a fashionable monthly top rate, even though it is
higher for individuals with higher incomes.
Mrs. Gonzalez can not buy a Medigap plan that covers capsules, however she should
preserve her Medigap coverage and sign up in a Part D prescription drug plan.
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is presently 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 blessings. How
might you advocate Agent John Miller to proceed?
Tell prospect Jerry Smith that he ought to keep in mind including a standalone Part D
prescription drug coverage coverage to his gift insurance.
We have an expert-written option to this hassle!
Ms. Moore plans to retire when she turns 65 in a few months. She is in wonderful health and
could have significant earnings while she retires. She is involved that her income will make it
, not possible for her to qualify for Medicare. What may want to you inform her to deal with her
problem?
Medicare is a application for human beings age 65 or older and people beneath age 65 with
certain disabilities, end-degree renal disorder, and Lou Gehrig's ailment so she could be
eligible for Medicare.
Mr. Capadona would like to buy a Medicare Advantage (MA) plan and a Medigap plan to
choose up fees now not protected via that plan. What need to you inform him?
It is illegal with a purpose to promote Mr. Capadona a Medigap plan if he's enrolled in an MA
plan, and except, Medigap handiest works with Original Medicare.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed profits. What may want to you
inform Mrs. Park that is probably of assistance?
She have to contact her country Medicaid organization to peer if she qualifies for one in all
several programs which can assist with Medicare charges for which she is accountable.
Mr. Schmidt would love to plan for retirement and has asked you what is blanketed
underneath Original Fee-for-Service (FFS) Medicare. What may want to you tell him?
Part A, which covers clinic, professional nursing facility, hospice, and home health services
and Part B, which covers expert services together with the ones furnished by a doctor are
blanketed below Original Medicare.
We have an professional-written option to this problem!
Mr. Wu is eligible for Medicare. He has limited economic assets but did not qualify for the
Part D low-profits subsidy. Where may he flip for assist together with his prescription drug
charges?
Mr. Wu may additionally nonetheless qualify for help in paying Part D charges via his State
Pharmaceutical Assistance Program.
Shirly Thomas become enrolled in Medicaid at some stage in the Public Health Emergency
(PHE). This coverage has lately been terminated due to the cease of the PHE. While Shirley
become enrolled in Medicaid, she overlooked an opportunity to sign up for Medicare and
now wants Part B. Which of the following statements first-class describes Shirley's potential
to now enroll in Medicare Part B?
Shirley is eligible for a Special Enrollment Period (SEP) for up to 6 months after the
termination of her Medicaid insurance. Under this SEP, Shirley can choose retroactive
insurance again to the date of termination from Medicaid or coverage starting the month
after the month of enrollment.
Anthony Boniface turned sixty five in 2023. He became now not receiving Social Security or
Railroad Retirement Benefits on his 65th birthday. He become interested in obtaining
Medicare coverage and is eligible for premium-free Part A. Before he ought to sign up in
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