Ahip 2025 final
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1. Mrs. Paterson is concerned about the de- Medigap plans help beneficiaries
ductibles and co-payments associated with Orig- cover Original Medicare benefits,
inal Medicare. What can you tell her about Medi- but they coordinate with Original
gap as an option to address this concern? Medicare coverage.
2. Anita Magri will turn age 65 in August 2023. Anita You are sorry to disappoint Anita,
intends to enroll in Original Medicare Part A and but a Medigap F plan is no longer
Part B. She would also like to enroll in a Medicare available to those who turn age 65
Supplement (Medigap) plan. Anita's older neigh- after January 1, 2020. Anita might
bor Mel has told her about the Medigap Plan F instead consider other Medigap
in which he is enrolled. It not only provides for- plans that offer foreign travel ben-
eign travel emergency benefits but also covers efits but do not cover the Part B
his Medicare Part B deductible. Anita comes to deductible.
you for advice. What should you tell her?
3. What impact, if any, have recent regulatory b.
changes had on Medigap plans? The Part B deductible is no longer
covered for individuals newly eligi-
ble for Medicare starting January
1, 2020.
4. Mr. Rainey is experiencing paranoid delusions Medicare will cover a total of 190
and his physician feels that he should be hospi- days of inpatient psychiatric care
talized. What should you tell Mr. Rainey (or his during Mr. Rainey's entire lifetime.
representative) about the length of an inpatient
psychiatric hospital stay that Medicare will cover?
5. Mrs. Shields is covered by Original Medicare. She
sustained a hip fracture and is being successful-
ly 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
1/8
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Study online at https://quizlet.com/_fbpyup
and rehabilitative care. What should you tell them
about Original Medicare's coverage of care in a
skilled nursing facility?
6. Mrs. West wears glasses and dentures and has Medicare does not cover massage
enjoyed considerable pain relief from arthri- therapy, or, in general, glasses or
tis through massage therapy. She is concerned dentures.
about whether or not Medicare will cover these
items and services. What should you tell her?
7. Ms. Gibson recently lost her employer group She can enroll in the PPO, but
health and drug coverage and now she wants to she will not be able to purchase a
enroll in a PPO that does not include drug cov- stand-alone Medicare Part D pre-
erage. What should you tell her about obtaining scription drug plan.
drug coverage?
8. Mrs. Radford asks whether there are any special Mrs. Radford must be entitled to
eligibility requirements for Medicare Advantage. Part A and enrolled in Part B to
What should you tell her? enroll in Medicare Advantage.
9. Mr. Barker enjoys a comfortable retirement in- You can offer to review the plans
come. He recently had surgery and expected that appeal process to help him ask the
he would have certain services and items covered plan to review the coverage deci-
by the plan with minimal out-of-pocket costs be- sion.
cause his MA-PD coverage has been very good.
However, when he received the bill, he was sur-
prised to see large charges in excess of his maxi-
mum out-of-pocket limit that included some ser-
vices and items he thought would be fully cov-
ered. He called you to ask what he could do? What
could you tell him?
10. He will have to enroll in Part B.
2/8
Study online at https://quizlet.com/_fbpyup
1. Mrs. Paterson is concerned about the de- Medigap plans help beneficiaries
ductibles and co-payments associated with Orig- cover Original Medicare benefits,
inal Medicare. What can you tell her about Medi- but they coordinate with Original
gap as an option to address this concern? Medicare coverage.
2. Anita Magri will turn age 65 in August 2023. Anita You are sorry to disappoint Anita,
intends to enroll in Original Medicare Part A and but a Medigap F plan is no longer
Part B. She would also like to enroll in a Medicare available to those who turn age 65
Supplement (Medigap) plan. Anita's older neigh- after January 1, 2020. Anita might
bor Mel has told her about the Medigap Plan F instead consider other Medigap
in which he is enrolled. It not only provides for- plans that offer foreign travel ben-
eign travel emergency benefits but also covers efits but do not cover the Part B
his Medicare Part B deductible. Anita comes to deductible.
you for advice. What should you tell her?
3. What impact, if any, have recent regulatory b.
changes had on Medigap plans? The Part B deductible is no longer
covered for individuals newly eligi-
ble for Medicare starting January
1, 2020.
4. Mr. Rainey is experiencing paranoid delusions Medicare will cover a total of 190
and his physician feels that he should be hospi- days of inpatient psychiatric care
talized. What should you tell Mr. Rainey (or his during Mr. Rainey's entire lifetime.
representative) about the length of an inpatient
psychiatric hospital stay that Medicare will cover?
5. Mrs. Shields is covered by Original Medicare. She
sustained a hip fracture and is being successful-
ly 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
1/8
, Ahip 2025 final
Study online at https://quizlet.com/_fbpyup
and rehabilitative care. What should you tell them
about Original Medicare's coverage of care in a
skilled nursing facility?
6. Mrs. West wears glasses and dentures and has Medicare does not cover massage
enjoyed considerable pain relief from arthri- therapy, or, in general, glasses or
tis through massage therapy. She is concerned dentures.
about whether or not Medicare will cover these
items and services. What should you tell her?
7. Ms. Gibson recently lost her employer group She can enroll in the PPO, but
health and drug coverage and now she wants to she will not be able to purchase a
enroll in a PPO that does not include drug cov- stand-alone Medicare Part D pre-
erage. What should you tell her about obtaining scription drug plan.
drug coverage?
8. Mrs. Radford asks whether there are any special Mrs. Radford must be entitled to
eligibility requirements for Medicare Advantage. Part A and enrolled in Part B to
What should you tell her? enroll in Medicare Advantage.
9. Mr. Barker enjoys a comfortable retirement in- You can offer to review the plans
come. He recently had surgery and expected that appeal process to help him ask the
he would have certain services and items covered plan to review the coverage deci-
by the plan with minimal out-of-pocket costs be- sion.
cause his MA-PD coverage has been very good.
However, when he received the bill, he was sur-
prised to see large charges in excess of his maxi-
mum out-of-pocket limit that included some ser-
vices and items he thought would be fully cov-
ered. He called you to ask what he could do? What
could you tell him?
10. He will have to enroll in Part B.
2/8
