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Examen

AHIP 2025 FINAL EXAM 50 QUESTIONS AND ANSWERS

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AHIP 2025 FINAL EXAM 50 QUESTIONS AND ANSWERS

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AHIP - 2027
fv fv

Studyfvonlinefvatfvhttps://quizlet.com/
_jp65r9
AHIP 2025 FINAL EXAM 50 QUESTIONS AND
ANSWERS

Mrs.fvTurnerfvisfvcomparingfvherfvemployer'sfvretireefvinsurancefvtofvOriginalfvMedicarefvandfvwouldfvlikefvtofvknowfvwhic
hfvoffvthefvfollowingfvservicesfvOriginalfvMedicarefvwillfvcoverfviffvthefvappropriatefvcriteriafvarefvmet.fvWhatfvcouldfvyoufvtel
lfvher?fv-fvanswer--OriginalfvMedicarefvcoversfvambulancefvservices.

Mrs.fvDuartefvisfvenrolledfvinfvOriginalfvMedicarefvPartsfvAfvandfvB.fvShefvhasfvrecentlyfvreviewedfvherfvMedicarefvSumm
aryfvNoticefv(MSN)fvandfvdisagreesfvwithfvafvdeterminationfvthatfvpartiallyfvdeniedfvonefvoffvherfvclaimsfvforfvservices.fvW
hatfvadvicefvwouldfvyoufvgivefvher?fv-fvanswer--
Mrs.fvDuartefvshouldfvfilefvanfvappealfvoffvthisfvinitialfvdeterminationfvwithinfv120fvdaysfvoffvthefvdatefvshefvreceivedfvthefv
MSNfvinfvthefvmail.

Mrs.fvGeisler'sfvneighborfvtoldfvherfvshefvshouldfvlookfvatfvherfvPartfvDfvoptionsfvduringfvthefvannualfvMedicarefvenrollmen
tfvperiodfvbecausefvthefvfeaturesfvoffvPartfvDfvmightfvhavefvchanged.fvMrs.fvGeislerfvcan'tfvrememberfvwhatfvPartfvDfvisfvs
ofvshefvcalledfvyoufvtofvaskfvwhatfvherfvneighborfvwasfvtalkingfvabout.fvWhatfvcouldfvyoufvtellfvher?fv-fvanswer--
PartfvDfvcoversfvprescriptionfvdrugsfvandfvshefvshouldfvlookfvatfvherfvpremiums,fvformulary,fvandfvcost-
sharingfvamongfvotherfvfactorsfvtofvseefviffvtheyfvhavefvchanged.

Mrs.fvParkfvisfvanfvelderlyfvretiree.fvMrs.fvParkfvhasfvafvlowfvfixedfvincome.fvWhatfvcouldfvyoufvtellfvMrs.fvParkfvthatfvmightfv
befvoffvassistance?fv-fvanswer--
ShefvshouldfvcontactfvherfvstatefvMedicaidfvagencyfvtofvseefviffvshefvqualifiesfvforfvonefvoffvseveralfvprogramsfvthatfvcanfvh
elpfvwithfvMedicarefvcostsfvforfvwhichfvshefvisfvresponsible.

Mrs.fvQuinnfvrecentlyfvturnedfv66fvandfvdecidedfvafterfvmanyfvyearsfvoffvworkfvtofvretirefvandfvbeginfvreceivingfvSocialfvSe
curityfvbenefits.fvShortlyfvthereafterfvMrs.fvQuinnfvreceivedfvafvletterfvinformingfvherfvthatfvshefvhadfvbeenfvautomaticallyf
venrolledfvinfvMedicarefvPartfvB.fvShefvwantsfvtofvunderstandfvwhatfvthisfvmeans.fvWhatfvshouldfvyoufvtellfvMrs.fvQuinn?fv-

fvanswer--

PartfvBfvprimarilyfvcoversfvphysicianfvservices.fvShefvwillfvbefvpayingfvafvmonthlyfvpremiumfvand,fvexceptfvforfvmanyfvpre
ventivefvandfvscreeningfvtests,fvgenerallyfvwillfvhavefv20%fvco-
paymentsfvforfvthesefvservices,fvinfvadditionfvtofvanfvannualfvdeductible.

