NR602 AHIP OVERVIEW of MEDICARE PRO
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GRAM BASICS: CHOICE, ELIGIBILTY,
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AND BENEFITS Latest Update 2022/2023
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,NR602 AHIP OVERVIEW of MEDICARE PROGRAM BASICS:CHt t t t t t t
OICE, ELIGIBILTY, AND BENEFITS Latest Update 2022/2023
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MODULE 1 t
• Ms. Moore plans to retire when she turns 65 in a few months. She is in e
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xcellent health and will have considerable income when she retires. She isconce
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rned that her income will make it impossible for her to qualify for Medicare. Wh
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at could you tell her to address her concern?
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a. Medicare is a program for people of all ages with specific mental healthdis
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abilities. Since she is in excellent health, she would not qualify, but shouldinstea
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d look into her state’s Medicaid program if she wants further coverage.
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Incorrect
b. Eligibility for Medicare is based on whether or not a person has ever bee
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n employed by the federal government. If she or her husband were everemplo
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yed by the federal government, she can enroll in Medicare. Incorrect
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c.Medicare is a program for people age 65 or older and those under age 65 withcert
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ain disabilities, end-
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t stage renal disease, and Lou Gehrig’s disease so she willbe eligible for Medicare. C
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orrect
d. Medicare is a program for people who have incomes and assets below spe
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cific limits, so you will have to find out her exact financial situation beforetelling
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her whether she can obtain Medicare coverage. Incorrect
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• Mr. Buck has several family members who died from different cancers.
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He wants to know if Medicare covers cancer screening. What shouldyou tell him
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?
,NR602 AHIP OVERVIEW of MEDICARE PROGRAM BASICS:CH
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OICE, ELIGIBILTY, AND BENEFITS Latest Update 2022/2023
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a. Medicare covers the periodic performance of a range of screening teststh
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at are meant to provide early detection of disease. Mr. Buck will need to check s
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pecific tests before obtaining them to see if they will be covered.
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Correct
b. Medicare covers all screening tests that have been approved by the FDAon
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a frequency determined by the treating physician. Incorrect
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c. Medicare covers some screening tests that must be performed within the firstye
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ar after enrollment.
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Beyond that point expenses for screening tests is the responsibility of thebe
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neficiary. Incorrect t
d. Medicare covers treatments for existing disease, injury and malformedli
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mbs or body parts. As such, it does not cover any screening tests and thesemus
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t be paid for by the beneficiary out of pocket. Incorrect
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• Mr. Patel is in good health and is preparing a budget in anticipation of his
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retirement when he turns 66. He wants to understand the health care costshe mig
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ht be exposed to under Medicare if he were to require hospitalization asa result of
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t an illness. In general terms, what could you tell him about his costs for inpatient h
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ospital services under Original Medicare?
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a. Under Original Medicare, the inpatient hospital co-payment is a flat per-
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day amount that remains the same throughout the first 60 days of a beneficiary’
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s stay. After day 60 the amount gradually increases until day 90.
t t t t t t t t t t t
, NR602 AHIP OVERVIEW of MEDICARE PROGRAM BASICS:CH
t t t t t t t
OICE, ELIGIBILTY, AND BENEFITS Latest Update 2022/2023
t t t t t t
After 90 days he would pay the full amount of all costs. Incorrect
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b. Under Original Medicare, there is a single deductible amount due for the firs
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t 60 days of any inpatient hospital stay, after which it converts into a per-
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t day coinsurance amount through day 90. After day 90, he would pay a daily amou
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nt up to 60 days over his lifetime, after which he would be responsible forall costs
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Correct
c.Under Original Medicare, the inpatient hospital co-
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payment is a percentageof allowed charges. The percentage increases after 60 d
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ays and again after 90days. Incorrect
t t t t t t
t t t t t
GRAM BASICS: CHOICE, ELIGIBILTY,
t t t
AND BENEFITS Latest Update 2022/2023
t t t t
,NR602 AHIP OVERVIEW of MEDICARE PROGRAM BASICS:CHt t t t t t t
OICE, ELIGIBILTY, AND BENEFITS Latest Update 2022/2023
t t t t t t
MODULE 1 t
• Ms. Moore plans to retire when she turns 65 in a few months. She is in e
t t t t t t t t t t t t t t t t
xcellent health and will have considerable income when she retires. She isconce
t t t t t t t t t t t t
rned that her income will make it impossible for her to qualify for Medicare. Wh
t t t t t t t t t t t t t t
at could you tell her to address her concern?
