AHIP Module 1 Graded A

AHIP Module 1 Graded A Question 1: Ms. Moore, who's planning to retire soon, is concerned that her income will make it impossible for her to qualify for Medicare. What should you tell her? Answer: Medicare is a program for people 65 or older, regardless of income level. Question 2: Mr. Schmidt wants to know what's covered under Original Fee-for-Service (FFS) Medicare. What can you tell him? Answer: Original Medicare covers Part A (hospital, skilled nursing facility, hospice, and home health services) and Part B (professional services, such as doctor visits). Question 3: Mr. Hernandez is worried that a Medicare Advantage plan might reduce his benefits below Original Medicare levels. What should you tell him? Answer: Medicare Advantage plans must cover all benefits available under Medicare Part A and Part B, and many also cover Part D prescription drugs. Question 4: Mrs. Roberts received a new Medicare ID card without her Social Security number. What should you tell her? Answer: The new card is valid and has been updated to protect against identity theft; she should destroy her old card. Question 5: Mrs. Willard wants to know how Original Medicare compares to a Medicare Health Plan's benefits package. What can you tell her? Answer: Medicare Health Plans may offer extra benefits like vision, hearing, and dental services not covered by Original Medicare, but must include a maximum out-of-pocket limit on Part A and Part B services. Question 6: Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what Medicare Supplemental Insurance provides. What can you tell him? Answer: Medicare Supplemental Insurance covers Part A and Part B cost sharing in Original FFS Medicare and may also cover services not covered by Medicare. Question 7: Chen will be 65 soon and is concerned about qualifying for Part A coverage despite being a US citizen. 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. Question 8: Mr. Bauer was declared disabled 18 months ago and has been receiving disability payments. Can he obtain coverage under Medicare? What should you tell him? Answer: He will be automatically enrolled in Medicare after receiving disability payments for 24 months, regardless of age. Question 9: Mr. Denton has end-stage renal disease and will start dialysis soon. Can he obtain coverage under Medicare? What should you tell him? Answer: He can sign up for Medicare at any time, with coverage usually starting on the fourth month after dialysis treatments begin. Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for the Part D low-income subsidy. Where might he turn for help with his prescription drug costs? ️Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program. 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 as a result of an illness. In general terms, what could you tell him about his costs for inpatient hospital services under Original Medicare? ️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 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? ️Medicare will cover Mrs. Shields' skilled nursing services provided during the first 20 days of her stay, after which she would have a coinsurance until she has been in the facility for 100 days 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? ️Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime. Mrs. Quinn has recently turned 66 and decided after many years of work to begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn and received a letter informing her that she has been automatically enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn? ️Part B primarily covers physician services. She will be paying a monthly premium and, with the exception of many preventive and screening tests, generally will have 20%