(solutions) 2022 AHIP Exam
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires.
She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to addres...
solutions 2022 ahip exam ms moore plans to retire when she turns 65 in a few months she is in excellent health and will have considerable income when she retires she is concerned that her inc
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2022 AHIP
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(solutions) 2022 AHIP Exam
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent
health and will have considerable income when she retires.
She is concerned that her income will make it impossible for her to qualify for
Medicare. What could you tell her to address her concern? Medicare is a
program for people age 65 or older and those under age 65 with certain disabilities,
end stage renal disease or Lou Gehrig's disease, so she will be eligible for
Medicare.
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? 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.
Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the
health plan may, at some time in the future, reduce his benefits below what is
available in Original Medicare. What should you tell him about his concern?
Medicare health plans must cover all benefits available under Medicare Part
A and Part B. Many also cover Part D prescription drugs.
Mrs. Raskin is a widow who will attain aged 65 and enroll in Medicare in just a
few weeks. She concerned about having prescription drug coverage. Which of the
following statements provides the best advice? Prescription drug coverage can
be obtained by enrolling in a Medicare Advantage plan that includes Part D
coverage.
Mrs. Willard wants to know generally how the benefits under Original Medicare
might compare to the benefit package of a Medicare Health Plan before she starts
looking at specific plans. What could you tell her? Medicare Health Plans may
offer extra benefits that Original Medicare does not offer such as vision, hearing,
and dental services and must include a maximum out-of-pocket limit on Part A and
Part B services.
Mr. Meoni's wife has a Medicare Advantage plan, but he wants to understand what
coverage Medicare Supplemental Insurance provides since his health care needs
are different from his wife's needs. What could you tell Mr.Meoni? Medicare
Supplemental Insurance would help cover his Part A and Part B cost sharing in
Original Fee-for-Service (FFS) Medicare as well as possibly some services that
Medicare does not cover.
,Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed
full time, and paid taxes during that entire period. She is concerned that she will
not qualify for coverage under part A because she was not born in the United
States. What should you tell her? Most individuals who are citizens and over
age 65 are covered under Part A by virtue of having paid
Medicare taxes while working, though some may be covered as a result of paying
monthly premiums.
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? After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
Mr. Davis is 49 years old and has been receiving disability benefits from the Social
Security Administration for 12 months. Can you sell him a Medicare Advantage or
Part D Prescription Drug policy? No, he cannot purchase a Medicare
Advantage or Part D policy because he has not received Social Security or
Railroad Retirement disability benefits for 24 months.
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? In order to obtain Part B coverage, she must pay a
standard monthly premium, though it is higher for
individuals with higher incomes.
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? Mr.
Diaz will not pay any penalty because he had continuous coverage under his
employer's plan.
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? 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.
Mrs. Kelly is entitled to Part A, but is not yet enrolled in Part B. She is considering
enrollment in a Medicare health plan. What should you advise her to do before she
will be able to enroll into a Medicare health plan? In order to join a Medicare
health plan, she also must enroll in Part B.
,Mrs. Park has a low, fixed income. What could you tell her that might be of
assistance? 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.
Mr. Yu has limited income and resources so you have encouraged him to see if he
qualifies for some type of financial assistance. Mr. Yu is not sure it is worth the
trouble to apply and wants to know what the assistance could do for him if he
qualifies. What could you tell him? He might qualify for help with Part D
prescription drug costs and help paying Part A and/or Part B premiums,
deductibles, and/or cost sharing.
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? 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 amount through day 90. After
day 90, he would pay a daily
amount up to 60 days over his lifetime, after which he would be responsible for all
costs
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? Medicare will cover Mrs. Schmidt's skilled
nursing services provided during the first 20 days of her stay, after which she
would have a coinsurance until she has been in the facility for 100 days.
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?
Medicare will cover a total of 190 days of inpatient psychiatric care during
Mr. Rainey's entire lifetime.
Mrs. Quinn has just turned 65 and 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? 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% co-payments for these
services, in addition to an
annual deductible.
, 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?
Medicare covers 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.
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? Original
Medicare covers ambulance services.
Mrs. Wolf wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through acupuncture. She is concerned about whether or not
Medicare will cover these items and services. What should you tell her?
Medicare does not cover acupuncture, or, in general, glasses or dentures.
Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the
health plan may, at some
time in the future, reduce his benefits below what is available in Original
Medicare. What should you tell him about his concern? Medicare health plans
must cover all benefits available under Medicare Part A and Part B. Many also
cover Part D prescription drugs.
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? 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.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
qualify for the Part D low-income
subsidy. Where might he turn for help with his prescription drug costs? Mr.
Wu may still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program.
Mrs. Willard wants to know generally how the benefits under Original Medicare
might compare to the benefit
package of a Medicare Health Plan before she starts looking at specific plans.
What could you tell her? Medicare Health Plans may offer extra benefits that
Original Medicare does not offer such as vision, hearing, and dental services and
must include a maximum out-of-pocket limit on Part A and Part B services.
Mrs. Wolf wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through
acupuncture. She is concerned about whether or not Medicare will cover these
items and services. What should you tell her? Medicare does not cover
acupuncture, or, in general, glasses or dentures.
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