AHIP Module 1
1. Mr. Diaz continued working with his company and was insured under his employer's
group plan until he reached age 68. He has heard that there is a premium penalty for those
who did not sign up for Part B when first eligible and wants to know how much he will have to
pay. What should you tell him?
Answer: Mr. Diaz will not pay any penalty because he had continuous coverageunder his
employer's plan.
2. Mrs. Paterson is concerned about the deductibles and co-payments as-sociated with
Original Medicare. What can you tell her about Medigap as an
option to address this concern?
Answer: All costs not covered by Medicare are coveredby some Medigap plans.
3. Mrs. Geisler's neighbor told her she should look at her Part D options during the annual
Medicare enrollment period because the features of Part Dmight have changed. Mrs. Geisler
can't remember what Part D is so she calledyou to ask what her neighbor was talking about.
What could you tell her?
Answer: PartD covers prescription drugs and she should look at her premiums, formulary,
and cost-sharing among other factors to see if they have changed.
4. Mr. Patel is in good health and is preparing a budget in anticipation of hisretirement when
he turns 66. He wants to understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization because of an illness. In general terms, what
could you tell him about his costs for inpatient hospital services under Original Medicare?
Answer: Under OriginalMedicare, there is a single deductible amount due for the first 60 days of
any inpatienthospital stay, after which it converts into a per-day coinsurance amount through
day 90. After day 90, he would pay a daily amount up to 60 days over his lifetime, afterwhich
he would be responsible for all costs.
5. Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare
Part A and Part B. She would also like to enroll in a MedicareSupplement (Medigap) plan.
Anita's older neighbor Mel has told her about theMedigap Plan F in which he is enrolled. It not
only provides foreign travel emergency benefits but also covers his Medicare Part B
deductible. Anita comes to you for advice. What should you tell her?
Answer: You are sorry to disappointAnita, but a Medigap F plan is no longer available to
those who turn age 65 after January 1, 2020. Anita might instead consider other Medigap plans
that offer foreigntravel benefits but do not cover the Part B deductible.
6. Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare.What should you tell Mr. Xi thatbest describes the health
coverage provided to Medicare beneficiaries?
Answer: Beneficiaries under Original Medicare have no cost-sharing for most preventive
services
1. Mr. Diaz continued working with his company and was insured under his employer's
group plan until he reached age 68. He has heard that there is a premium penalty for those
who did not sign up for Part B when first eligible and wants to know how much he will have to
pay. What should you tell him?
Answer: Mr. Diaz will not pay any penalty because he had continuous coverageunder his
employer's plan.
2. Mrs. Paterson is concerned about the deductibles and co-payments as-sociated with
Original Medicare. What can you tell her about Medigap as an
option to address this concern?
Answer: All costs not covered by Medicare are coveredby some Medigap plans.
3. Mrs. Geisler's neighbor told her she should look at her Part D options during the annual
Medicare enrollment period because the features of Part Dmight have changed. Mrs. Geisler
can't remember what Part D is so she calledyou to ask what her neighbor was talking about.
What could you tell her?
Answer: PartD covers prescription drugs and she should look at her premiums, formulary,
and cost-sharing among other factors to see if they have changed.
4. Mr. Patel is in good health and is preparing a budget in anticipation of hisretirement when
he turns 66. He wants to understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization because of an illness. In general terms, what
could you tell him about his costs for inpatient hospital services under Original Medicare?
Answer: Under OriginalMedicare, there is a single deductible amount due for the first 60 days of
any inpatienthospital stay, after which it converts into a per-day coinsurance amount through
day 90. After day 90, he would pay a daily amount up to 60 days over his lifetime, afterwhich
he would be responsible for all costs.
5. Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare
Part A and Part B. She would also like to enroll in a MedicareSupplement (Medigap) plan.
Anita's older neighbor Mel has told her about theMedigap Plan F in which he is enrolled. It not
only provides foreign travel emergency benefits but also covers his Medicare Part B
deductible. Anita comes to you for advice. What should you tell her?
Answer: You are sorry to disappointAnita, but a Medigap F plan is no longer available to
those who turn age 65 after January 1, 2020. Anita might instead consider other Medigap plans
that offer foreigntravel benefits but do not cover the Part B deductible.
6. Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare.What should you tell Mr. Xi thatbest describes the health
coverage provided to Medicare beneficiaries?
Answer: Beneficiaries under Original Medicare have no cost-sharing for most preventive
services
