AHIP Medicare Training Module 1 Final Review

AHIP Medicare Training Module 1 Final Review Question 1: What recent regulatory change has impacted Medigap plans? Answer: Starting January 1, 2020, Medigap plans sold to individuals who are newly eligible for Medicare are no longer allowed to cover the Part B deductible. Question 2: Mrs. Geisler's neighbor told her to look at her Part D options during the annual Medicare enrollment period. What could 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. Question 3: Mrs. Shields is covered by Original Medicare and needs skilled nursing care after a hospital stay. What should you tell her about Medicare's coverage of care in a skilled nursing facility? Answer: 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. Question 4: Mr. Rainey needs inpatient psychiatric hospitalization. What should you tell him about the length of an inpatient psychiatric hospital stay that Medicare will cover? Answer: Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime. Question 5: Mr. Buck wants to know if Medicare covers cancer screening. What should you tell him? Answer: Medicare covers the periodic performance of a range of screening tests that are meant to provide early detection of disease. Mr. Buck will need to check specific tests before obtaining them to see if they will be covered. Madeline Martinez was widowed several years ago. Her husband worked for many years and contributed into the Medicare system. He also left a substantial estate which provides Madeline with an annual income of approximately $130,000. Madeline, who has only worked part-time for the last three years, will soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for advice. What should you tell her? A. You should tell Madeline that she will be able to enroll in both Medicare Part A and Part B without paying monthly premiums due to her husband's long work record and participation in the Medicare system. B. You should tell Madeline that she will need to pay premiums for Part A because of her short work history. You should also tell Madeline that she will pay part B premiums at the highest rate because her income over the last several years has exceeded $100,000. C. You should tell Madeline that she will b ️C. You should tell Madeline that she will be able to enroll in Medicare Part A without paying monthly premiums due to her husband's long work record and participation in the Medicare system. You should also tell Madeline that she will pay Part B premiums at more than the standard lowest rate but less than the highest rate due to her substantial income. Explanation: Madeline will be able to enroll in premium-free Part A due to her husband's work record. She will pay a premium for Part B coverage based on her income level (her income-related monthly adjustment amount [IRMMA]). An income level of $100,000 would mean Mrs. Martinez would pay a premium more than the standard (lowest) amount but not the highest level which looks at incomes above $500,000 for those filing individual income tax returns. Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through acupuncture. She is concerned about whether or not Medicare will cover these items and services. What should you tell her? A. Medicare does not cover massage therapy, or, in general, glasses or dentures. B. Medicare covers 80% of the cost of these three services. C. Medicare covers glasses, but not dentures or massage therapy. D. Medicare covers 50% of the cost of these three services. ️A. Medicare does not cover massage therapy, or, in general, glasses or dentures. Explanation: Neither Medicare Part A nor Part B covers massage therapy, dentures, or routine eye examinations to prescribe eyeglasses. Ms. Henderson believes that she will qualify for Medicare coverage when she turns 65, without paying any premiums, because she has been working for 40 years and paying Medicare taxes. What should you tell her? A. She is correct that she will not have to pay a premium because State programs cover the cost of Part B premiums for all Medicare beneficiaries. B. Medicare beneficiaries only pay a Part B premium if they are enrolled in a Medicare Advantage plan. C. To obtain Part B coverage, she must pay a standard monthly premium, though it is higher for individuals with higher incomes. D. She is correct because she will be covered under Part A, without paying premiums and she has worked for 40 years so she will not have to pay Part B premiums. ️C. To obtain Part B coverage, she must pay a standard monthly premium, though it is higher for individuals with higher incomes.