AHIP 2024 FINAL EXAM
UPDATED QUESTION AND
VERIFIED ANSWERS A+ GRADED
GUARANTEED PASS
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? - ANSWER-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.
,Mr. Kelly wants to know whether he is eligible to sign up
for a private fee-for-service (PFFS) plan. What questions
would you need to ask to determine his eligibility? -
ANSWER-You would need to ask Mr. Kelly if he is entitled
to Part A, enrolled in Part B, and if he lives in the PFFS
plan's service area.
Mrs. Burton is a retiree with substantial income. She is
enrolled in an MA-PD plan and was disappointed with the
service she received from her primary care physician
because she was told she would have to wait five weeks
to get an appointment when she was feeling ill. She
called you to ask what she could do so she would not
have to put up with such poor access to care. What could
you tell her? - ANSWER-She could file a grievance with
her plan to complain about the lack of timeliness in
getting an appointment.
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? - ANSWER-There are Medicare health plans
such as HMOs, PPOs, PFFS, and MSAs.
Mr. Diaz continued working with his company and was
insured under his employer's group plan until he reached
age 68. He has heard that there is a premium penalty for
those who did not sign up for Part B when first eligible
and wants to know how much he will have to pay. What
should you tell him? - ANSWER-Mr. Diaz will not pay any
penalty because he had continuous coverage under his
employer's plan.
Mrs. Turner is comparing her employer's retiree
insurance to Original Medicare and would like to know
which of the following services Original Medicare will
cover if the appropriate criteria are met. What could you
tell her? - ANSWER-Original Medicare covers ambulance
services.
Mrs. Quinn recently turned 66 and decided after many
years of work to retire and begin receiving Social Security
, benefits. Shortly thereafter Mrs. Quinn received a letter
informing her that she had been automatically enrolled
in Medicare Part B. She wants to understand what this
means. What should you tell Mrs. Quinn? - ANSWER-Part
B primarily covers physician services. She will be paying a
monthly premium and, except for many preventive and
screening tests, generally will have 20% co-payments for
these services, in addition to an annual deductible.
What impact, if any, have recent regulatory changes had
on Medigap plans? - ANSWER-The Part B deductible is no
longer covered for individuals newly eligible for Medicare
starting January 1, 2020.
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 Medicare
Part D prescription drug plan. What should you tell him?
- ANSWER-He generally would pay a monthly premium,
annual deductible, and per-prescription cost-sharing.
UPDATED QUESTION AND
VERIFIED ANSWERS A+ GRADED
GUARANTEED PASS
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? - ANSWER-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.
,Mr. Kelly wants to know whether he is eligible to sign up
for a private fee-for-service (PFFS) plan. What questions
would you need to ask to determine his eligibility? -
ANSWER-You would need to ask Mr. Kelly if he is entitled
to Part A, enrolled in Part B, and if he lives in the PFFS
plan's service area.
Mrs. Burton is a retiree with substantial income. She is
enrolled in an MA-PD plan and was disappointed with the
service she received from her primary care physician
because she was told she would have to wait five weeks
to get an appointment when she was feeling ill. She
called you to ask what she could do so she would not
have to put up with such poor access to care. What could
you tell her? - ANSWER-She could file a grievance with
her plan to complain about the lack of timeliness in
getting an appointment.
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? - ANSWER-There are Medicare health plans
such as HMOs, PPOs, PFFS, and MSAs.
Mr. Diaz continued working with his company and was
insured under his employer's group plan until he reached
age 68. He has heard that there is a premium penalty for
those who did not sign up for Part B when first eligible
and wants to know how much he will have to pay. What
should you tell him? - ANSWER-Mr. Diaz will not pay any
penalty because he had continuous coverage under his
employer's plan.
Mrs. Turner is comparing her employer's retiree
insurance to Original Medicare and would like to know
which of the following services Original Medicare will
cover if the appropriate criteria are met. What could you
tell her? - ANSWER-Original Medicare covers ambulance
services.
Mrs. Quinn recently turned 66 and decided after many
years of work to retire and begin receiving Social Security
, benefits. Shortly thereafter Mrs. Quinn received a letter
informing her that she had been automatically enrolled
in Medicare Part B. She wants to understand what this
means. What should you tell Mrs. Quinn? - ANSWER-Part
B primarily covers physician services. She will be paying a
monthly premium and, except for many preventive and
screening tests, generally will have 20% co-payments for
these services, in addition to an annual deductible.
What impact, if any, have recent regulatory changes had
on Medigap plans? - ANSWER-The Part B deductible is no
longer covered for individuals newly eligible for Medicare
starting January 1, 2020.
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 Medicare
Part D prescription drug plan. What should you tell him?
- ANSWER-He generally would pay a monthly premium,
annual deductible, and per-prescription cost-sharing.