AnitafvMagrifvwillfvturnfvagefv65fvinfvAugustfv2023.fvAnitafvintendsfvtofvenrollfvinfvOriginalfvMedicarefvPartfvAfvandfvPartfvB.fv
ShefvwouldfvalsofvlikefvtofvenrollfvinfvafvMedicarefvSupplementfv(Medigap)fvplan.fvAnita'sfvolderfvneighborfvMelfvhasfvtoldfv
herfvaboutfvthefvMedigapfvPlanfvFfvinfvwhichfvhefvisfvenrolled.fvItfvnotfvonlyfvprovidesfvforeignfvtravelfvemergencyfvbenefitsf
vbutfvalsofvcoversfvhisfvMedicarefvPartfvBfvdeductible.fvAnitafvcomesfvtofvyoufvforfvadvice.fvWhatfvshouldfvyoufvtellfvher?fv-

fvanswer--

YoufvarefvsorryfvtofvdisappointfvAnita,fvbutfvafvMedigapfvFfvplanfvisfvnofvlongerfvavailablefvtofvthosefvwhofvturnfvagefv65fvaft
erfvJanuaryfv1,fv2020.fvAnitafvmightfvinsteadfvconsiderfvotherfvMedigapfvplansfvthatfvofferfvforeignfvtravelfvbenefitsfvbutfvd
ofvnotfvcoverfvthefvPartfvBfvdeductible.

Mr.fvSinghfvwouldfvlikefvdrugfvcoveragefvbutfvdoesfvnotfvwantfvtofvbefvenrolledfvinfvafvMedicarefvAdvantagefvplan.fvWhatfvs
houldfvyoufvtellfvhim?fv-fvanswer--Mr.fvSinghfvcanfvenrollfvinfvafvstand-
alonefvprescriptionfvdrugfvplanfvandfvcontinuefvtofvbefvcoveredfvforfvPartfvAfvandfvPartfvBfvservicesfvthroughfvOriginalfvFe
e-for-ServicefvMedicare.


1fv/fv7

, AHIP - 2027
fv fv

Studyfvonlinefvatfvhttps://quizlet.com/
_jp65r9
Mrs.fvChenfvwillfvbefv65fvsoon,fvhasfvbeenfvafvcitizenfvforfvtwelvefvyears,fvhasfvbeenfvemployedfvfullfvtime,fvandfvpaidfvtaxe
sfvduringfvthatfventirefvperiod.fvShefvisfvconcernedfvthatfvshefvwillfvnotfvqualifyfvforfvcoveragefvunderfvpartfvAfvbecausefvsh
efvwasfvnotfvbornfvinfvthefvUnitedfvStates.fvWhatfvshouldfvyoufvtellfvher?fv-fvanswer--
Mostfvindividualsfvwhofvarefvcitizensfvandfvagefv65fvorfvoverfvarefvcoveredfvunderfvPartfvAfvbyfvvirtuefvoffvhavingfvpaidfvMe
dicarefvtaxesfvwhilefvworking,fvthoughfvsomefvmayfvbefvcoveredfvasfvafvresultfvoffvpayingfvmonthlyfvpremiums.

Mr.fvXifvwillfvsoonfvturnfvagefv65fvandfvhasfvcomefvtofvyoufvforfvadvicefvasfvtofvwhatfvservicesfvarefvprovidedfvunderfvOrigin
alfvMedicare.fvWhatfvshouldfvyoufvtellfvMr.fvXifvthatfvbestfvdescribesfvthefvhealthfvcoveragefvprovidedfvtofvMedicarefvbene
ficiaries?fv-fvanswer--BeneficiariesfvunderfvOriginalfvMedicarefvhavefvnofvcost-sharingfvforfvmostfvpreventivefvservices.

Mr.fvBarkerfvenjoysfvafvcomfortablefvretirementfvincome.fvHefvrecentlyfvhadfvsurgeryfvandfvexpectedfvthatfvhefvwouldfvha
vefvcertainfvservicesfvandfvitemsfvcoveredfvbyfvthefvplanfvwithfvminimalfvout-of-pocketfvcostsfvbecausefvhisfvMA-
PDfvcoveragefvhasfvbeenfvveryfvgood.fvHowever,fvwhenfvhefvreceivedfvthefvbill,fvhefvwasfvsurprisedfvtofvseefvlargefvcharg
esfvinfvexcessfvoffvhisfvmaximumfvout-of-
pocketfvlimitfvthatfvincludedfvsomefvservicesfvandfvitemsfvhefvthoughtfvwouldfvbefvfullyfvcovered.fvHefvcalledfvyoufvtofvaskfv
whatfvhefvcouldfvdo?fvWhatfvcouldfvyoufvtellfvhim?fv-fvanswer--
Youfvcanfvofferfvtofvreviewfvthefvplansfvappealfvprocessfvtofvhelpfvhimfvaskfvthefvplanfvtofvreviewfvthefvcoveragefvdecision.

