NR602 AHIP OVERVIEW of MEDICARE
PROGRAM BASICS: CHOICE, ELIGIBILTY,
AND BENEFITS Latest Update
,NR602 AHIP OVERVIEW of MEDICARE PROGRAM BASICS:
CHOICE, ELIGIBILTY, AND BENEFITS Latest Update
MODULE 1
• Ms. Moore plans to retire when she turns 65 in a few months. She is
in excellent health and will have considerable income when she retires. She is
concerned that her income will make it impossible for her to qualify for
Medicare. What could you tell her to address her concern?
a. Medicare is a program for people of all ages with specific mental health
disabilities. Since she is in excellent health, she would not qualify, but should
instead look into her state’s Medicaid program if she wants further coverage.
Incorrect
b. Eligibility for Medicare is based on whether or not a person has ever
been employed by the federal government. If she or her husband were ever
employed by the federal government, she can enroll in Medicare. Incorrect
c.Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, end- stage renal disease, and Lou Gehrig’s disease so she will
be eligible for Medicare. Correct
d. Medicare is a program for people who have incomes and assets below
specific limits, so you will have to find out her exact financial situation before
telling her whether she can obtain Medicare coverage. Incorrect
• Mr. Buck has several family members who died from different
cancers. He wants to know if Medicare covers cancer screening. What should
you tell him?
,a. Medicare covers the periodic performance of a range of screening tests
that are meant to provide early detection of disease. Mr. Buck will need to
check specific tests before obtaining them to see if they will be covered.
Correct
b. Medicare covers all screening tests that have been approved by the FDA
on a frequency determined by the treating physician. Incorrect
c. Medicare covers some screening tests that must be performed within the first
year after enrollment.
Beyond that point expenses for screening tests is the responsibility of the
beneficiary. Incorrect
d. Medicare covers treatments for existing disease, injury and malformed
limbs or body parts. As such, it does not cover any screening tests and these
must be paid for by the beneficiary out of pocket. Incorrect
• 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 as
a result of an illness. In general terms, what could you tell him about his costs
for inpatient hospital services under Original Medicare?
a. Under Original Medicare, the inpatient hospital co-payment is a flat per-
day amount that remains the same throughout the first 60 days of a
beneficiary’s stay. After day 60 the amount gradually increases until day 90.
, After 90 days he would pay the full amount of all costs. Incorrect
b. 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 Correct
c.Under Original Medicare, the inpatient hospital co-payment is a percentage
of allowed charges. The percentage increases after 60 days and again after 90
days. Incorrect
PROGRAM BASICS: CHOICE, ELIGIBILTY,
AND BENEFITS Latest Update
,NR602 AHIP OVERVIEW of MEDICARE PROGRAM BASICS:
CHOICE, ELIGIBILTY, AND BENEFITS Latest Update
MODULE 1
• Ms. Moore plans to retire when she turns 65 in a few months. She is
in excellent health and will have considerable income when she retires. She is
concerned that her income will make it impossible for her to qualify for
Medicare. What could you tell her to address her concern?
a. Medicare is a program for people of all ages with specific mental health
disabilities. Since she is in excellent health, she would not qualify, but should
instead look into her state’s Medicaid program if she wants further coverage.
Incorrect
b. Eligibility for Medicare is based on whether or not a person has ever
been employed by the federal government. If she or her husband were ever
employed by the federal government, she can enroll in Medicare. Incorrect
c.Medicare is a program for people age 65 or older and those under age 65 with
certain disabilities, end- stage renal disease, and Lou Gehrig’s disease so she will
be eligible for Medicare. Correct
d. Medicare is a program for people who have incomes and assets below
specific limits, so you will have to find out her exact financial situation before
telling her whether she can obtain Medicare coverage. Incorrect
• Mr. Buck has several family members who died from different
cancers. He wants to know if Medicare covers cancer screening. What should
you tell him?
,a. Medicare covers the periodic performance of a range of screening tests
that are meant to provide early detection of disease. Mr. Buck will need to
check specific tests before obtaining them to see if they will be covered.
Correct
b. Medicare covers all screening tests that have been approved by the FDA
on a frequency determined by the treating physician. Incorrect
c. Medicare covers some screening tests that must be performed within the first
year after enrollment.
Beyond that point expenses for screening tests is the responsibility of the
beneficiary. Incorrect
d. Medicare covers treatments for existing disease, injury and malformed
limbs or body parts. As such, it does not cover any screening tests and these
must be paid for by the beneficiary out of pocket. Incorrect
• 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 as
a result of an illness. In general terms, what could you tell him about his costs
for inpatient hospital services under Original Medicare?
a. Under Original Medicare, the inpatient hospital co-payment is a flat per-
day amount that remains the same throughout the first 60 days of a
beneficiary’s stay. After day 60 the amount gradually increases until day 90.
, After 90 days he would pay the full amount of all costs. Incorrect
b. 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 Correct
c.Under Original Medicare, the inpatient hospital co-payment is a percentage
of allowed charges. The percentage increases after 60 days and again after 90
days. Incorrect
