AHIP FINAL

Mr. Davis is 52 years old and has recently been diagnosed with end stagerenaldisease(ESRD)andwillsoonbegindialysis.Heis wondering if he can obtain coverage under Medicare. What should youtellhim?CorrectAns-Hemaysign-upfor Medicareatany time however coverage usually begins on the fourth month after dialysistreatments start. Juan Perez, who is turning age 65 next month, intends to work for severalmoreyearsatSmallcap,Incorporated.Smallcaphasa workforceof15employeesandoffersemployer-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?CorrectAns-Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medicare would become the primarypayorofhishealthcareclaimsandSmallcapdoesnothave to continue to offer him coverage comparable to those under age 65 underitsemployer-sponsoredgroup healthplan. Mr.Moy'swifehasaMedicareAdvantageplan,buthewantsto understandwhatcoverageMedicareSupplementalInsurance provides since his health care needs are different from his wife's needs.WhatcouldyoutellMr.Moy?CorrectAns-Medicare Supplemental Insurance would help cover his Part A and Part B deductibles or coinsurance in Original Fee-for-Service (FFS) MedicareaswellaspossiblysomeservicesthatMedicaredoesnot 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 ofthe yearto ensurenogapincoverage.Whatcan you tellher?CorrectAns-She may enroll at any time while she is covered under her employer plan, but she will have a special eight monthenrollmentperiodafterthelastmonthonheremployerplan thatdiffersfromthe standardgeneralenrollmentperiod,during