AHIP -MODULES 1-5 EXAM QUESTIONS 2025\26 |
GUARANTEED ACCURATE ANSWERS |COMPLETE!!
Terms in this set (105)
Mr. Capadona would like to It is illegal for you to sell Mr. Capadona a Medigap plan if he is
purchase a Medicare Advantage enrolled in an MA plan, and besides, Medigap only works with
(MA) plan and a Medigap Original Medicare.
plan to pick up costs not
covered by that plan. What
should you tell him?
Agent John Miller is meeting Tell prospect Jerry Smith that he should consider adding a
with Jerry Smith, a new prospect. standalone Part D prescription drug coverage policy to his
Jerry is currently enrolled in present coverage.
Medicare Parts A and B.
Jerry has also purchased a
Medicare Supplement
(Medigap) plan which he has
had for several years.
However, the plan does
not provide drug benefits. How
would you advise Agent John
Miller to proceed?
,Mr. Wu is eligible for Medicare. Mr. Wu may still qualify for help in paying Part D costs through
He has limited financial his State Pharmaceutical Assistance Program (SPAP).
resources but failed to qualify
for the Part D low-income
subsidy. Where might he turn for
help with his prescription
drug costs?
Mr. Vasquez is in good Under Original Medicare, there is a single deductible amount
health and is preparing a due for the first 60 days of any inpatient hospital stay, after
budget in anticipation of his which it converts into a per-day coinsurance amount through day
retirement 90.
when he turns 66. He wants to After day 90, he would pay a daily amount up to 60 days over
understand the health care his lifetime, after which he would be responsible for all costs.
costs he might be exposed to
under Medicare if he were to
require hospitalization because
of an illness. In general terms,
what could you tell him about
his costs for inpatient hospital
services under Original
Medicare?
,Mr. Moy will soon turn age 65. Medicare Supplemental Insurance would help cover his Part A
He is slightly younger than deductible and Part B coinsurance or copayments in Original
his wife. Mr. Moy's wife has Fee-for-Service (FFS) Medicare as well as possibly some services
a that Medicare does not cover.
Medicare Advantage plan, but
he wants to understand
what coverage Medicare
Supplemental Insurance
provides since his health care
needs are different from his
wife's needs. What could you
tell Mr. Moy?
, Juan Perez, who is turning age Juan is likely to be eligible for Medicare once he turns age 65
65 next month, intends to work and if he enrolls, Medicare would become the primary payor
for several more years at of his healthcare claims and Smallcap does not have to
Smallcap, Incorporated. continue to offer him coverage comparable to those under age
Smallcap has a workforce of 15 65 under its employer-sponsored group health plan. Juan is
employees and offers likely to be
employer-sponsored healthcare eligible for Medicare once he turns age 65 and if he enrolls,
coverage. Juan is a naturalized Medicare would become the primary payor of his healthcare
citizen and has contributed to claims but Smallcap must continue to offer him coverage under
the Medicare system for over 20 its employer-sponsored group health plan and would become a
years. Juan asks you if he will be secondary payor.
entitled to Medicare and if he
enrolls how that will impact
his employer- sponsored
healthcare coverage. How
would you respond?
GUARANTEED ACCURATE ANSWERS |COMPLETE!!
Terms in this set (105)
Mr. Capadona would like to It is illegal for you to sell Mr. Capadona a Medigap plan if he is
purchase a Medicare Advantage enrolled in an MA plan, and besides, Medigap only works with
(MA) plan and a Medigap Original Medicare.
plan to pick up costs not
covered by that plan. What
should you tell him?
Agent John Miller is meeting Tell prospect Jerry Smith that he should consider adding a
with Jerry Smith, a new prospect. standalone Part D prescription drug coverage policy to his
Jerry is currently enrolled in present coverage.
Medicare Parts A and B.
Jerry has also purchased a
Medicare Supplement
(Medigap) plan which he has
had for several years.
However, the plan does
not provide drug benefits. How
would you advise Agent John
Miller to proceed?
,Mr. Wu is eligible for Medicare. Mr. Wu may still qualify for help in paying Part D costs through
He has limited financial his State Pharmaceutical Assistance Program (SPAP).
resources but failed to qualify
for the Part D low-income
subsidy. Where might he turn for
help with his prescription
drug costs?
Mr. Vasquez is in good Under Original Medicare, there is a single deductible amount
health and is preparing a due for the first 60 days of any inpatient hospital stay, after
budget in anticipation of his which it converts into a per-day coinsurance amount through day
retirement 90.
when he turns 66. He wants to After day 90, he would pay a daily amount up to 60 days over
understand the health care his lifetime, after which he would be responsible for all costs.
costs he might be exposed to
under Medicare if he were to
require hospitalization because
of an illness. In general terms,
what could you tell him about
his costs for inpatient hospital
services under Original
Medicare?
,Mr. Moy will soon turn age 65. Medicare Supplemental Insurance would help cover his Part A
He is slightly younger than deductible and Part B coinsurance or copayments in Original
his wife. Mr. Moy's wife has Fee-for-Service (FFS) Medicare as well as possibly some services
a that Medicare does not cover.
Medicare Advantage plan, but
he wants to understand
what coverage Medicare
Supplemental Insurance
provides since his health care
needs are different from his
wife's needs. What could you
tell Mr. Moy?
, Juan Perez, who is turning age Juan is likely to be eligible for Medicare once he turns age 65
65 next month, intends to work and if he enrolls, Medicare would become the primary payor
for several more years at of his healthcare claims and Smallcap does not have to
Smallcap, Incorporated. continue to offer him coverage comparable to those under age
Smallcap has a workforce of 15 65 under its employer-sponsored group health plan. Juan is
employees and offers likely to be
employer-sponsored healthcare eligible for Medicare once he turns age 65 and if he enrolls,
coverage. Juan is a naturalized Medicare would become the primary payor of his healthcare
citizen and has contributed to claims but Smallcap must continue to offer him coverage under
the Medicare system for over 20 its employer-sponsored group health plan and would become a
years. Juan asks you if he will be secondary payor.
entitled to Medicare and if he
enrolls how that will impact
his employer- sponsored
healthcare coverage. How
would you respond?
