AHIP Module 1 Answers
Ms. Moore plans to retire when she turns 65 in
a few months. She is in excellent health and Medicare is a program for people 65
will have considerable income when she or older and those under the age 65
retires. She is concerned that her income will with certain disabilities, end-stage
make it impossible for her to qualify for renal disease, and Lou Gehrig’s
Medicare. What could you tell her to address disease so she will be eligible for
her concern? Medicare.
Mr. Schmidt would like to plan for retirement
and has asked you what is covered under Part A, which covers hospital, skilled
Original Fee-for-Service (FFS) Medicare? nursing facility, hospice, and home
What could you tell him? 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 Medicare Advantage plans must
plan may, at some time in the future, reduce cover all benefits available under
his benefits below what is available in Original Medicare Part A and Part B. Many
Medicare. What should you tell him about his also cover Part D prescription drugs.
concern?
Mrs. Roberts has just received a new
Medicare identity card in the mail. She is The card she received is valid, the
concerned that it is a forgery since it does not change has been made to protect
have her Social Security number on it. What Medicare beneficiaries from identity
should you tell her? theft, and she should now destroy her
old card.
Mrs. Willard wants to know generally how the
benefits under Original Medicare might Medicare Health Plans may offer
compare to the benefit package of a Medicare extra benefits that Original Medicare
Health Plan before she starts looking at does not offer such as vision, hearing,
specific plans. What could you tell her? and dental services and must include
a maximum out-of-pocket limit on
Part A and Part B services.
Mr. Moy’s wife has a Medicare Advantage
plan, but he wants to understand what Medicare Supplemental Insurance
coverage Medicare Supplemental Insurance would help cover his Part A and Part
provides since his health care needs are B cost sharing in Original Fee-for-
different from his wife’s needs. What could Service (FFS) Medicare as well as
you tell Mr. Moy?
, possibly some services that Medicare
does not cover.
Chen will be 65 soon, has been a citizen for
twelve years, has been employed full time, Most individuals who are citizens and
and paid taxes during that entire period. She over age 65 are covered under Part A
is concerned that she will not qualify for by virtue of having paid Medicare
coverage under Part A because she was not taxes while working, though some
born in the US. What should you tell her? may be covered as a result of paying
monthly premiums.
Bauer is 49 years old, but eighteen months
ago he was declared disabled by the SSA and After receiving such disability
has been receiving disability payments. He is payments for 24 months, he will be
wondering whether he can obtain coverage automatically enrolled in Medicare,
under Medicare. What should you tell him? regardless of age.
Mr. Denton is 52 years old and has recently
been diagnosed with end-stage renal disease He may sign-up for Medicare at any
and will soon begin dialysis. He is wondering if time however coverage usually
he can obtain coverage under Medicare. What begins on the fourth month after
should you tell him? dialysis treatments start.
Ms. Henderson believes that she will qualify
for Medicare coverage when she turns 65, w/o In order to obtain Part B coverage,
paying any premiums, because she has been she must pay a standard monthly
working for 40 years and paying Medicare premium, though it is higher for
taxes. What should you tell her? individuals with higher incomes.
Mr. Diaz continued working with his company
and was insured under his employer’s group Mr. Diaz will not pay any penalty
plan until he reached 68 years old. He has because he had continuous coverage
heard that there is a premium penalty for under his employer’s plan.
those who did not sign up for Part B when first
eligible and wants to know how much he will
have to pay.
Mrs. Pena is 66 years old, has coverage
under an employer plan and will retire next She may not enroll at any time while
year. She heard she must enroll in Part B at she is covered under her employer
the beginning of the year to ensure no gap in plan, but she will have a special eight
coverage. month enrollment period that differs
from the standard general enrollment
period, during which she may enroll in
Medicare Part B.
Ms. Moore plans to retire when she turns 65 in
a few months. She is in excellent health and Medicare is a program for people 65
will have considerable income when she or older and those under the age 65
retires. She is concerned that her income will with certain disabilities, end-stage
make it impossible for her to qualify for renal disease, and Lou Gehrig’s
Medicare. What could you tell her to address disease so she will be eligible for
her concern? Medicare.
Mr. Schmidt would like to plan for retirement
and has asked you what is covered under Part A, which covers hospital, skilled
Original Fee-for-Service (FFS) Medicare? nursing facility, hospice, and home
What could you tell him? 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 Medicare Advantage plans must
plan may, at some time in the future, reduce cover all benefits available under
his benefits below what is available in Original Medicare Part A and Part B. Many
Medicare. What should you tell him about his also cover Part D prescription drugs.
concern?
Mrs. Roberts has just received a new
Medicare identity card in the mail. She is The card she received is valid, the
concerned that it is a forgery since it does not change has been made to protect
have her Social Security number on it. What Medicare beneficiaries from identity
should you tell her? theft, and she should now destroy her
old card.
Mrs. Willard wants to know generally how the
benefits under Original Medicare might Medicare Health Plans may offer
compare to the benefit package of a Medicare extra benefits that Original Medicare
Health Plan before she starts looking at does not offer such as vision, hearing,
specific plans. What could you tell her? and dental services and must include
a maximum out-of-pocket limit on
Part A and Part B services.
Mr. Moy’s wife has a Medicare Advantage
plan, but he wants to understand what Medicare Supplemental Insurance
coverage Medicare Supplemental Insurance would help cover his Part A and Part
provides since his health care needs are B cost sharing in Original Fee-for-
different from his wife’s needs. What could Service (FFS) Medicare as well as
you tell Mr. Moy?
, possibly some services that Medicare
does not cover.
Chen will be 65 soon, has been a citizen for
twelve years, has been employed full time, Most individuals who are citizens and
and paid taxes during that entire period. She over age 65 are covered under Part A
is concerned that she will not qualify for by virtue of having paid Medicare
coverage under Part A because she was not taxes while working, though some
born in the US. What should you tell her? may be covered as a result of paying
monthly premiums.
Bauer is 49 years old, but eighteen months
ago he was declared disabled by the SSA and After receiving such disability
has been receiving disability payments. He is payments for 24 months, he will be
wondering whether he can obtain coverage automatically enrolled in Medicare,
under Medicare. What should you tell him? regardless of age.
Mr. Denton is 52 years old and has recently
been diagnosed with end-stage renal disease He may sign-up for Medicare at any
and will soon begin dialysis. He is wondering if time however coverage usually
he can obtain coverage under Medicare. What begins on the fourth month after
should you tell him? dialysis treatments start.
Ms. Henderson believes that she will qualify
for Medicare coverage when she turns 65, w/o In order to obtain Part B coverage,
paying any premiums, because she has been she must pay a standard monthly
working for 40 years and paying Medicare premium, though it is higher for
taxes. What should you tell her? individuals with higher incomes.
Mr. Diaz continued working with his company
and was insured under his employer’s group Mr. Diaz will not pay any penalty
plan until he reached 68 years old. He has because he had continuous coverage
heard that there is a premium penalty for under his employer’s plan.
those who did not sign up for Part B when first
eligible and wants to know how much he will
have to pay.
Mrs. Pena is 66 years old, has coverage
under an employer plan and will retire next She may not enroll at any time while
year. She heard she must enroll in Part B at she is covered under her employer
the beginning of the year to ensure no gap in plan, but she will have a special eight
coverage. month enrollment period that differs
from the standard general enrollment
period, during which she may enroll in
Medicare Part B.