t t t t t t t t
a. Medicare is a program for people of all ages with specific mental healthdis
t t t t t t t t t t t t t
abilities. Since she is in excellent health, she would not qualify, but shouldinstea
t t t t t t t t t t t t t
d look into her state’s Medicaid program if she wants further coverage.
t t t t t t t t t t t
Incorrect
b. Eligibility for Medicare is based on whether or not a person has ever bee
t t t t t t t t t t t t t
n employed by the federal government. If she or her husband were everemplo
t t t t t t t t t t t t t
yed by the federal government, she can enroll in Medicare. Incorrect
t t t t t t t t t t
c.Medicare is a program for people age 65 or older and those under age 65 withcert
t t t t t t t t t t t t t t t t
ain disabilities, end-
t t
t stage renal disease, and Lou Gehrig’s disease so she willbe eligible for Medicare. C
t t t t t t t t t t t t t t
orrect
d. Medicare is a program for people who have incomes and assets below spe
t t t t t t t t t t t t
cific limits, so you will have to find out her exact financial situation beforetelling
t t t t t t t t t t t t t t t
her whether she can obtain Medicare coverage. Incorrect
t t t t t t t
• Mr. Buck has several family members who died from different cancers.
t t t t t t t t t t t
He wants to know if Medicare covers cancer screening. What shouldyou tell him
t t t t t t t t t t t t t
?
,NR602 AHIP OVERVIEW of MEDICARE PROGRAM BASICS:CH
t t t t t t t
OICE, ELIGIBILTY, AND BENEFITS Latest Update 2022/2023
t t t t t t
a. Medicare covers the periodic performance of a range of screening teststh
t t t t t t t t t t t
at are meant to provide early detection of disease. Mr. Buck will need to check s
t t t t t t t t t t t t t t t
pecific tests before obtaining them to see if they will be covered.
t t t t t t t t t t t
Correct
b. Medicare covers all screening tests that have been approved by the FDAon
t t t t t t t t t t t t
a frequency determined by the treating physician. Incorrect
t t t t t t t t
c. Medicare covers some screening tests that must be performed within the firstye
t t t t t t t t t t t t
ar after enrollment.
t t
Beyond that point expenses for screening tests is the responsibility of thebe
t t t t t t t t t t t t
neficiary. Incorrect t
d. Medicare covers treatments for existing disease, injury and malformedli
t t t t t t t t t
mbs or body parts. As such, it does not cover any screening tests and thesemus
t t t t t t t t t t t t t t t
t be paid for by the beneficiary out of pocket. Incorrect
t t t t t t t t t t
• Mr. Patel is in good health and is preparing a budget in anticipation of his
t t t t t t t t t t t t t t t
retirement when he turns 66. He wants to understand the health care costshe mig
t t t t t t t t t t t t t t
ht be exposed to under Medicare if he were to require hospitalization asa result of
t t t t t t t t t t t t t t t
t an illness. In general terms, what could you tell him about his costs for inpatient h
t t t t t t t t t t t t t t t
ospital services under Original Medicare?
t t t t
a. Under Original Medicare, the inpatient hospital co-payment is a flat per-
t t t t t t t t t t
day amount that remains the same throughout the first 60 days of a beneficiary’
t t t t t t t t t t t t t t
s stay. After day 60 the amount gradually increases until day 90.
t t t t t t t t t t t
, NR602 AHIP OVERVIEW of MEDICARE PROGRAM BASICS:CH
t t t t t t t
OICE, ELIGIBILTY, AND BENEFITS Latest Update 2022/2023
t t t t t t
After 90 days he would pay the full amount of all costs. Incorrect
t t t t t t t t t t t t
b. Under Original Medicare, there is a single deductible amount due for the firs
t t t t t t t t t t t t
t 60 days of any inpatient hospital stay, after which it converts into a per-
t t t t t t t t t t t t t t
t day coinsurance amount through day 90. After day 90, he would pay a daily amou
t t t t t t t t t t t t t t
nt up to 60 days over his lifetime, after which he would be responsible forall costs
t t t t t t t t t t t t t t t t t
Correct
c.Under Original Medicare, the inpatient hospital co-
t t t t t t
payment is a percentageof allowed charges. The percentage increases after 60 d
t t t t t t t t t t t t
ays and again after 90days. Incorrect
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