AHIP Medicare QUESTIONS AND ANSWERS
Mr. Wu is eligible for -Mr. Wu may still qualify for help in paying Part D costs
Medicare. He has limited through his State Pharmaceutical Assistance Program.
financial resources but
failed to qualify for the Part D
low-income subsidy. Where
might he turn for help with
his prescription drug costs?
What impact, if any, will recent -The Part B deductible will no longer be covered for
regulatory changes have individuals newly eligible for Medicare starting January 1,
upon Medigap plans? 2020
Mrs. Turner is comparing -Original Medicare covers ambulance services.
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?
Agent John Miller is meeting -Tell prospect Jerry Smith that he should consider adding a
with Jerry Smith, a new standalone Part D prescription drug coverage policy to his
prospect. Jerry is currently present coverage.
enrolled in Medicare Parts A
and B. Jerry has also
purchased a Medicare
Supplement (Medigap) plan
which he has had for several
years. However, the plan
does not provide drug benefits.
How would
you advise Agent John Miller to
proceed?
,Mrs. Paterson is concerned -Medigap plans help beneficiaries cover coinsurance, co-
about the deductibles and payments, and/or deductibles for medically necessary
co-payments associated with services.
Original Medicare. What can
you tell her about Medigap as
an option to address
this concern?
Anita Magri will turn age 65 in -You are sorry to disappoint Anita but a Medigap Part F plan
August 2020. Anita intends to is no longer available to those who turn age 65 after January
enroll in Original Medicare 1,2020. Anita might instead consider other Medigap plans
Part A and Part B. She would that offer foreign travel benefits but do not cover the
also like to enroll in a Part B deductible.
Medicare Supplement
(Medigap) plan. Anita's older
neighbor Mel has told her
about the Medigap Part F plan
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?
Mr. Singh would like drug -Mr. Singh can enroll in a stand-alone prescription drug
coverage but does not want plan and continue to be covered for Part A and Part B
to be enrolled in a Medicare services through Original Fee-for-Service Medicare.
Advantage plan. What should
you tell him?
Mrs. Shields is covered by -Medicare will cover Mrs. Shield's skilled nursing services
Original Medicare. She provided during the first 20 days of her stay, after which she
sustained a hip fracture and is would have a copay until she has been in the facility for 100
being successfully treated days.
for that condition. However,
she and her physicians feel
that after her lengthy hospital
stay she will need a month or
two of nursing and
rehabilitative care. What
, should you tell them about
Original Medicare's coverage
of care in a skilled nursing
facility?
Mr. Bauer is 49 years old, -After receiving such disability payments for 24 months, he
but eighteen months ago he will be automatically enrolled in Medicare, regardless of
was declared disabled by the age.
Social Security Administration
and has been receiving
disability payments. He is
wondering whether he can
obtain coverage under
Medicare. What should you
tell him?
Mrs. Quinn recently turned 66 -Part B primarily covers physician services. She will be paying
and decided after many years a monthly premium and, with the exception of many
of work to begin receiving preventive and screening tests, generally will have 20%
Social Security benefits. coinsurance for these services, in addition to an annual
Shortly thereafter Mrs. Quinn deductible.
received a letter informing
her that she has been
automatically enrolled in
Medicare Part B. She wants
to understand what this
means. What should you tell
Mrs. Quinn?
Mr. Wu is eligible for -Mr. Wu may still qualify for help in paying Part D costs
Medicare. He has limited through his State Pharmaceutical Assistance Program.
financial resources but
failed to qualify for the Part D
low-income subsidy. Where
might he turn for help with
his prescription drug costs?
What impact, if any, will recent -The Part B deductible will no longer be covered for
regulatory changes have individuals newly eligible for Medicare starting January 1,
upon Medigap plans? 2020
Mrs. Turner is comparing -Original Medicare covers ambulance services.
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?
Agent John Miller is meeting -Tell prospect Jerry Smith that he should consider adding a
with Jerry Smith, a new standalone Part D prescription drug coverage policy to his
prospect. Jerry is currently present coverage.
enrolled in Medicare Parts A
and B. Jerry has also
purchased a Medicare
Supplement (Medigap) plan
which he has had for several
years. However, the plan
does not provide drug benefits.
How would
you advise Agent John Miller to
proceed?
,Mrs. Paterson is concerned -Medigap plans help beneficiaries cover coinsurance, co-
about the deductibles and payments, and/or deductibles for medically necessary
co-payments associated with services.
Original Medicare. What can
you tell her about Medigap as
an option to address
this concern?
Anita Magri will turn age 65 in -You are sorry to disappoint Anita but a Medigap Part F plan
August 2020. Anita intends to is no longer available to those who turn age 65 after January
enroll in Original Medicare 1,2020. Anita might instead consider other Medigap plans
Part A and Part B. She would that offer foreign travel benefits but do not cover the
also like to enroll in a Part B deductible.
Medicare Supplement
(Medigap) plan. Anita's older
neighbor Mel has told her
about the Medigap Part F plan
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?
Mr. Singh would like drug -Mr. Singh can enroll in a stand-alone prescription drug
coverage but does not want plan and continue to be covered for Part A and Part B
to be enrolled in a Medicare services through Original Fee-for-Service Medicare.
Advantage plan. What should
you tell him?
Mrs. Shields is covered by -Medicare will cover Mrs. Shield's skilled nursing services
Original Medicare. She provided during the first 20 days of her stay, after which she
sustained a hip fracture and is would have a copay until she has been in the facility for 100
being successfully treated days.
for that condition. However,
she and her physicians feel
that after her lengthy hospital
stay she will need a month or
two of nursing and
rehabilitative care. What
, should you tell them about
Original Medicare's coverage
of care in a skilled nursing
facility?
Mr. Bauer is 49 years old, -After receiving such disability payments for 24 months, he
but eighteen months ago he will be automatically enrolled in Medicare, regardless of
was declared disabled by the age.
Social Security Administration
and has been receiving
disability payments. He is
wondering whether he can
obtain coverage under
Medicare. What should you
tell him?
Mrs. Quinn recently turned 66 -Part B primarily covers physician services. She will be paying
and decided after many years a monthly premium and, with the exception of many
of work to begin receiving preventive and screening tests, generally will have 20%
Social Security benefits. coinsurance for these services, in addition to an annual
Shortly thereafter Mrs. Quinn deductible.
received a letter informing
her that she has been
automatically enrolled in
Medicare Part B. She wants
to understand what this
means. What should you tell
Mrs. Quinn?
