AHIP 2025
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare
enrollment period because the features of Part D might have changed. Mrs. Geisler can't remember
what Part D is so she called you to ask what her neighbor was talking about. What could you tell her? -
(correct Answer) - Part D covers prescription drugs and she should look at her premiums, formulary, and
cost-sharing amont other factors to see if they have changed.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan.
What should you tell him? - (correct Answer) - Mr. Singh will have to 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. 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? - (correct Answer) - Original Medicare covers ambulance services.
What impact, if any, have recent regulatory changes had on Medigap plans? - (correct Answer) - The Part
B deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020
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? - (correct Answer) - Medicare will cover a total of 190 days of
inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed her Medicare
Summary Notice (MSN) and disagrees with a determination that partially denied one of her claims for
services. What advice would you give her? - (correct Answer) - Mrs. Duarte should file an appeal of this
initial determination within 120 days of the date she received the MSN in the mail.
Anita Magri will turn age 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? - (correct Answer) - You are sorry to disappoint Anita, but a Medigap 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.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare
enrollment period because the features of Part D might have changed. Mrs. Geisler can't remember
what Part D is so she called you to ask what her neighbor was talking about. What could you tell her? -
(correct Answer) - Part D covers prescription drugs and she should look at her premiums, formulary, and
cost-sharing amont other factors to see if they have changed.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan.
What should you tell him? - (correct Answer) - Mr. Singh will have to 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. 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? - (correct Answer) - Original Medicare covers ambulance services.
What impact, if any, have recent regulatory changes had on Medigap plans? - (correct Answer) - The Part
B deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020
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? - (correct Answer) - Medicare will cover a total of 190 days of
inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed her Medicare
Summary Notice (MSN) and disagrees with a determination that partially denied one of her claims for
services. What advice would you give her? - (correct Answer) - Mrs. Duarte should file an appeal of this
initial determination within 120 days of the date she received the MSN in the mail.
Anita Magri will turn age 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? - (correct Answer) - You are sorry to disappoint Anita, but a Medigap 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.
