AHIP Final Exam 2024 Newest/ Questions with
Correct Verified Answers/ Graded A+
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? - Correct Answer - Medicare will cover a total of
190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
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? - Correct Answer - Medicare will cover a total of
190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
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 Answer - Mrs. Duarte should file and
appeal of this initial determination within 120 days of the date she received
the MSN in the mail
Your friend's mother just moved to an assisted living facility and he asked if
you could present a program for the residents about the MA-PD plans you
market. What could you tell him? - Correct Answer - You appreciate the
opportunity and would be happy to schedule an appointment with anyone
at their request.
pg. 1
, Mrs. Andrews asked how a Private Fee-for-Service (PFFS) plan might
affect her access to services since she receives some assistance for her
health care costs from the State. What should you tell her? - Correct
Answer - Medicaid may provide additional benefits, but Medicaid will
coordinate benefits only with Medicaid participating providers.
Mrs. Schmidt is moving and a friend told her she might qualify for a
"Special Election Period" to enroll in a new Medicare Advantage plan. She
contacted you to ask what a Special Election Period is. What could you tell
her? - Correct Answer - It is a time period, outside of the Annual Election
Period, when a Medicare beneficiary can select a new or different Medicare
Advantage and/or Part D prescription drug plan. Typically the Special
Election Period is beneficiary specific and results from events, such as
when the beneficiary moves outside of the service area.
Mrs. Quinn has just turned 65, is in excellent health, and has a relatively
high income. She uses no medications and sees no reason to spend
money on a Medicare prescription drug plan if she does not need the
coverage. What could you tell her about the implications of such a
decision? - Correct Answer - If she does not sign up for a Medicare
prescription drug plan as soon as she is eligible to do so, if she does sign
up at a later date, her premium will be permanently increased by 1% of the
national average premium for every month that she was not covered.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should you
tell her? - Correct Answer - Mrs. Ramos can obtain care from any provider
who participates in Original Medicare, but generally will have a higher cost-
sharing amount if she sees a provider who/that is not part of the PPO
network.
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
pg. 2
Correct Verified Answers/ Graded A+
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? - Correct Answer - Medicare will cover a total of
190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
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? - Correct Answer - Medicare will cover a total of
190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
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 Answer - Mrs. Duarte should file and
appeal of this initial determination within 120 days of the date she received
the MSN in the mail
Your friend's mother just moved to an assisted living facility and he asked if
you could present a program for the residents about the MA-PD plans you
market. What could you tell him? - Correct Answer - You appreciate the
opportunity and would be happy to schedule an appointment with anyone
at their request.
pg. 1
, Mrs. Andrews asked how a Private Fee-for-Service (PFFS) plan might
affect her access to services since she receives some assistance for her
health care costs from the State. What should you tell her? - Correct
Answer - Medicaid may provide additional benefits, but Medicaid will
coordinate benefits only with Medicaid participating providers.
Mrs. Schmidt is moving and a friend told her she might qualify for a
"Special Election Period" to enroll in a new Medicare Advantage plan. She
contacted you to ask what a Special Election Period is. What could you tell
her? - Correct Answer - It is a time period, outside of the Annual Election
Period, when a Medicare beneficiary can select a new or different Medicare
Advantage and/or Part D prescription drug plan. Typically the Special
Election Period is beneficiary specific and results from events, such as
when the beneficiary moves outside of the service area.
Mrs. Quinn has just turned 65, is in excellent health, and has a relatively
high income. She uses no medications and sees no reason to spend
money on a Medicare prescription drug plan if she does not need the
coverage. What could you tell her about the implications of such a
decision? - Correct Answer - If she does not sign up for a Medicare
prescription drug plan as soon as she is eligible to do so, if she does sign
up at a later date, her premium will be permanently increased by 1% of the
national average premium for every month that she was not covered.
Mrs. Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should you
tell her? - Correct Answer - Mrs. Ramos can obtain care from any provider
who participates in Original Medicare, but generally will have a higher cost-
sharing amount if she sees a provider who/that is not part of the PPO
network.
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
pg. 2
