Exam (elaborations)
AHIP 2025 Updated Final Exam | Qs & As| 100% Correct| Grade A (Verified Answers)
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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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
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3. Exam (elaborations) - Ahip 2025 updated final exam | qs & as| 100% correct| grade a (verified answers)
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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.