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AHIP - 2026 - MODULES 1-5 Q AND ANSWERS

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AHIP - 2026 - MODULES 1-5 Q AND ANSWERS

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AHIP - 2027
fv fv

Studyfvonlinefvatfvhttps://quizlet.com/
_jp65r9

AHIP - 2026 - MODULES 1-5 Q AND ANSWERS

Mr.fvCapadonafvwouldfvlikefvtofvpurchasefvafvMedicarefvAdvantagefv(MA)fvplanfvandfvafvMedigapfvplanfvtofvpickfvupfvcost
sfvnotfvcoveredfvbyfvthatfvplan.fvWhatfvshouldfvyoufvtellfvhim?fv-fvanswer--
ItfvisfvillegalfvforfvyoufvtofvsellfvMr.fvCapadonafvafvMedigapfvplanfviffvhefvisfvenrolledfvinfvanfvMAfvplan,fvandfvbesides,fvMedig
apfvonlyfvworksfvwithfvOriginalfvMedicare.

AgentfvJohnfvMillerfvisfvmeetingfvwithfvJerryfvSmith,fvafvnewfvprospect.fvJerryfvisfvcurrentlyfvenrolledfvinfvMedicarefvPartsfv
AfvandfvB.fvJerryfvhasfvalsofvpurchasedfvafvMedicarefvSupplementfv(Medigap)fvplanfvwhichfvhefvhasfvhadfvforfvseveralfvye
ars.fvHowever,fvthefvplanfvdoesfvnotfvprovidefvdrugfvbenefits.fvHowfvwouldfvyoufvadvisefvAgentfvJohnfvMillerfvtofvproceed
?fv-fvanswer--
TellfvprospectfvJerryfvSmithfvthatfvhefvshouldfvconsiderfvaddingfvafvstandalonefvPartfvDfvprescriptionfvdrugfvcoveragefvpo
licyfvtofvhisfvpresentfvcoverage.

Mr.fvWufvisfveligiblefvforfvMedicare.fvHefvhasfvlimitedfvfinancialfvresourcesfvbutfvfailedfvtofvqualifyfvforfvthefvPartfvDfvlow-
incomefvsubsidy.fvWherefvmightfvhefvturnfvforfvhelpfvwithfvhisfvprescriptionfvdrugfvcosts?fv-fvanswer--
Mr.fvWufvmayfvstillfvqualifyfvforfvhelpfvinfvpayingfvPartfvDfvcostsfvthroughfvhisfvStatefvPharmaceuticalfvAssistancefvProgra
mfv(SPAP).

Mr.fvVasquezfvisfvinfvgoodfvhealthfvandfvisfvpreparingfvafvbudgetfvinfvanticipationfvoffvhisfvretirementfvwhenfvhefvturnsfv66.fv
HefvwantsfvtofvunderstandfvthefvhealthfvcarefvcostsfvhefvmightfvbefvexposedfvtofvunderfvMedicarefviffvhefvwerefvtofvrequiref
vhospitalizationfvbecausefvoffvanfvillness.fvInfvgeneralfvterms,fvwhatfvcouldfvyoufvtellfvhimfvaboutfvhisfvcostsfvforfvinpatientfv

hospitalfvservicesfvunderfvOriginalfvMedicare?fv-fvanswer--
UnderfvOriginalfvMedicare,fvtherefvisfvafvsinglefvdeductiblefvamountfvduefvforfvthefvfirstfv60fvdaysfvoffvanyfvinpatientfvhospi
talfvstay,fvafterfvwhichfvitfvconvertsfvintofvafvper-
dayfvcoinsurancefvamountfvthroughfvdayfv90.fvAfterfvdayfv90,fvhefvwouldfvpayfvafvdailyfvamountfvupfvtofv60fvdaysfvoverfvhisf
vlifetime,fvafterfvwhichfvhefvwouldfvbefvresponsiblefvforfvallfvcosts.



Mr.fvMoyfvwillfvsoonfvturnfvagefv65.fvHefvisfvslightlyfvyoungerfvthanfvhisfvwife.fvMr.fvMoy'sfvwifefvhasfvafvMedicarefvAdvanta
gefvplan,fvbutfvhefvwantsfvtofvunderstandfvwhatfvcoveragefvMedicarefvSupplementalfvInsurancefvprovidesfvsincefvhisfvhe
althfvcarefvneedsfvarefvdifferentfvfromfvhisfvwife'sfvneeds.fvWhatfvcouldfvyoufvtellfvMr.fvMoy?fv-fvanswer--
MedicarefvSupplementalfvInsurancefvwouldfvhelpfvcoverfvhisfvPartfvAfvdeductiblefvandfvPartfvBfvcoinsurancefvorfvcopay
mentsfvinfvOriginalfvFee-for-
Servicefv(FFS)fvMedicarefvasfvwellfvasfvpossiblyfvsomefvservicesfvthatfvMedicarefvdoesfvnotfvcover.