Mr.fvLombardifvisfvinterestedfvinfvafvMedicarefvAdvantagefv(MA)fvPPOfvplanfvthatfvyoufvrepresent.fvItfvisfvonefvoffvthreefvpl
ansfvoperatedfvbyfvthefvsamefvorganizationfvinfvMr.fvLombardi'sfvarea.fvThefvMAfvPPOfvplanfvdoesfvnotfvincludefvdrugfvco
verage,fvbutfvthefvotherfvtwofvplansfvdo.fvMr.fvLombardifvlikesfvthefvPPOfvplanfvthatfvdoesfvnotfvincludefvdrugfvcoveragefva
ndfvintendsfvtofvobtainfvhisfvdrugfvcoveragefvthroughfvafvstand-
alonefvMedicarefvprescriptionfvdrugfvplan.fvWhatfvshouldfvyoufvtellfvhimfvaboutfvthisfvsituation?fv-fvanswer--
HefvcouldfvenrollfveitherfvinfvonefvoffvthefvMAfvplansfvthatfvincludefvprescriptionfvdrugfvcoveragefvorfvOriginalfvMedicarefvw
ithfvafvMedigapfvplanfvandfvstandalonefvPartfvDfvprescriptionfvdrugfvcoverage,fvbutfvhefvcannotfvenrollfvinfvthefvMA-
onlyfvPPOfvplanfvandfvafvstand-alonefvprescriptionfvdrugfvplan.

Mr.fvLopezfvhasfvheardfvthatfvhefvcanfvsignfvupfvforfvafvproductfvcalledfv"MedicarefvAdvantage"fvbutfvisfvnotfvsurefvaboutfvw
hatfvtypefvoffvplanfvdesignsfvarefvavailablefvthroughfvthisfvprogram.fvWhatfvshouldfvyoufvtellfvhimfvaboutfvthefvtypesfvoffvhe
althfvplansfvthatfvarefvavailablefvthroughfvthefvMedicarefvAdvantagefvprogram?fv-fvanswer--
TherefvarefvMedicarefvhealthfvplansfvsuchfvasfvHMOs,fvPPOs,fvPFFS,fvandfvMSAs.

Mr.fvKellyfvwantsfvtofvknowfvwhetherfvhefvisfveligiblefvtofvsignfvupfvforfvafvprivatefvfee-for-
servicefv(PFFS)fvplan.fvWhatfvquestionsfvwouldfvyoufvneedfvtofvaskfvtofvdeterminefvhisfveligibility?fv-fvanswer--
YoufvwouldfvneedfvtofvaskfvMr.fvKellyfviffvhefvisfventitledfvtofvPartfvA,fvenrolledfvinfvPartfvB,fvandfviffvhefvlivesfvinfvthefvPFFSfvpl
an'sfvservicefvarea.

Mr.fvWellsfvisfvtryingfvtofvunderstandfvthefvdifferencefvbetweenfvOriginalfvMedicarefvandfvMedicarefvAdvantage.fvWhatfv
wouldfvbefvthefvcorrectfvdescription?fv-fvanswer--
MedicarefvAdvantagefvisfvafvwayfvoffvcoveringfvallfvthefvOriginalfvMedicarefvbenefitsfvthroughfvprivatefvhealthfvinsurancef
vcompanies.



Mrs.fvLyonsfvisfvinfvgoodfvhealth,fvusesfvafvsinglefvprescription,fvandfvlivesfvindependentlyfvinfvherfvownfvhome.fvShefvisfva
ttractedfvbyfvthefvideafvoffvmaintainingfvcontrolfvoverfvafvMedicalfvSavingsfvAccountfv(MSA)fvbutfvisfvnotfvsurefviffvthefvplanf
vassociatedfvwithfvthefvaccountfvwillfvfitfvherfvneeds.fvWhatfvspecificfvpiecefvoffvinformationfvaboutfvafvMedicarefvMSAfvpla

nfvwouldfvitfvbefvimportantfvforfvherfvtofvknow,fvpriorfvtofvenrollingfvinfvsuchfvafvplan?fv-fvanswer--
AllfvMSAsfvcoverfvPartfvAfvandfvPartfvBfvbenefits,fvbutfvnotfvPartfvDfvprescriptionfvdrugfvbenefits,fvwhichfvcouldfvbefvobtain
edfvbyfvalsofvenrollingfvinfvafvseparatefvprescriptionfvdrugfvplan.

Mrs.fvChoufvlikesfvafvPrivatefvFee-for-
Servicefv(PFFS)fvplanfvavailablefvinfvherfvareafvthatfvdoesfvnotfvincludefvdrugfvcoverage.fvShefvwantsfvtofvenrollfvinfvthefvpl
2fv/fv7

Información del documento

Subido en
2 de julio de 2026
Número de páginas
7
Escrito en
2025/2026
Tipo
Examen
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