AHIP COMPREHENSIVE EXAM SCRIPT
VERIFIED QUESTIONS COMPLETE
ANSWERS GRADED APLUS
◉ Mr. Chen has heard about Medical Savings Account (MSA), but
wants to know if it is just about saving money, or if he will get
insurance coverage for his health care expenditures as well. What
should you tell him?
Answer: Under the Medicare Advantage program. an MSA plan
involves the combination of high deductible health plan and savings
account for health expenses. Medicare will make contributions to
this savings account to help him pay his health care expenses while
in the deductible.
◉ 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?
Answer: Most individuals who are citizens and over age 65 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.
, ◉ Ms. Edwards is enrolled in a Medicare Advantage plan that
includes prescription drug plan (PDP) coverage. She is traveling and
wishes to fill two of her prescriptions that she has lost. How would
you advise her?
Answer: She may fill prescriptions for covered drugs at non-network
pharmacies, but likely at a higher cost than paid at an in-network
pharmacy.
◉ Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because
he continues to work and is covered by an employer health plan, he
has not enrolled in Part B or Part D. He receives a notice on June 1
that his employer is cutting back on prescription drug benefits and
that as of July 1 his coverage will no longer be creditable. He has
come to you for advice. What advice would you give Mr. Rockwell
about special enrollment periods (SEPs)?
Answer: Mr. Rockwell is eligible for a SEP due to his involuntary loss
of creditable drug coverage; the SEP begins in June and ends
September 1 - two months after the loss of creditable coverage.
◉ 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?
Answer: Medicare will cover a total of 190 days of inpatient
psychiatric care during Mr. Rainey's entire lifetime.
VERIFIED QUESTIONS COMPLETE
ANSWERS GRADED APLUS
◉ Mr. Chen has heard about Medical Savings Account (MSA), but
wants to know if it is just about saving money, or if he will get
insurance coverage for his health care expenditures as well. What
should you tell him?
Answer: Under the Medicare Advantage program. an MSA plan
involves the combination of high deductible health plan and savings
account for health expenses. Medicare will make contributions to
this savings account to help him pay his health care expenses while
in the deductible.
◉ 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?
Answer: Most individuals who are citizens and over age 65 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.
, ◉ Ms. Edwards is enrolled in a Medicare Advantage plan that
includes prescription drug plan (PDP) coverage. She is traveling and
wishes to fill two of her prescriptions that she has lost. How would
you advise her?
Answer: She may fill prescriptions for covered drugs at non-network
pharmacies, but likely at a higher cost than paid at an in-network
pharmacy.
◉ Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because
he continues to work and is covered by an employer health plan, he
has not enrolled in Part B or Part D. He receives a notice on June 1
that his employer is cutting back on prescription drug benefits and
that as of July 1 his coverage will no longer be creditable. He has
come to you for advice. What advice would you give Mr. Rockwell
about special enrollment periods (SEPs)?
Answer: Mr. Rockwell is eligible for a SEP due to his involuntary loss
of creditable drug coverage; the SEP begins in June and ends
September 1 - two months after the loss of creditable coverage.
◉ 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?
Answer: Medicare will cover a total of 190 days of inpatient
psychiatric care during Mr. Rainey's entire lifetime.