JuanfvPerez,fvwhofvisfvturningfvagefv65fvnextfvmonth,fvintendsfvtofvworkfvforfvseveralfvmorefvyearsfvatfvSmallcap,fvIncorpo
rated.fvSmallcapfvhasfvafvworkforcefvoffv15fvemployeesfvandfvoffersfvemployer-
sponsoredfvhealthcarefvcoverage.fvJuanfvisfvafvnaturalizedfvcitizenfvandfvhasfvcontributedfvtofvthefvMedicarefvsystemfvfo
rfvoverfv20fvyears.fvJuanfvasksfvyoufviffvhefvwillfvbefventitledfvtofvMedicarefvandfviffvhefvenrollsfvhowfvthatfvwillfvimpactfvhisfve
mployer-fvsponsoredfvhealthcarefvcoverage.fvHowfvwouldfvyoufvrespond?fv-fvanswer--
JuanfvisfvlikelyfvtofvbefveligiblefvforfvMedicarefvoncefvhefvturnsfvagefv65fvandfviffvhefvenrolls,fvMedicarefvwouldfvbecomefvth
efvprimaryfvpayorfvoffvhisfvhealthcarefvclaimsfvandfvSmallcapfvdoesfvnotfvhavefvtofvcontinuefvtofvofferfvhimfvcoveragefvco
mparablefvtofvthosefvunderfvagefv65fvunderfvitsfvemployer-
sponsoredfvgroupfvhealthfvplan.fvJuanfvisfvlikelyfvtofvbefveligiblefvforfvMedicarefvoncefvhefvturnsfvagefv65fvandfviffvhefvenroll
s,fvMedicarefvwouldfvbecomefvthefvprimaryfvpayorfvoffvhisfvhealthcarefvclaimsfvbutfvSmallcapfvmustfvcontinuefvtofvofferfvh
imfvcoveragefvunderfvitsfvemployer-sponsoredfvgroupfvhealthfvplanfvandfvwouldfvbecomefvafvsecondaryfvpayor.

1fv/
fv14

, AHIP - 2027
fv fv

Studyfvonlinefvatfvhttps://quizlet.com/
_jp65r9
Ms.fvKumarfvplansfvtofvretirefvwhenfvshefvturnsfv65fvinfvafvfewfvmonths.fvShefvisfvinfvexcellentfvhealthfvandfvwillfvhavefvcons
iderablefvincomefvwhenfvshefvretires.fvShefvisfvconcernedfvthatfvherfvincomefvwillfvmakefvitfvimpossiblefvforfvherfvtofvqualif
yfvforfvMedicare.fvWhatfvcouldfvyoufvtellfvherfvtofvaddressfvherfvconcern?fv-fvanswer--
Medicarefvisfvafvprogramfvforfvpeoplefvagefv65fvorfvolderfvandfvthosefvunderfvagefv65fvwithfvcertainfvdisabilities,fvend-
stagefvrenalfvdisease,fvandfvLoufvGehrig'sfvdiseasefvsofvshefvwillfvbefveligiblefvforfvMedicare.

Mrs.fvEllisfvrecentlyfvturnedfv66fvandfvdecidedfvafterfvmanyfvyearsfvoffvworkfvtofvretirefvandfvbeginfvreceivingfvSocialfvSecu
rityfvbenefits.fvShortlyfvthereafterfvMrs.fvEllisfvreceivedfvafvletterfvinformingfvherfvthatfvshefvhadfvbeenfvautomaticallyfvenr
olledfvinfvMedicarefvPartfvB.fvShefvwantsfvtofvunderstandfvwhatfvthisfvmeans.fvWhatfvshouldfvyoufvtellfvMrs.fvEllis?fv-
fvanswer--

PartfvBfvprimarilyfvcoversfvphysicianfvservices.fvShefvwillfvbefvpayingfvafvmonthlyfvpremiumfvand,fvexceptfvforfvmanyfvpre
ventivefvandfvscreeningfvtests,fvgenerallyfvwillfvhavefv20%fvco-
paymentsfvforfvthesefvservices,fvinfvadditionfvtofvanfvannualfvdeductible.

Mr.fvSinghfvwouldfvlikefvdrugfvcoveragefvbutfvdoesfvnotfvwantfvtofvbefvenrolledfvinfvafvMedicarefvAdvantagefvplan.fvWhatfvs
houldfvyoufvtellfvhim?fv-fvanswer--Mr.fvSinghfvcanfvenrollfvinfvafvstand-
alonefvprescriptionfvdrugfvplanfvandfvcontinuefvtofvbefvcoveredfvforfvPartfvAfvandfvPartfvBfvservicesfvthroughfvOriginalfvFe
e-for-ServicefvMedicare.

