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AHIP/NUR Community Exam : Questions and Answers, certified latest update 2022/2023 GRADED A+

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• Mr. Roberts is concerned that if he signs up for a Medicare Advantage plan, the health planmay, at some time in the future, reduce his benefits below what is available in Original Medicare. What should you tell him about his concern? • Medicare health plans must cover all benefits available under Medicare Part A and Part B. Manyalso cover Part D prescription drugs • Mrs. Carol enrolled in the ABC Medicare Advantage (MA) plan several years ago. Her doctorrecently confirmed a diagnosis of end-stage renal disease (ESRD). What options does she have in regard to her MA plan during the next open enrollment season? • She may remain in her ABC MA plan or enroll in a Special Needs Plan (SNP) for individualssuffering from ESRD if one is available in her area • Mrs. Prudence is a widow who will attain age 65 and AHIP/NUR Community Exam : Questions and Answers, certified latest update 2022/2023 GRADED A+ AHIP/NUR Community Exam : Questions and Answers, certified latest update 2022/2023 GRADED A+ enroll in Medicare in just a few weeks. She concerned about having prescription drug coverage. Which of the following statements providesthe best advice? • Prescription drug coverage can be obtained by enrolling in a Medicare Advantage plan thatincludes Part D coverage • Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability toaccess providers. What should you tell him? • In most Medicare Advantage HMOs, Mr. Kumar must obtain his services only from providerswho have a contractual relationship with the plan (except in an emergency) AHIP/NUR Community Exam : Questions and Answers, certified latest update 2022/2023 GRADED A+ AHIP/NUR Community Exam : Questions and Answers, certified latest update 2022/2023 GRADED A+ • Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree group health plan that includes drug coverage with nominal copays. He heard about a neighbor’s MA-PD plan that you represent and because he takes numerous prescription drugs,he is considering signing up for it. What should you tell him? • Beneficiaries should check with their employer or union group benefits administrator beforechanging plans to avoid losing coverage they want to keep • Mrs. Walters is enrolled in her state’s Medicaid program in addition to Medicare. What shouldshe be aware of when considering enrollment in a Medicare Health Plan? • Medicaid will coordinate benefits only with Medicaid participating providers. • Mrs. Andrews asked how a Private Fee-for-Service AHIP/NUR Community Exam : Questions and Answers, certified latest update 2022/2023 GRADED A+ AHIP/NUR Community Exam : Questions and Answers, certified latest update 2022/2023 GRADED A+ (PFFS) plan might affect her access to services since she receives some assistance for her health care costs from the State. Whatshould you tell her? • Medicaid may provide additional benefits, but Medicaid will coordinate benefits only withMedicaid participating providers. • Mr. Rivera has QMB-Plus eligibility and is thus covered by both Medicare and Medicaid. He decides to enroll in a Medicare Advantage (MA) plan. Later in the year, Mr. Rivera needs dentures, a service only covered under Medicaid. What action would you recommend he take in order to have this cost covered? • He should go to a Medicaid provider or obtain the services through a Medicaid manage careplan if he is enrolled in one • Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and willhave

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Uploaded on
April 23, 2024
Number of pages
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Written in
2023/2024
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