AHIP 2021 QUESTIONS AND ANSWERS

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? a. Medicare Part B generally provides prescription drug coverage. b. Beneficiaries under Original Medicare have no cost-sharing for most preventive services which include immunizations such as annual flu shots. c. Medicare Part A generally covers medically necessary physician and other health care professional services. d. Benefits covered by Medicare Parts A and B include routine dental care, hearing aids, and routine eye care. - Answer- b. Beneficiaries under Original Medicare have no cost-sharing for most preventive services which include immunizations such as annual flu shots. (Beneficiaries enrolled in both Original Medicare (Parts A and B) have no cost-sharing for most preventive services. These services include immunizations such as annual flu shots.) Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. What should you tell him? a. Mr. Singh must leave Original Medicare to receive drug coverage. b. Part D prescription drug coverage can only be obtained by enrollment into a Medicare Advantage plan that also covers Part A and Part B services. c. Mr. Singh will have to enroll in Medicaid if he wishes to obtain prescription drug coverage through some means other than a Medicare Advantage plan. d. 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. - Answer- d. 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. (Prescription drug coverage is available to those who enroll in a stand-alone Part D prescription drug plan and continue coverage under Original Medicare Part A and Part B.) 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? a. Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services. b. Medigap plans are not sold by private companies and are a government insurance product.