AHIP Module Quizzes 2022/2023 (Latest Update With
Verified Answers)
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? Correct Ans - After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age
Mrs. Geisler's neighbor told her she should look at her Part D options during
the annual Medicare enrollment period because 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?
Correct Ans - Part D covers prescription drugs & she should look at her
premiums, formulary, & cost sharing among other factors to see if they have
changed
Mr. Davis is 52 years old and has recently been diagnosed with end-stage
renal diease (ESRD) and will soon begin dialysis. He is wondering if he can
obtain coverage under Medicare. What should you tell him? Correct Ans -
He may sign up for Medicare at any time however coverage usually begins
on the fourth month after dialysis treatments start
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?
Correct Ans - Beneficiaries under Original Medicare have no cost-sharing
for most preventive services which inc. immunizations such as annual flu
shots
Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a
substantial estate which provides Madeline w/ an annual income of approx.
$130,000. Madeline, who has only worked part-time for the last 3 years, will
soon turn age 65 and hopes to enroll in Original Medicare. She comes to you
for advice. What should you tell her? Correct Ans - You should tell
Madeline that she will be able to enroll in Medicare Part A w/out paying
monthly premiums due to her husband's long work record & participation in
the Medicare system. You should also tell Madeline that she will pay Part B
premiums at more than the standard lowest rate but less than the highest
rate due to her substantial income
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? Correct Ans -
Medicare is a program for people age 65 or older & those under age 65 w/
certain disabilities, end-stage renal disease, & Lou Gehrig's disease so she
will be eligible for Medicare
Mrs. Quinn recently turned 66 and decided after __________ Social Security
benefits. Shortly thereafter, Mrs. Quinn received a letter informing her she
has been automatically enrolled in Medicare Part B. She wants to understand
what this means. What should you tell her? Correct Ans - Part B primarily
covers physician services. She will be paying a monthly premium &, with the
exception of many preventive and screening tests, generally will have 20%
coinsurance for these services, in addition to an annual deductible
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 w/
his prescription drug costs? Correct Ans - He may still qualify for help in
paying Part D costs through his State Pharmaceutical Assistance Program
Mr. Moy'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 him?
Correct Ans - Medicare Supplemental Insurance would help cover his Part
A & B cost sharing in Original Fee-for-Service (FFS) Medicare as well as
possibly some services that Medicare does not cover
Anita Magri will turn 65 in August 2020. Anita intends to enroll in Original
Medicare Part A & B. She would also like to enroll in a Medicare Supplement
(Medigap) plan. Anita's older neighbor Mel had told her about Medigap Part F
plan in which he is enrolled. It not only provides foreign travel emergency
benefits, but also covers his Medicare Part B deductible. Anita comes to you
for advice. What should you tell her? Correct Ans - You are sorry to
disappoint her but a Medigap Part F plan is no longer available to those who
turn 65 after Jan. 1, 2020. Anita might instead consider other Medigap plans
that offer foreign travel benefits but do not cover the Part B deductible
Mr. Singh would like drug coverage, but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him? Correct Ans - Mr.
Singh can enroll in a stand alone prescription drug plan & continue to be
covered for Part A & B services through Original Fee-for-Service Medicare
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? Correct Ans - Original Medicare covers ambulance services
, 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? Correct
Ans - Medicare will cover Mrs. Shields skill nursing services 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
What impact, if any, will recent regulatory changes have upon Medigap
plans? Correct Ans - The Part B deductible will no longer be covered for
individuals newly eligible for Medicare starting Jan. 1, 2020
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is
currently enrolled in Medicare Parts A & B. Jerry has also purchased a
Medicare Supplement (Medigap) plan which he has had for several years.
However, the plan does not provide drug benefits. How would you advise
Agent John Miller to proceed? Correct Ans - Tell prospect Jerry Smith that
he should consider adding a standalone Part D prescription drug coverage
policy to his present coverage
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? Correct Ans -
Most individuals who are citizens & 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
Juan Perez, who is turning 65 next month, intends to work for several more
years at Smallcap, Inc. Smallcap has a workforce of 15 employees & offers
employer sponsored healthcare coverage. Juan is a naturalized citizen & has
contributed to the Medicare system for over 20 years. Juans asks you if he
will be entitled to Medicare & if he enrolls how that impact his employer
sponsored healthcare coverage. How would you respond? Correct Ans -
Juan is likely to be eligible for Medicare once he turns 65 & if he enrolls
Medicare would become the primary payor of his healthcare claims &
Smallcap does not have to continue to offer him coverage comparable to
those under 65 under its employer sponsored group health plan
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? Correct Ans - Part A, which covers hospital, skilled nursing facility,
hospice, & some home health services & part B, which covers professional
services such as those provided by a doctor are covered under Original
Medicare
Verified Answers)
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? Correct Ans - After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age
Mrs. Geisler's neighbor told her she should look at her Part D options during
the annual Medicare enrollment period because 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?
