AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
• Mr. Roberts is concerned that if he signs up for a Medicare
h h h h h h h h h h h
h Advantage plan, the health planmay, at some time in the f h h h h h h h h h h h
uture, reduce his benefits below what is available in Origi
h h h h h h h h h
nal Medicare. What should you tell him about his concern
h h h h h h h h h
?
• Medicare health plans must cover all benefits available und
h h h h h h h h
er Medicare Part A and Part B. Manyalso cover Part D presc
h h h h h h h h h h h h
ription drugs h
• Mrs. Carol enrolled in the ABC Medicare Advantage (MA) p
h h h h h h h h h
lan several years ago. Her doctorrecently confirmed a dia
h h h h h h h h h
gnosis of end- h h
stage renal disease (ESRD). What options does she have i
h h h h h h h h h
n regard to her MA plan during the next open enrollment s
h h h h h h h h h h h
eason?
• She may remain in her ABC MA plan or enroll in a Specia
h h h h h h h h h h h h
l Needs Plan (SNP) for individualssuffering from ESRD if
h h h h h h h h h
h one is available in her area
h h h h h
AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
,AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+
h h
• Mrs. Prudence is a widow who will attain age 65 and enroll i
h h h h h h h h h h h h
n Medicare in just a few weeks. She concerned about havin
h h h h h h h h h h
g prescription drug coverage. Which of the following state
h h h h h h h h
ments providesthe best advice?
h h h h
• Prescription drug coverage can be obtained by enrollin
h h h h h h h
g in a Medicare Advantage plan thatincludes Part D cov
h h h h h h h h h h
erage
• Mr. Kumar is considering a Medicare Advantage HMO an
h h h h h h h h
d has questions about his ability toaccess providers. W
h h h h h h h h h
hat should you tell him?
h h h h
• In most Medicare Advantage HMOs, Mr. Kumar must obt
h h h h h h h h
ain his services only from providerswho have a contract
h h h h h h h h h
ual relationship with the plan (except in an emergency)
h h h h h h h h
AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+
h h
,AHIP/NUR Community Exam
h h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
• Mr. Romero is 64, retiring soon, and considering enrollme
h h h h h h h h
nt in his employer-
h h h
sponsored retiree group health plan that includes drug co
h h h h h h h h
verage with nominal copays. He heard about a neighbor’s
h h h h h h h h h
MA-
PD plan that you represent and because he takes numerou
h h h h h h h h h
s prescription drugs,he is considering signing up for it. W
h h h h h h h h h h
hat should you tell him?
h h h h
• Beneficiaries should check with their employer or unio h h h h h h h
n group benefits administrator beforechanging plans to
h h h h h h h
h avoid losing coverage they want to keep
h h h h h h
• Mrs. Walters is enrolled in her state’s Medicaid program in
h h h h h h h h h
h addition to Medicare. What shouldshe be aware of when c
h h h h h h h h h h
onsidering enrollment in a Medicare Health Plan?h h h h h h
• Medicaid will coordinate benefits only with Medicaid participati
h h h h h h h
ng providers.
h
AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
, AHIP/NUR Community Exam
h h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
• Mrs. Andrews asked how a Private Fee-for-
h h h h h h
Service (PFFS) plan might affect her access to services si
h h h h h h h h h
nce she receives some assistance for her health care cos
h h h h h h h h h
ts from the State. Whatshould you tell her?
h h h h h h h h
• Medicaid may provide additional benefits, but Medicah h h h h h
id will coordinate benefits only withMedicaid particip
h h h h h h h
ating providers. h
• Mr. Rivera has QMB-
h h h
Plus eligibility and is thus covered by both Medicare and M
h h h h h h h h h h
edicaid. He decides to enroll in a Medicare Advantage (MA)
h h h h h h h h h h
plan. Later in the year, Mr. Rivera needs dentures, a service
h h h h h h h h h h
h only covered under Medicaid. What action would you reco
h h h h h h h h
mmend he take inorder to have this cost covered?
h h h h h h h h h
• He should go to a Medicaid provider or obtain the servic
h h h h h h h h h h
es through a Medicaid manage careplan if he is enrolled i
h h h h h h h h h h h
n one
h
• Ms. Moore plans to retire when she turns 65 in a few month
h h h h h h h h h h h h
AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
• Mr. Roberts is concerned that if he signs up for a Medicare
h h h h h h h h h h h
h Advantage plan, the health planmay, at some time in the f h h h h h h h h h h h
uture, reduce his benefits below what is available in Origi
h h h h h h h h h
nal Medicare. What should you tell him about his concern
h h h h h h h h h
?