Mrs.fvCookfvisfvanfvelderlyfvretiree.fvMrs.fvCookfvhasfvafvlowfvfixedfvincome.fvWhatfvcouldfvyoufvtellfvMrs.fvCookfvthatfvmight
fvbefvoffvassistance?fv-fvanswer--

ShefvshouldfvcontactfvherfvstatefvMedicaidfvagencyfvtofvseefviffvshefvqualifiesfvforfvonefvoffvseveralfvprogramsfvthatfvcanfvh
elpfvwithfvMedicarefvcostsfvforfvwhichfvshefvisfvresponsible.

Ms.fvHendersonfvbelievesfvthatfvshefvwillfvqualifyfvforfvMedicarefvCoveragefvwhenfvshefvturnsfv65,fvwithoutfvpayingfvanyfv
premiums,fvbecausefvshefvhasfvbeenfvworkingfvforfv40fvyearsfvandfvpayingfvMedicarefvtaxes.fvWhatfvshouldfvyoufvtellfvhe
r?fv-fvanswer--
TofvobtainfvPartfvBfvcoverage,fvshefvmustfvpayfvafvstandardfvmonthlyfvpremium,fvthoughfvitfvisfvhigherfvforfvindividualsfvwit
hfvhigherfvincomes.

Mr.fvBauerfvisfv49fvyearsfvold,fvbutfveighteenfvmonthsfvagofvhefvwasfvdeclaredfvdisabledfvbyfvthefvSocialfvSecurityfvAdmini
strationfvandfvhasfvbeenfvreceivingfvdisabilityfvpayments.fvHefvisfvwonderingfvwhetherfvhefvcanfvobtainfvcoveragefvunderf
vMedicare.fvWhatfvshouldfvyoufvtellfvhim?fv-fvanswer--

Afterfvreceivingfvsuchfvdisabilityfvpaymentsfvforfv24fvmonths,fvhefvwillfvbefvautomaticallyfvenrolledfvinfvMedicare,fvregardl
essfvoffvage.

Mr.fvSchmidtfvwouldfvlikefvtofvplanfvforfvretirementfvandfvhasfvaskedfvyoufvwhatfvisfvcoveredfvunderfvOriginalfvFee-for-
Servicefv(FFS)fvMedicare.fvWhatfvcouldfvyoufvtellfvhim?fv-fvanswer--
PartfvA,fvwhichfvcoversfvhospital,fvskilledfvnursingfvfacility,fvhospice,fvandfvhomefvhealthfvservicesfvandfvPartfvB,fvwhichfv
coversfvprofessionalfvservicesfvsuchfvasfvthosefvprovidedfvbyfvafvdoctorfvarefvcoveredfvunderfvOriginalfvMedicare.

AnthonyfvBonifacefvturnedfv65fvinfv2024.fvHefvwasfvnotfvreceivingfvSocialfvSecurityfvorfvRailroadfvRetirementfvBenefitsfvo
nfvhisfv65thfvbirthday.fvHefvwasfvinterestedfvinfvobtainingfvMedicarefvcoveragefvandfvisfveligiblefvforfvpremium-
freefvPartfvA.fvBeforefvhefvcouldfvenrollfvinfvMedicare,fvhisfventirefvareafvwasfvimpactedfvbyfvafvhurricanefvcausingfvmassi
vefvfloodingfvandfvseverefvwindfvdamage.fvThefvFederalfvgovernmentfvdeclaredfvthisfvtofvbefvafvnaturalfvdisasterfvwhichfv
hasfvrecentlyfvended.fvDuringfvthisfvperiodfvAnthony'sfvinitialfvenrollmentfvperiodfvexpired.fvAnthonyfvasksfvyoufvhowfvhef
vcanfvnowfvobtainfvMedicarefvcoverage.fvWhatfvshouldfvyoufvsay?fv-fvanswer--

Anthonyfvisfveligiblefvforfvafvspecialfvenrollmentfvperiodfv(SEP)fvbecausefvhefvmissedfvanfvenrollmentfvperiodfvduefvtofvth
efvimpactfvoffvthefvFederallyfvdeclaredfvdisaster.fvThisfvSEPfvwillfvallowfvAnthonyfvtofvenrollfvinfvPartfvBfvupfvtofvsixfvmonths
fvafterfvthefvendfvoffvthefvemergencyfvdeclaration. fvAnthonyfvmayfvenrollfvinfvpremium-

freefvPartfvAfvatfvanyfvtimefvandfvhisfvPartfvAfvcoveragefvwillfvbefvretroactivefvforfvupfvtofv6fvmonths.
2fv/
fv14

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