AHIP FINAL EXAM WITH 100% C0RRECT QUESTIONS AND ANSWERS

AHIP FINAL EXAM WITH 100% C0RRECT QUESTIONS AND ANSWERS Mr. ,Lopez ,has ,heard ,that ,he, can ,sign ,up ,for ,a, product ,called ,"Medicare ,Advantage" ,but ,is ,not ,sure, about ,what ,type ,of ,plan ,designs ,are,available ,through ,this ,program. ,What should ,you ,tell ,him ,about ,the ,types ,of ,health ,plans ,that ,are,available ,through ,the,Medicare,Advantage,program?correct ,answersThey ,are,Medicare,health,plans,such,as,HMOs, ,PPOs, ,PFFS, ,and ,MSAs. Mr. ,Sanchez ,has ,just ,turned ,65 ,and ,is ,entitled ,to ,Part ,A ,but ,has ,not ,enrolled ,in ,Part ,B because ,he,has ,coverage ,through ,an ,employer ,plan. ,If ,he,wants ,to ,enroll ,in ,a,Medicare Advantage ,plan, ,what ,will ,he,have ,to ,do?correct ,answersHe ,will ,have,to,enroll ,in,Part ,B. Mr., Moy’s, wife ,has ,a ,Medicare,Advantage ,plan, ,but ,he,wants ,to ,understand ,what coverage ,Medicare,Supplemental ,Insurance,provides ,since ,his ,health,care,needs ,are, different ,from ,his,wife's ,needs. ,What ,could,you ,tell ,Mr. ,Moy? correct ,answers Medicare,Supplemental ,Insurance,would,help ,cover ,his ,Part ,A ,and ,Part ,B ,deductibles ,or coinsurance ,in ,Original ,Fee-for-Service ,(FFS) ,Medicare ,as ,well ,as ,possibly ,some services ,that ,Medicare ,does ,not ,cover. Mrs. ,Peňa,is ,66 ,years ,old, ,has ,coverage ,under ,an ,employer ,plan, ,and ,will ,retire ,next year. ,She,heard ,she,must ,enroll ,in ,Part ,B ,at ,the ,beginning ,of ,the,year ,to,ensure,no,gap,in,coverage. ,What ,can,you,tell ,her?correct ,answersShe ,may ,enroll ,at ,any ,time,while ,she ,is ,covered ,under ,her ,employer ,plan, ,but ,she ,will ,have ,a ,special ,eight-month enrollment ,period ,after ,the ,last ,month ,on ,her ,employer ,plan ,that ,differs ,from ,the,standard ,general ,enrollment ,period, ,during ,which,she,may ,enroll ,in,Medicare,Part ,B. 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?correct ,answersMost ,individuals ,who ,are,citizens ,and ,age ,65 ,or ,over ,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. Mrs. ,Gonzalez ,is ,enrolled ,in ,Original ,Medicare,and ,has ,a,Medigap ,policy ,as ,well, ,but ,it provides ,no ,drug ,coverage. ,She ,would ,like ,to ,keep ,the ,coverage ,she,has ,but ,replace her ,existing ,Medigap ,plan ,with ,one,that ,provides ,drug,coverage. ,What ,should ,you,tell ,her?correct ,answersMrs. ,Gonzalez ,cannot ,purchase,a,Medigap,plan,that ,covers ,drugs,,but ,she,could ,keep ,her ,Medigap ,policy ,and ,enroll ,in ,a,Part ,D ,prescription ,drug ,plan. Mrs. ,West ,wears ,glasses ,and ,dentures ,and ,has ,enjoyed ,considerable ,pain ,relief ,from arthritis ,through ,massage ,therapy. ,She,is ,concerned ,about ,whether ,or,not ,Medicare,will,cover ,these,items,and,services. ,What ,should ,you ,tell ,her?correct ,answersMedicare does ,not ,cover ,massage ,therapy, ,or, ,in ,general, ,glasses ,or ,dentures. 