AHIP final exam 540 QUESTIONS AND ANSWERS EXAM 2024-2025 |
ACTUAL EXAM WITH A STUDY GUIDE AND PRACTICE EX4AM |
ACCURATE REAL EXAM QUESTIONS AND ANSWERS | GUARANTEED
PASS | LATEST UPDATE
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture
and is being successfully treated 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? -
CORRECT ANSWER Medicare will cover Mrs. Shield's skilled nursing
services provided during the first 20 days of her stay, after which she
would have a copay until she has been in the facility for 100 days.
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through massage therapy. She is concerned about
whether or not Medicare will cover these items and services. What should
you tell her? - CORRECT ANSWER Medicare does not cover massage
therapy, or, in general, glasses or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance? - CORRECT ANSWER
She should contact her state Medicaid agency to see if she qualifies for
one of several programs that can help with Medicare costs for which she
is responsible.
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? - CORRECT
ANSWER He generally would pay a monthly premium, annual deductible,
and per-prescription cost-sharing.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as
well, but it provides no drug coverage. She would like to keep the
,coverage she has but replace her existing Medigap plan with one that
provides drug coverage. What should you tell her? - CORRECT ANSWER
Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she
could keep her Medigap policy and enroll in a Part D prescription drug
plan.
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? -
CORRECT ANSWER He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments
start.
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.
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 among other
factors to see if they have changed.
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.
Mr. Xi will soon turn age 65 and has come to you for advice as to what
services are provided under Original Medicare. What should you tell Mr. Xi
that best describes the health coverage provided to Medicare
,beneficiaries? - CORRECT ANSWER Beneficiaries under Original
Medicare have no cost-sharing for most preventive services.
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 can 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. Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is
concerned that she will not qualify for coverage under part A because she
was not born in the United States. What should you tell her? - CORRECT
ANSWER Most individuals who are citizens and age 65 or over are
covered under Part A by virtue of having paid Medicare taxes while
working, though some may be covered as a result of paying monthly
premiums.
Mrs. Quinn recently turned 66 and decided after many years of work to
retire and begin receiving Social Security benefits. Shortly thereafter Mrs.
Quinn received a letter informing her that she had been automatically
enrolled in Medicare Part B. She wants to understand what this means.
What should you tell Mrs. Quinn? - CORRECT ANSWER Part B primarily
covers physician services. She will be paying a monthly premium and,
except for many preventive and screening tests, generally will have 20%
co-payments for these services, in addition to an annual deductible.
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? - CORRECT ANSWER 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.
, 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.
Mrs. Paterson is concerned about the deductibles and co-payments
associated with Original Medicare. What can you tell her about Medigap as
an option to address this concern? - CORRECT ANSWER Medigap plans
do not cover Original Medicare benefits, but they coordinate with Original
Medicare coverage.
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.
Ms. Brooks has aggressive cancer and would like to know if Medicare will
cover hospice services in case she needs them. What should you tell her?
- CORRECT ANSWER Medicare covers hospice services, and they will be
available for her.
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? - CORRECT ANSWER Mr. Diaz will not pay any penalty because
he had continuous coverage under his employer's plan.
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.
ACTUAL EXAM WITH A STUDY GUIDE AND PRACTICE EX4AM |
ACCURATE REAL EXAM QUESTIONS AND ANSWERS | GUARANTEED
PASS | LATEST UPDATE
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture
and is being successfully treated 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? -
CORRECT ANSWER Medicare will cover Mrs. Shield's skilled nursing
services provided during the first 20 days of her stay, after which she
would have a copay until she has been in the facility for 100 days.
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through massage therapy. She is concerned about
whether or not Medicare will cover these items and services. What should
you tell her? - CORRECT ANSWER Medicare does not cover massage
therapy, or, in general, glasses or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance? - CORRECT ANSWER
She should contact her state Medicaid agency to see if she qualifies for
one of several programs that can help with Medicare costs for which she
is responsible.
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? - CORRECT
ANSWER He generally would pay a monthly premium, annual deductible,
and per-prescription cost-sharing.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as
well, but it provides no drug coverage. She would like to keep the
,coverage she has but replace her existing Medigap plan with one that
provides drug coverage. What should you tell her? - CORRECT ANSWER
Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she
could keep her Medigap policy and enroll in a Part D prescription drug
plan.
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? -
CORRECT ANSWER He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments
start.
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.
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 among other
factors to see if they have changed.
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.
Mr. Xi will soon turn age 65 and has come to you for advice as to what
services are provided under Original Medicare. What should you tell Mr. Xi
that best describes the health coverage provided to Medicare
,beneficiaries? - CORRECT ANSWER Beneficiaries under Original
Medicare have no cost-sharing for most preventive services.
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 can 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. Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is
concerned that she will not qualify for coverage under part A because she
was not born in the United States. What should you tell her? - CORRECT
ANSWER Most individuals who are citizens and age 65 or over are
covered under Part A by virtue of having paid Medicare taxes while
working, though some may be covered as a result of paying monthly
premiums.
Mrs. Quinn recently turned 66 and decided after many years of work to
retire and begin receiving Social Security benefits. Shortly thereafter Mrs.
Quinn received a letter informing her that she had been automatically
enrolled in Medicare Part B. She wants to understand what this means.
What should you tell Mrs. Quinn? - CORRECT ANSWER Part B primarily
covers physician services. She will be paying a monthly premium and,
except for many preventive and screening tests, generally will have 20%
co-payments for these services, in addition to an annual deductible.
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? - CORRECT ANSWER 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.
, 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.
Mrs. Paterson is concerned about the deductibles and co-payments
associated with Original Medicare. What can you tell her about Medigap as
an option to address this concern? - CORRECT ANSWER Medigap plans
do not cover Original Medicare benefits, but they coordinate with Original
Medicare coverage.
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.
Ms. Brooks has aggressive cancer and would like to know if Medicare will
cover hospice services in case she needs them. What should you tell her?
- CORRECT ANSWER Medicare covers hospice services, and they will be
available for her.
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? - CORRECT ANSWER Mr. Diaz will not pay any penalty because
he had continuous coverage under his employer's plan.
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.
