Ahip 2025 Module 1
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? - ANS Beneficiaries under Original Medicare have no
cost-sharing for most preventive services
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social
Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What
should you tell Mrs. Quinn? - ANS Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive screening and tests, generally will
have 20 percent co-payments for these services in addition to an annual deductible
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? - ANS He may sign up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatment
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? - ANS He generally would pay a monthly
premium, annual deductible, and per-prescription cost sharing.
Ms. Brooks has an aggressive cancer and would like to know if Medicare will cover hospice
services in case she needs them. What should you tell her? - ANS Medicare covers hospice
services and they will be available to her.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - ANS She should contact her state Medicaid agency to see if she
qualifies for one of several programs that can help with Medicare costs for which she is
responsible.
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? - ANS Mrs. Duarte should file an
appeal of this initial determination within 120 days of the date she received the MSN in the mail.
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
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? - ANS Beneficiaries under Original Medicare have no
cost-sharing for most preventive services
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social
Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What
should you tell Mrs. Quinn? - ANS Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive screening and tests, generally will
have 20 percent co-payments for these services in addition to an annual deductible
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? - ANS He may sign up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatment
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? - ANS He generally would pay a monthly
premium, annual deductible, and per-prescription cost sharing.
Ms. Brooks has an aggressive cancer and would like to know if Medicare will cover hospice
services in case she needs them. What should you tell her? - ANS Medicare covers hospice
services and they will be available to her.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - ANS She should contact her state Medicaid agency to see if she
qualifies for one of several programs that can help with Medicare costs for which she is
responsible.
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? - ANS Mrs. Duarte should file an
appeal of this initial determination within 120 days of the date she received the MSN in the mail.
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
