AHIP Medicare Training Module 1 Final Review Revision Question And Answers 100% Correct.

What impact, if any, have recent regulatory changes had upon Medigap plans? A. The Part A deductible is no longer covered under Medigap plans for all enrollees starting January 1, 2020. B. The Part A deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020. C. The Part B deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020. D. The Part B deductible is now covered for some newly eligible individuals depending on their financial status. - correct answer C. The Part B deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020. Explanation: Starting January 1, 2020, Medigap plans sold to individuals who are newly eligible to Medicare are no longer allowed to cover the Part B deductible. If an individual already had one of the plans before January 1, 2020, they can keep their plan. If an individual was eligible for Medicare before January 1, 2020, but are not yet enrolled, he or she may be able to purchase one of these plans. Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare enrollment period because features of Part D might have changed. Mrs. Geisler can't remember what Part D is so she called you to ask what her neighbor was talking about. What could you tell her? A. Part D covers hospital and home health services and the cost-sharing has changed this year. B. Part D covers physician and non-physician practitioner services and the deductible has not changed this year, but the physician charges may go up. C. Part D covers prescription drugs and she should look at her premiums, formulary, and cost-sharing among other factors to see if they have changed. D. Part D covers long-term care services and she shouldn't worry because there has been no change in coverage. - correct answer C. Part D covers prescription drugs and she should look at her premiums, formulary, and cost-sharing among other factors to see if they have changed. Explanation: Part D provides prescription drug coverage. Premiums, plan formularies, and cost-sharing, among other factors, may change from one plan year to another. 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? A. Medicare will cover an unlimited number of days in a skilled-nursing facility, as long as a physician certifies that such care is needed. B. Mrs. Shields will have to apply for Medicaid to have her skilled nursing services covered because Medicare does not provide such a benefit. C. Once she has expended her liquid assets, Medicare will cover 80% of Mrs. Shield's long-term care costs. D. Medicare will cover Mrs. Shield's skilled nursing services provided during the first 20 days of her stay, after which she would have a copay until she has been in the f - correct answer D. Medicare will cover Mrs. Shield's skilled nursing services provided during the first 20 days of her stay, after which she would have a copay until she has been in the facility for 100 days. Explanation: Mrs. Shields has experienced a long hospital stay, over the 3-day time period to qualify for skilled nursing and rehabilitative care benefits under Medicare. 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? A. Medicare inpatient psychiatric coverage is limited to the same number of days covered for typical inpatient stays. B. Inpatient psychiatric services are not covered under Original Medicare. C. Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime. D. Medicare will cover, at its allowable amount, as many stays as are needed throughout Mr. Rainey's life, as long as no single stay exceeds 190 days. - correct answer C. Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime. Explanation: Medicare Part A provides coverage for inpatient psychiatric care for up to 190 lifetime days. Mr. Buck has several family members who died from different cancers. He wants to know if Medicare covers cancer screening. What should you tell him? A. Medicare covers treatments for existing disease, injury, and malformed limbs or body parts. As such, it does not cover any screening tests and these must be paid for by the beneficiary out-of-pocket. B. Medicare covers all screening tests that have been approved by the FDA on a frequency determined by the treating physician. C. Medicare covers the periodic performance of a range of screening tests that are meant to provide early detection of disease. Mr. Buck will need to check specific tests before obtaining them to see if they will be covered. D. Medicare covers some screening tests that must be performed within the first year after enrollment. Beyond that point expenses for screening tests are the responsibility of the beneficiary. - correct answer C. Medicare covers the periodic performance of a range of screening tests that are meant to provide early detection of disease. Mr. Buck will need to check specific tests before obtaining them to see if they will be covered. Explanation: Original Medicare and Medicare Advantage plans cover most preventive services, such as screening tests, but beneficiaries must confirm coverage of specific tests with their plans. Madeline Martinez was widowed several years ago. Her husband worked for many years and contributed into the Medicare system. He also left a substantial estate which provides Madeline with an annual income of approximately $130,000. Madeline, who has only worked part-time for the last three years, will soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for advice. What should you tell her? A. You should tell Madeline that she will be able to enroll in both Medicare Part A and Part B without paying monthly premiums due to her husband's long work record and participation in the Medicare system. B. You should tell Madeline that she will need to pay premiums for Part A because of her short work history. You should also tell Madeline that she will pay part B premiums at the highest rate because her income over the last several years has exceeded $100,000. C. You should tell Madeline that she will b - correct answer C. You should tell Madeline that she will be able to enroll in Medicare Part A without paying monthly premiums due to her husband's long work record and participation in the Medicare system. You should also tell Madeline that she will pay Part B premiums at more than the standard lowest rate but less than the highest rate due to her substantial income. Explanation: Madeline will be able to enroll in premium-free Part A due to her husband's work record. She will pay a premium for Part B coverage based on her income level (her income-related monthly adjustment amount [IRMMA]). An income level of $100,000 would mean Mrs. Martinez would pay a premium more than the standard (lowest) amount but not the highest level which looks at incomes above $500,000 for those filing individual income tax returns. Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through acupuncture. She is concerned about whether or not Medicare will cover these items and services. What should you tell her? A. Medicare does not cover massage therapy, or, in general, glasses or dentures. B. Medicare covers 80% of the cost of these three services. C. Medicare covers glasses, but not dentures or massage therapy. D. Medicare covers 50% of the cost of these three services. - correct answer A. Medicare does not cover massage therapy, or, in general, glasses or dentures.