AHIP Final Exam Questions and Correct
Detailed Answers with Rationales (Verified
Answers) Already Graded A+ Newest
Version
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. Shield's skilled nursing services provided
during the first 20 days of her stay, after which she would have a
copay until she has been in the facility for 100 days.
Mrs. West wears glasses and dentures and has enjoyed
considerable pain relief from arthritis through massage
therapy. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her?
Medicare does not cover massage therapy, or, in general, glasses
or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed
income. What could you tell Mrs. Park 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. Alonso receives some help paying for his two generic
prescription drugs from his employer's retiree coverage, but
he wants to compare it to a Part D prescription drug plan. He
,asks you what costs he would generally expect to encounter
when enrolling into a standard Medicare Part D prescription
drug plan. What should you tell him?
He generally would pay a monthly premium, annual deductible,
and per-prescription cost-sharing.
Mrs. Gonzalez is enrolled in Original Medicare and has a
Medigap policy as well, but it provides no drug coverage.
She would like to keep the coverage she has but replace her
existing Medigap plan with one that provides drug coverage.
What should you tell her?
Mrs. Gonzalez cannot purchase a Medigap plan that covers
drugs, but she could keep her Medigap policy and enroll in a Part
D prescription drug plan.
Mr. Davis is 52 years old and has recently been diagnosed
with end-stage renal disease (ESRD) and will soon begin
dialysis. He is wondering if he can obtain coverage under
Medicare. What should you tell him?
He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
Mrs. Duarte is enrolled in Original Medicare Parts A and B.
She has recently reviewed her Medicare Summary Notice
(MSN) and disagrees with a determination that partially
denied one of her claims for services. What advice would you
give her?
Mrs. Duarte should file an appeal of this initial determination
within 120 days of the date she received the MSN in the mail.
Mrs. Geisler's neighbor told her she should look at her Part D
options during the annual Medicare enrollment period
because the features of Part D might have changed. Mrs.
Geisler can't remember what Part D is so she called you to
ask what her neighbor was talking about. What could you tell
her?
, Part D covers prescription drugs and she should look at her
premiums, formulary, and cost-sharing among other factors to see
if they have changed.
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.
Mr. Xi will soon turn age 65 and has come to you for advice
as to what services are provided under Original Medicare.
What should you tell Mr. Xi that best describes the health
coverage provided to Medicare beneficiaries?
Beneficiaries under Original Medicare have no cost-sharing for
most preventive services.
Mr. Singh would like drug coverage but does not want to be
enrolled in a Medicare Advantage plan. What should you tell
him?
Mr. Singh can enroll in a stand-alone prescription drug plan and
continue to be covered for Part A and Part B services through
Original Fee-for-Service Medicare.
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 age 65 or over 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.
Detailed Answers with Rationales (Verified
Answers) Already Graded A+ Newest
Version
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. Shield's skilled nursing services provided
during the first 20 days of her stay, after which she would have a
copay until she has been in the facility for 100 days.
Mrs. West wears glasses and dentures and has enjoyed
considerable pain relief from arthritis through massage
therapy. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her?
Medicare does not cover massage therapy, or, in general, glasses
or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed
income. What could you tell Mrs. Park 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. Alonso receives some help paying for his two generic
prescription drugs from his employer's retiree coverage, but
he wants to compare it to a Part D prescription drug plan. He
,asks you what costs he would generally expect to encounter
when enrolling into a standard Medicare Part D prescription
drug plan. What should you tell him?
He generally would pay a monthly premium, annual deductible,
and per-prescription cost-sharing.
Mrs. Gonzalez is enrolled in Original Medicare and has a
Medigap policy as well, but it provides no drug coverage.
She would like to keep the coverage she has but replace her
existing Medigap plan with one that provides drug coverage.
What should you tell her?
Mrs. Gonzalez cannot purchase a Medigap plan that covers
drugs, but she could keep her Medigap policy and enroll in a Part
D prescription drug plan.
Mr. Davis is 52 years old and has recently been diagnosed
with end-stage renal disease (ESRD) and will soon begin
dialysis. He is wondering if he can obtain coverage under
Medicare. What should you tell him?
He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
Mrs. Duarte is enrolled in Original Medicare Parts A and B.
She has recently reviewed her Medicare Summary Notice
(MSN) and disagrees with a determination that partially
denied one of her claims for services. What advice would you
give her?
Mrs. Duarte should file an appeal of this initial determination
within 120 days of the date she received the MSN in the mail.
Mrs. Geisler's neighbor told her she should look at her Part D
options during the annual Medicare enrollment period
because the features of Part D might have changed. Mrs.
Geisler can't remember what Part D is so she called you to
ask what her neighbor was talking about. What could you tell
her?
, Part D covers prescription drugs and she should look at her
premiums, formulary, and cost-sharing among other factors to see
if they have changed.
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.
Mr. Xi will soon turn age 65 and has come to you for advice
as to what services are provided under Original Medicare.
What should you tell Mr. Xi that best describes the health
coverage provided to Medicare beneficiaries?
Beneficiaries under Original Medicare have no cost-sharing for
most preventive services.
Mr. Singh would like drug coverage but does not want to be
enrolled in a Medicare Advantage plan. What should you tell
him?
Mr. Singh can enroll in a stand-alone prescription drug plan and
continue to be covered for Part A and Part B services through
Original Fee-for-Service Medicare.
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 age 65 or over 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.
