AHIP STUDY GUIDE

AHIP STUDY GUIDE 2018 – FOR STUDY PURPOSES ONLY KEY WORD SEARCH – HOLD DOWN KEYS “CTRL + F” 1 Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern? Choose one answer. a. Medicare is a program for people who have incomes and assets below specific limits, so you will have to find out her exact financial situation before telling her whether she can obtain Medicare coverage. b. Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end stage renal disease or Lou Gehrig’s disease, so she will be eligible for Medicare. c. Medicare is a program for people of all ages with specific mental health disabilities. Since she is in excellent health, she would not qualify, but should instead look into her state’s Medicaid program if she wants further coverage. d. Eligibility for Medicare is based on whether or not a person has ever been employed by the federal government. If she or her husband were ever employed by the federal government, she can enroll in Medicare. Source: Medicare Program Basics Question2 Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-for-Service (FFS) Medicare? What could you tell him? Choose one answer. a. Part D, which covers prescription drug services, is covered under Original Medicare. b. Part A, which covers long term custodial care services, is covered under Original Medicare. c. Part C, which always covers dental and vision services, is covered under Original Medicare. d. Part A, which covers hospital, skilled nursing facility, hospice and home health services and Part B, which covers professional services such as those provided by a doctor are covered under Original Medicare. Source: Different Ways to Get Medicare Question3 Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan may, at some time in the future, reduce his benefits below what is available in Original Medicare. What should you tell him about his concern? Choose one answer. a. Medicare health plans have the option of deciding, each year, what services they will cover. He is correct that the health plan could eliminate some benefits covered by Medicare and he should think carefully before enrolling in a Medicare health plan. b. He should not be concerned because Medicare health plans must cover all IRS-approved health care expenses, which means that all of them provide substantially greater benefits than are available under Medicare Part A and Part B. c. Medicare health plans must cover all benefits available under Medicare Part A and Part B. Many also cover Part D prescription drugs. d. Medicare health plans offer a menu of benefits, from which he may choose, so if he ever wants to increase his coverage, he need only contact the plan and select other options. Source: Different Ways to Get Medicare, continued Question4 Mrs. Raskin is a widow who will attain aged 65 and enroll in Medicare in just a few weeks. She concerned about having prescription drug coverage. Which of the following statements provides the best advice? Choose one answer. a. Prescription drug coverage can be obtained by purchasing a Medicare Supplement (Medigap) Plan F policy. b. Comprehensive prescription drug coverage is now included under Part B of Medicare. c. Prescription drug coverage can be obtained by enrolling in a Medicare Advantage plan that includes Part D coverage. d. Comprehensive prescription drug coverage is offered by all Medicare Advantage Plans (Part C). Source: Overview of Different Ways to Get Medicare Question5 Mrs. Willard wants to know generally how the benefits under Original Medicare might compare to the benefit package of a Medicare Health Plan before she starts looking at specific plans. What could you tell her? Choose one answer. a. Medicare Health Plans may offer extra benefits that Original Medicare does not offer such as vision, hearing, and dental services and must include a maximum out-of-pocket limit on Part A and Part B services. b. Medicare Health Plans are not permitted to offer any benefits beyond those available under the Original Medicare program and must have the same maximum out-of-pocket limit on Part A and Part B services as FFS Medicare. c. All Medicare Health Plans offer cost-sharing that is lower than Original Medicare for all Part A and Part B covered services, but the maximum out-of-pocket limit is higher than in Original Medicare. d. Medicare Health Plans do not necessarily have to cover all of the Original Medicare Part A and Part B services, but must include a maximum out-of-pocket limit.