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?correct ,answersUnder ,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. Ms. ,Henderson ,believes ,that ,she,will ,qualify ,for ,Medicare ,Coverage,when ,she,turns ,65, ,without ,paying ,any ,premiums, ,because ,she,has ,been ,working ,for ,40 ,years ,and ,paying ,Medicare ,taxes. ,What ,should ,you ,tell ,her?correct ,answersTo ,obtain ,Part ,B ,coverage, she,must ,pay ,a,standard ,monthly ,premium, ,though,it ,is,higher ,for ,individuals ,with,higher,incomes. Mr. ,Alonso ,receives ,some ,help ,paying ,for ,his ,two ,generic ,prescription ,drugs ,from ,his employer's ,retiree ,coverage, ,but ,he ,wants ,to ,compare ,it ,to ,a ,Part ,D ,prescription ,drug plan. ,He,asks ,you ,what ,costs ,he,would ,generally ,expect ,to ,encounter ,when ,enrolling into ,a,standard ,MedicarePart ,D ,prescription,drug,plan. ,What ,should,you,tell ,him?correct,answers,He ,generally ,would ,pay ,a ,monthly ,premium, ,annual ,deductible, ,and ,per-prescription ,costsharing. Mr. ,Davis ,is ,52,years ,old ,and ,has ,recently ,been ,diagnosed ,with ,end-stage ,renal ,disease,(ESRD) ,and,will ,soon,begin,dialysis. ,He,is ,wondering,if ,he ,can ,obtain ,coverage ,under Medicare. ,What ,should ,you ,tell ,him?correct ,answersHe ,may ,sign-up ,for ,Medicare ,at any ,time ,however ,coverage ,usually ,begins ,on ,the,fourth ,month ,after ,dialysis ,treatments start. Juan ,Perez, ,who ,is ,turning ,age,65 ,next ,month, ,intends ,to ,work ,for ,several ,more,years ,at,Smallcap, ,Incorporated. ,Smallcap,has ,a,workforce,of15 ,employees ,and ,offers employer-sponsored ,healthcare ,coverage. ,Juan ,is ,a,naturalized ,citizen ,and ,has contributed ,to ,the ,Medicare ,system ,for ,over ,20 ,years. ,Juan ,asks ,you ,if ,he ,will ,be entitled ,to ,Medicare ,and ,if ,he,enrolls ,how ,that ,will ,impact ,his ,employer-sponsored healthcare ,coverage. ,How ,would ,you ,respond?correct ,answersJuan ,is ,likely ,to ,be eligible ,for ,Medicare ,once ,he ,turns ,age,65 ,and,if ,he,enrolls ,Medicare,would,become,the,primary ,payor ,of ,his ,healthcare ,claims ,and ,Smallcap ,does ,not ,have ,to ,continue ,to ,offerhim ,coverage ,comparable ,to ,those ,under ,age ,65 ,under ,its ,employer- sponsored ,group ,health ,plan. Ms. ,Moore ,plans ,to ,retire ,when ,she,turns ,65 ,in ,a,few ,months. ,She ,is ,in ,excellent ,health and ,will ,have ,considerable ,income ,when ,she,retires. ,She ,is ,concerned ,that ,her ,income will ,make,it ,impossible ,for ,her ,to ,qualify ,for ,Medicare. ,What ,could,you,tell ,her ,to,address,her ,concern?correct ,answersMedicare ,is ,a ,program ,for ,people ,age ,65 ,or ,older ,and those,under ,age ,65 ,with ,certain ,disabilities, ,end-stage ,renal ,disease, ,and ,Lou ,Gehrig'sdisease ,so ,she ,will ,be ,eligible ,for ,Medicare. 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?correct ,answersBeneficiaries ,under,Original ,Medicare,have,no ,cost-sharing ,for ,most ,preventive ,services ,which ,include immunizations ,such ,as ,annual ,flu ,shots. Mrs. ,Duarte ,is ,enrolled ,in ,Original ,Medicare ,Parts ,A ,and ,B. ,She,has ,recently ,reviewed her ,Medicare ,Summary ,Notice ,(MSN) ,and ,disagrees ,with ,a,determination ,that ,partially denied ,one,of ,her ,claims ,for ,services. ,What ,advice ,would ,you ,give,her?correct answersMrs. ,Duarte ,should ,file,an ,appeal ,of ,this ,initial ,determination,within,120 ,days ,of,the,date ,she,received ,the ,MSN ,in ,the ,mail