• Medicare health plans must cover all benefits available und
h h h h h h h h
er Medicare Part A and Part B. Manyalso cover Part D presc
h h h h h h h h h h h h
ription drugs h
• Mrs. Carol enrolled in the ABC Medicare Advantage (MA) p
h h h h h h h h h
lan several years ago. Her doctorrecently confirmed a dia
h h h h h h h h h
gnosis of end- h h
stage renal disease (ESRD). What options does she have i
h h h h h h h h h
n regard to her MA plan during the next open enrollment s
h h h h h h h h h h h
eason?
• She may remain in her ABC MA plan or enroll in a Specia
h h h h h h h h h h h h
l Needs Plan (SNP) for individualssuffering from ESRD if
h h h h h h h h h
h one is available in her area
h h h h h
AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
,AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+
h h
• Mrs. Prudence is a widow who will attain age 65 and enroll i
h h h h h h h h h h h h
n Medicare in just a few weeks. She concerned about havin
h h h h h h h h h h
g prescription drug coverage. Which of the following state
h h h h h h h h
ments providesthe best advice?
h h h h
• Prescription drug coverage can be obtained by enrollin
h h h h h h h
g in a Medicare Advantage plan thatincludes Part D cov
h h h h h h h h h h
erage
• Mr. Kumar is considering a Medicare Advantage HMO an
h h h h h h h h
d has questions about his ability toaccess providers. W
h h h h h h h h h
hat should you tell him?
h h h h
• In most Medicare Advantage HMOs, Mr. Kumar must obt
h h h h h h h h
ain his services only from providerswho have a contract
h h h h h h h h h
ual relationship with the plan (except in an emergency)
h h h h h h h h
AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+
h h
,AHIP/NUR Community Exam
h h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
• Mr. Romero is 64, retiring soon, and considering enrollme
h h h h h h h h
nt in his employer-
h h h
sponsored retiree group health plan that includes drug co
h h h h h h h h
verage with nominal copays. He heard about a neighbor’s
h h h h h h h h h
MA-
PD plan that you represent and because he takes numerou
h h h h h h h h h
s prescription drugs,he is considering signing up for it. W
h h h h h h h h h h
hat should you tell him?
h h h h
• Beneficiaries should check with their employer or unio h h h h h h h
n group benefits administrator beforechanging plans to
h h h h h h h
h avoid losing coverage they want to keep
h h h h h h
• Mrs. Walters is enrolled in her state’s Medicaid program in
h h h h h h h h h
h addition to Medicare. What shouldshe be aware of when c
h h h h h h h h h h
onsidering enrollment in a Medicare Health Plan?h h h h h h
• Medicaid will coordinate benefits only with Medicaid participati
h h h h h h h
ng providers.
h
AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
, AHIP/NUR Community Exam
h h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
• Mrs. Andrews asked how a Private Fee-for-
h h h h h h
Service (PFFS) plan might affect her access to services si
h h h h h h h h h
nce she receives some assistance for her health care cos
h h h h h h h h h
ts from the State. Whatshould you tell her?
h h h h h h h h
• Medicaid may provide additional benefits, but Medicah h h h h h
id will coordinate benefits only withMedicaid particip
h h h h h h h
ating providers. h
• Mr. Rivera has QMB-
h h h
Plus eligibility and is thus covered by both Medicare and M
h h h h h h h h h h
edicaid. He decides to enroll in a Medicare Advantage (MA)
h h h h h h h h h h
plan. Later in the year, Mr. Rivera needs dentures, a service
h h h h h h h h h h
h only covered under Medicaid. What action would you reco
h h h h h h h h
mmend he take inorder to have this cost covered?
h h h h h h h h h
• He should go to a Medicaid provider or obtain the servic
h h h h h h h h h h
es through a Medicaid manage careplan if he is enrolled i
h h h h h h h h h h h
n one
h
• Ms. Moore plans to retire when she turns 65 in a few month
h h h h h h h h h h h h
AHIP/NUR Community Exam h h
: Questions and Answers, certified latest update 2022/
h h h h h h hhhh
2023 GRADED A+h h
