AHIP_test_
AHIP_test_
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
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
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
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
,AHIP_test_
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
,AHIP_test_
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. 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. Lopez has heard that he can sign up for a product called “Medicare Advantage”
but is not sure about what type of plan designs are available through this program.
What should you tell him about the types of health plans that are available through
the Medicare Advantage program?
They are Medicare health plans such as HMOs, PPOs, PFFS, SNPs, and MSAs
Mr. Wells is trying to understand the difference between Original Medicare and
Medicare Advantage. What would be a correct description?
Medicare Advantage is a way of covering all of the Original Medicare benefits
through private health insurance companies
During a sales presentation in Ms. Sullivan’s home, she tells you that she has
heard about a type of Medicare health plan known as Private Fee-for-Service
(PFFS). She wants to know if this would be available to her. What should you tell
her about PFFS plans?
A PFFS plan is one of various types of Medicare Advantage plans offered by private
entities and she may enroll in one if it is available in her area.
Mrs. Radford asks whether there are any special eligibility requirements
for Medicare Advantage. What should you tell her?
Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare
Advantage
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but has
recently stopped paying his Part B premium. He would like to enroll in a Medicare
Advantage (MA) plan and is still covered by Part A. What should you tell him?
He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare
Part B.
Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan several years ago.
Her doctor recently confirmed a diagnosis of end-stage renal disease (ESRD). What
options does Mrs.
Billings have in regard to her MA plan during the next open enrollment season?
She may remain in her ABC MA plan or enroll in a Special Needs Plan (SNP) for
, AHIP_test_
individuals suffering from ESRD if one is available in her area
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his
ability to access providers. What should you tell him?
In most Medicare Advantage HMOs, Mr. Kumar must obtain his services only from
providers who have a contractual relationship with the plan (except in an
emergency)
AHIP_test_
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
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
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
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
,AHIP_test_
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
,AHIP_test_
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. 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. Lopez has heard that he can sign up for a product called “Medicare Advantage”
but is not sure about what type of plan designs are available through this program.
What should you tell him about the types of health plans that are available through
the Medicare Advantage program?
They are Medicare health plans such as HMOs, PPOs, PFFS, SNPs, and MSAs
Mr. Wells is trying to understand the difference between Original Medicare and
Medicare Advantage. What would be a correct description?
Medicare Advantage is a way of covering all of the Original Medicare benefits
through private health insurance companies
During a sales presentation in Ms. Sullivan’s home, she tells you that she has
heard about a type of Medicare health plan known as Private Fee-for-Service
(PFFS). She wants to know if this would be available to her. What should you tell
her about PFFS plans?
A PFFS plan is one of various types of Medicare Advantage plans offered by private
entities and she may enroll in one if it is available in her area.
Mrs. Radford asks whether there are any special eligibility requirements
for Medicare Advantage. What should you tell her?
Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare
Advantage
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but has
recently stopped paying his Part B premium. He would like to enroll in a Medicare
Advantage (MA) plan and is still covered by Part A. What should you tell him?
He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in Medicare
Part B.
Mrs. Billings enrolled in the ABC Medicare Advantage (MA) plan several years ago.
Her doctor recently confirmed a diagnosis of end-stage renal disease (ESRD). What
options does Mrs.
Billings have in regard to her MA plan during the next open enrollment season?
She may remain in her ABC MA plan or enroll in a Special Needs Plan (SNP) for
, AHIP_test_
individuals suffering from ESRD if one is available in her area
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his
ability to access providers. What should you tell him?
In most Medicare Advantage HMOs, Mr. Kumar must obtain his services only from
providers who have a contractual relationship with the plan (except in an
emergency)
