AHIP Module 1 Complete Answers

AHIP Module 1 Complete Answers Question 1: Mrs. Chen, a 65-year-old citizen, is concerned she won't qualify for Part A coverage due to not being born in the United States. What should you tell her? Answer: As a citizen over age 65, Mrs. Chen is likely to be covered under Part A by virtue of having paid Medicare taxes while working, although some may be covered by paying monthly premiums. Question 2: What impact will the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have on Medigap plans? Answer: Starting January 1, 2020, the Part B deductible will no longer be covered for individuals newly eligible for Medicare. Question 3: Mrs. Moore is concerned that her high income will make it impossible for her to qualify for Medicare. What can you tell her? Answer: Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's disease, so Mrs. Moore will be eligible for Medicare. Question 4: Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and wants to know which services Original Medicare covers. What can you tell her? Answer: Original Medicare covers ambulance services if the appropriate criteria are met. Question 5: Mr. Wu has limited financial resources and failed to qualify for the Part D low-income subsidy. Where might he turn for help with his prescription drug costs? Answer: Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program. Question 6: Mr. Diaz continued working with his company and was insured under his employer's group plan until he reached age 68. He wants to know how much he'll pay as a penalty for not signing up for Part B when first eligible. What should you tell him? Answer: Mr. Diaz will not pay any penalty since he had continuous coverage under his employer's plan. Question 7: Mrs. Peňa is 66 years old, has coverage under an employer plan, and will retire next year. She heard she must enroll in Part B at the beginning of the year to ensure no gap in coverage. What can you tell her? Answer: She may enroll at any time while she is covered under her employer plan, but she will have a special eight-month enrollment period that differs from the standard general enrollment period, during which she may enroll in Medicare Part B. Question 8: Mrs. Kelly is entitled to Part A but has not yet enrolled in Part B and is considering enrollment in a Medicare health plan (Part C). What should you advise her to do before enrolling in a Medicare health plan? Answer: In order to join a Medicare health plan, she also must enroll in Part B. Question 9: Mrs. Geisler can't remember what Part D is and asked about it. What can you tell her? Answer: 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 during the annual Medicare enrollment period. Question 10: Mrs. Paterson is concerned about deductibles and co-payments associated with Original Medicare. What can you tell her about Medigap as an option to address this concern? Answer: Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services.