Correct Ans - Part D covers prescription drugs & she should look at her
premiums, formulary, & cost sharing among other factors to see if they have
changed
Mr. Davis is 52 years old and has recently been diagnosed with end-stage
renal diease (ESRD) and will soon begin dialysis. He is wondering if he can
obtain coverage under Medicare. What should you tell him? Correct Ans -
He may sign up for Medicare at any time however coverage usually begins
on the fourth month after dialysis treatments start
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?
Correct Ans - Beneficiaries under Original Medicare have no cost-sharing
for most preventive services which inc. immunizations such as annual flu
shots
Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a
substantial estate which provides Madeline w/ an annual income of approx.
$130,000. Madeline, who has only worked part-time for the last 3 years, will
soon turn age 65 and hopes to enroll in Original Medicare. She comes to you
for advice. What should you tell her? Correct Ans - You should tell
Madeline that she will be able to enroll in Medicare Part A w/out paying
monthly premiums due to her husband's long work record & participation in
the Medicare system. You should also tell Madeline that she will pay Part B
premiums at more than the standard lowest rate but less than the highest
rate due to her substantial income
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? Correct Ans -
Medicare is a program for people age 65 or older & those under age 65 w/
certain disabilities, end-stage renal disease, & Lou Gehrig's disease so she
will be eligible for Medicare
Mrs. Quinn recently turned 66 and decided after __________ Social Security
benefits. Shortly thereafter, Mrs. Quinn received a letter informing her she
has been automatically enrolled in Medicare Part B. She wants to understand
what this means. What should you tell her? Correct Ans - Part B primarily
covers physician services. She will be paying a monthly premium &, with the
exception of many preventive and screening tests, generally will have 20%
coinsurance for these services, in addition to an annual deductible
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 w/
his prescription drug costs? Correct Ans - He may still qualify for help in
paying Part D costs through his State Pharmaceutical Assistance Program
Mr. Moy'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 him?
Correct Ans - Medicare Supplemental Insurance would help cover his Part
A & B cost sharing in Original Fee-for-Service (FFS) Medicare as well as
possibly some services that Medicare does not cover
Anita Magri will turn 65 in August 2020. Anita intends to enroll in Original
Medicare Part A & B. She would also like to enroll in a Medicare Supplement
(Medigap) plan. Anita's older neighbor Mel had told her about Medigap Part F
plan in which he is enrolled. It not only provides foreign travel emergency
benefits, but also covers his Medicare Part B deductible. Anita comes to you
for advice. What should you tell her? Correct Ans - You are sorry to
disappoint her but a Medigap Part F plan is no longer available to those who
turn 65 after Jan. 1, 2020. Anita might instead consider other Medigap plans
that offer foreign travel benefits but do not cover the Part B deductible
Mr. Singh would like drug coverage, but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him? Correct Ans - Mr.
Singh can enroll in a stand alone prescription drug plan & continue to be
covered for Part A & B services through Original Fee-for-Service Medicare
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? Correct Ans - Original Medicare covers ambulance services
, 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? Correct
Ans - Medicare will cover Mrs. Shields skill nursing services 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
What impact, if any, will recent regulatory changes have upon Medigap
plans? Correct Ans - The Part B deductible will no longer be covered for
individuals newly eligible for Medicare starting Jan. 1, 2020
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is
currently enrolled in Medicare Parts A & B. Jerry has also purchased a
Medicare Supplement (Medigap) plan which he has had for several years.
However, the plan does not provide drug benefits. How would you advise
Agent John Miller to proceed? Correct Ans - Tell prospect Jerry Smith that
he should consider adding a standalone Part D prescription drug coverage
policy to his present coverage
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? Correct Ans -
Most individuals who are citizens & 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
Juan Perez, who is turning 65 next month, intends to work for several more
years at Smallcap, Inc. Smallcap has a workforce of 15 employees & offers
employer sponsored healthcare coverage. Juan is a naturalized citizen & has
contributed to the Medicare system for over 20 years. Juans asks you if he
will be entitled to Medicare & if he enrolls how that impact his employer
sponsored healthcare coverage. How would you respond? Correct Ans -
Juan is likely to be eligible for Medicare once he turns 65 & if he enrolls
Medicare would become the primary payor of his healthcare claims &
Smallcap does not have to continue to offer him coverage comparable to
those under 65 under its employer sponsored group health plan
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? Correct Ans - Part A, which covers hospital, skilled nursing facility,
hospice, & some home health services & part B, which covers professional
services such as those provided by a doctor are covered under Original
Medicare
