AHIP FINAL
AHIP FINAL EXAM WITH
QUESTIONS AND CORRECT
ANSWERS/RATED A+
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? - ANS
>>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.
Mrs. West wears glasses and dentures and has enjoyed
considerable pain relief from arthritis through massage
therapy. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her? - ANS
>>Medicare does not cover massage therapy, or, in general,
glasses or dentures.
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
,AHIP FINAL
can help with Medicare costs for which she is responsible.
, AHIP FINAL
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.
Mrs. Gonzalez is enrolled in Original Medicare and has a
Medigap policy as well, but it provides no drug coverage. She
would like to keep the coverage she has but replace her
existing Medigap plan with one that provides drug coverage.
What should you tell her? - ANS >>Mrs. Gonzalez cannot
purchase a Medigap plan that covers drugs, but she could keep
her Medigap policy and enroll in a Part D prescription drug
plan.
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 treatments start.
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.
AHIP FINAL EXAM WITH
QUESTIONS AND CORRECT
ANSWERS/RATED A+
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? - ANS
>>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.
Mrs. West wears glasses and dentures and has enjoyed
considerable pain relief from arthritis through massage
therapy. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her? - ANS
>>Medicare does not cover massage therapy, or, in general,
glasses or dentures.
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
,AHIP FINAL
can help with Medicare costs for which she is responsible.
, AHIP FINAL
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.
Mrs. Gonzalez is enrolled in Original Medicare and has a
Medigap policy as well, but it provides no drug coverage. She
would like to keep the coverage she has but replace her
existing Medigap plan with one that provides drug coverage.
What should you tell her? - ANS >>Mrs. Gonzalez cannot
purchase a Medigap plan that covers drugs, but she could keep
her Medigap policy and enroll in a Part D prescription drug
plan.
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 treatments start.
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.
