PY2027 AHIP Module 1-5 Review & Final
assessment
,Jason is experiencing paranoid delusions and his physician feels that he
should be hospitalized. What should you tell Jason (or his representative)
about the length of an inpatient psychiatric hospital stay that Medicare will
cover? - correct ans:Medicare will cover a total of 190 days of inpatient
psychiatric care during Jason's entire lifetime.
Mr. Harvey would like to purchase a Medicare Advantage (MA) plan and a
Medigap plan to pick up costs not covered by that plan. What should you tell
him? - correct ans:It is illegal for you to sell Mr. Harvey a Medigap plan if he is
enrolled in an MA plan, and besides, Medigap only works with Original
Medicare.
Kevin Birch enrolled in Original Medicare (Parts A and B). Mr. Birch has been
receiving rehabilitation services in a skilled nursing facility. He calls you to
say that he has just received a notice that Medicare will no longer cover his
stay and he still cannot walk properly. He thinks they are ending his services
too soon. What do you tell him? - correct ans:He should follow the directions
on the notice to file a fast appeal. Mr. Birch should file it by noon of the
calendar day following receipt of the provider's notice of termination of
services.
Mr. Ray would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him? - correct ans:Mr. Ray
can enroll in a stand-alone prescription drug plan and continue to be covered
for Part A and Part B services through Original Fee-for-Service Medicare.
Mrs. Sanders 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 under Part A because she
was not born in the United States. What should you tell her? - correct
ans:Most individuals who are citizens and age 65 or over are covered under
Part A by virtue of having paid Medicare taxes while working, though some
may be covered as a result of paying monthly premiums.
, Mr. Bell 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? - correct ans:He may
sign up for Medicare at any time; however, coverage usually begins on the
fourth month after dialysis treatments start.
Mrs. Larson 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? - correct ans:Mrs. Larson cannot
purchase a Medigap plan that covers drugs, but she could keep her Medigap
policy and enroll in a Part D prescription drug plan.
What impact, if any, have recent regulatory changes had on Medigap plans? -
correct ans:The Part B deductible is no longer covered for individuals newly
eligible for Medicare starting January 1, 2020.
Jane's neighbor told her she should look at her Part D options during the
annual Medicare enrollment period because the features of Part D might
have changed. Jane can't remember what Part D is so she called you to ask
what her neighbor was talking about. What could you tell her? - correct
ans:Part D covers prescription drugs and she should look at her premiums,
formulary, and cost-sharing among other factors to see if they have
changed.
Joan and Loretta are both enrolled in Medicare. Joan pays a premium for Part
A coverage. Loretta does not. Which of the following statements best
explains this difference? - correct ans:Joan worked only a short time and did
not accumulate sufficient work credits. Loretta worked for well over 10 years
accumulating credit for more than 40 quarters of contributions to the
Medicare program.
Mary Alice is covered by Original Medicare Parts A and B. During her initial
enrollment period she purchased a standard Medigap Plan A policy from you
assessment
,Jason is experiencing paranoid delusions and his physician feels that he
should be hospitalized. What should you tell Jason (or his representative)
about the length of an inpatient psychiatric hospital stay that Medicare will
cover? - correct ans:Medicare will cover a total of 190 days of inpatient
psychiatric care during Jason's entire lifetime.
Mr. Harvey would like to purchase a Medicare Advantage (MA) plan and a
Medigap plan to pick up costs not covered by that plan. What should you tell
him? - correct ans:It is illegal for you to sell Mr. Harvey a Medigap plan if he is
enrolled in an MA plan, and besides, Medigap only works with Original
Medicare.
Kevin Birch enrolled in Original Medicare (Parts A and B). Mr. Birch has been
receiving rehabilitation services in a skilled nursing facility. He calls you to
say that he has just received a notice that Medicare will no longer cover his
stay and he still cannot walk properly. He thinks they are ending his services
too soon. What do you tell him? - correct ans:He should follow the directions
on the notice to file a fast appeal. Mr. Birch should file it by noon of the
calendar day following receipt of the provider's notice of termination of
services.
Mr. Ray would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him? - correct ans:Mr. Ray
can enroll in a stand-alone prescription drug plan and continue to be covered
for Part A and Part B services through Original Fee-for-Service Medicare.
Mrs. Sanders 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 under Part A because she
was not born in the United States. What should you tell her? - correct
ans:Most individuals who are citizens and age 65 or over are covered under
Part A by virtue of having paid Medicare taxes while working, though some
may be covered as a result of paying monthly premiums.
, Mr. Bell 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? - correct ans:He may
sign up for Medicare at any time; however, coverage usually begins on the
fourth month after dialysis treatments start.
Mrs. Larson 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? - correct ans:Mrs. Larson cannot
purchase a Medigap plan that covers drugs, but she could keep her Medigap
policy and enroll in a Part D prescription drug plan.
What impact, if any, have recent regulatory changes had on Medigap plans? -
correct ans:The Part B deductible is no longer covered for individuals newly
eligible for Medicare starting January 1, 2020.
Jane's neighbor told her she should look at her Part D options during the
annual Medicare enrollment period because the features of Part D might
have changed. Jane can't remember what Part D is so she called you to ask
what her neighbor was talking about. What could you tell her? - correct
ans:Part D covers prescription drugs and she should look at her premiums,
formulary, and cost-sharing among other factors to see if they have
changed.
Joan and Loretta are both enrolled in Medicare. Joan pays a premium for Part
A coverage. Loretta does not. Which of the following statements best
explains this difference? - correct ans:Joan worked only a short time and did
not accumulate sufficient work credits. Loretta worked for well over 10 years
accumulating credit for more than 40 quarters of contributions to the
Medicare program.
Mary Alice is covered by Original Medicare Parts A and B. During her initial
enrollment period she purchased a standard Medigap Plan A policy from you
