Ahip 2025 Module 1
Anita Magri will turn 65 in August 2023. 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 Plan F 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?
- ANS-You are sorry to disappoint Anita, but a Medigap F plan is no longer available
to those who turn 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. Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug
plan. He asks you what costs he would generally expect to encounter when enrolling
into a standard Medicare Part D prescription drug plan. What should you tell him? -
ANS-He generally would pay a monthly premium, annual deductible, and
per-prescription cost sharing.
\Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal
disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain
coverage under Medicare. What should you tell him? - ANS-He may sign up for
Medicare at any time however coverage usually begins on the fourth month after
dialysis treatment
\Mr. Diaz continued working with his company and was insured under his employer's
group plan until he reached age 68. He has heard that there is a premium penalty for
those who did not sign up for Part B when first eligible and wants to know how much
he will have to pay. What should you tell him? - ANS-Mr. Diaz will not pay any
penalty because he had continuous coverage under his employer's plan.
\Mr. Patel is in good health and is preparing a budget in anticipation of his retirement
when he turns 66. He wants to understand the health care costs he might be
exposed to under Medicare if he were to require hospitalization because of an
illness. In general terms, what could you tell him about his costs for inpatient hospital
services under Original Medicare? - ANS-Under Original Medicare, there is a single
deductible amount due for the first 60 days of any inpatient hospital stay, after which
it converts into a per-day coinsurance amount through day 90. After day 90, he
would pay a daily amount up to 60 days over his lifetime, after which he would be
responsible for all costs.
\Mr. Rainey is experiencing paranoid delusions and his physician feels that he should
be hospitalized. What should you tell Mr. Rainey (or his representative) about the
length of an inpatient psychiatric hospital stay that Medicare will cover? -
ANS-Medicare will cover a total of 190 days of inpatient psychiatric care during Mr.
Rainey's entire lifetime.
Anita Magri will turn 65 in August 2023. 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 Plan F 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?
- ANS-You are sorry to disappoint Anita, but a Medigap F plan is no longer available
to those who turn 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. Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug
plan. He asks you what costs he would generally expect to encounter when enrolling
into a standard Medicare Part D prescription drug plan. What should you tell him? -
ANS-He generally would pay a monthly premium, annual deductible, and
per-prescription cost sharing.
\Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal
disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain
coverage under Medicare. What should you tell him? - ANS-He may sign up for
Medicare at any time however coverage usually begins on the fourth month after
dialysis treatment
\Mr. Diaz continued working with his company and was insured under his employer's
group plan until he reached age 68. He has heard that there is a premium penalty for
those who did not sign up for Part B when first eligible and wants to know how much
he will have to pay. What should you tell him? - ANS-Mr. Diaz will not pay any
penalty because he had continuous coverage under his employer's plan.
\Mr. Patel is in good health and is preparing a budget in anticipation of his retirement
when he turns 66. He wants to understand the health care costs he might be
exposed to under Medicare if he were to require hospitalization because of an
illness. In general terms, what could you tell him about his costs for inpatient hospital
services under Original Medicare? - ANS-Under Original Medicare, there is a single
deductible amount due for the first 60 days of any inpatient hospital stay, after which
it converts into a per-day coinsurance amount through day 90. After day 90, he
would pay a daily amount up to 60 days over his lifetime, after which he would be
responsible for all costs.
\Mr. Rainey is experiencing paranoid delusions and his physician feels that he should
be hospitalized. What should you tell Mr. Rainey (or his representative) about the
length of an inpatient psychiatric hospital stay that Medicare will cover? -
ANS-Medicare will cover a total of 190 days of inpatient psychiatric care during Mr.
Rainey's entire lifetime.
