AHIP Medicare Questions and answers
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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 with his prescription drug costs? ✔✔-
Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical
Assistance Program.
What impact, if any, will recent regulatory changes have upon Medigap plans? ✔✔-The Part B
deductible will no longer be covered for individuals newly eligible for Medicare starting January
1, 2020
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? ✔✔-Original Medicare covers ambulance services.
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled in
Medicare Parts A and 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? ✔✔-Tell prospect Jerry Smith that he should consider
adding a standalone Part D prescription drug coverage policy to his present coverage.
,Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. What can you tell her about Medigap as an option to address this concern? ✔✔-
Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for
medically necessary services.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare Part A
and Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's
older neighbor Mel has told her about the 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? ✔✔-You are sorry to disappoint Anita
but a Medigap Part F plan is no longer available to those who turn age 65 after January 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? ✔✔-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. 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.
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.
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social
Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What
should you tell Mrs. Quinn? ✔✔-Part B primarily covers physician services. She will be paying
a monthly premium and, with the exception of many preventive and screening tests, generally
will have 20% coinsurance for these services, in addition to an annual deductible.
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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 with his prescription drug costs? ✔✔-
Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical
Assistance Program.
What impact, if any, will recent regulatory changes have upon Medigap plans? ✔✔-The Part B
deductible will no longer be covered for individuals newly eligible for Medicare starting January
1, 2020
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? ✔✔-Original Medicare covers ambulance services.
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled in
Medicare Parts A and 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? ✔✔-Tell prospect Jerry Smith that he should consider
adding a standalone Part D prescription drug coverage policy to his present coverage.
,Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. What can you tell her about Medigap as an option to address this concern? ✔✔-
Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for
medically necessary services.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare Part A
and Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's
older neighbor Mel has told her about the 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? ✔✔-You are sorry to disappoint Anita
but a Medigap Part F plan is no longer available to those who turn age 65 after January 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? ✔✔-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. 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.
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.
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social
Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What
should you tell Mrs. Quinn? ✔✔-Part B primarily covers physician services. She will be paying
a monthly premium and, with the exception of many preventive and screening tests, generally
will have 20% coinsurance for these services, in addition to an annual deductible.
