AHIP MEDICARE TRAINING MODULE 1
FINAL REVIEW WITH CORRECT
SOLUTIONS
What impact, if any, have recent regulatory changes had upon Medigap plans?
A. The Part A deductible is no longer covered under Medigap plans for all enrollees
starting January 1, 2020.
B. The Part A deductible is no longer covered for individuals newly eligible for Medicare
starting January 1, 2020.
C. The Part B deductible is no longer covered for individuals newly eligible for Medicare
starting January 1, 2020.
D. The Part B deductible is now covered for some newly eligible individuals depending
on their financial status. - ANSWER-C. The Part B deductible is no longer covered for
individuals newly eligible for Medicare starting January 1, 2020.
Explanation: Starting January 1, 2020, Medigap plans sold to individuals who are newly
eligible to Medicare are no longer allowed to cover the Part B deductible. If an individual
already had one of the plans before January 1, 2020, they can keep their plan. If an
individual was eligible for Medicare before January 1, 2020, but are not yet enrolled, he
or she may be able to purchase one of these plans.
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. - ANSWER-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. - ANSWER-C. To obtain Part B coverage, she must
pay a standard monthly premium, though it is higher for individuals with higher incomes.
Explanation: Typically, people eligible for Medicare pay the standard monthly premium
rate for Part B. However, this amount may vary based on an individual's income.
Mrs. Paterson is concerned about the deductibles and co-payments associated with
Original Medicare. What can you tell her about Medigap as an option to address this
concern?
A. Medigap plans help beneficiaries cover Original Medicare benefits, but they
coordinate with Original Medicare coverage.
B. Medigap plans are not sold by private companies and are a government insurance
product.
C. All costs not covered by Medicare are covered by some Medigap plans.
D. If Mrs. Paterson applies during the Medigap open enrollment period, she will have to
undergo a medical review to determine if
she has a pre-existing condition that would increase the premium for a Medigap policy. -
ANSWER-A. Medigap plans help beneficiaries cover Original Medicare benefits, but
they coordinate with Original Medicare coverage.
Explanation: Medigap plans coordinate coverage and works only with Original
Medicare.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual
Medicare enrollment period because features of Part D might have changed. Mrs.
Geisler can't remember what Part D is so she called you to ask what her neighbor was
talking about. What could you tell her?
A. Part D covers hospital and home health services and the cost-sharing has changed
this year.
B. Part D covers physician and non-physician practitioner services and the deductible
has not changed this year, but the physician charges may go up.
C. 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.
D. Part D covers long-term care services and she shouldn't worry because there has
been no change in coverage. - ANSWER-C. 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.
Explanation: Part D provides prescription drug coverage. Premiums, plan formularies,
and cost-sharing, among other factors, may change from one plan year to another.
FINAL REVIEW WITH CORRECT
SOLUTIONS
What impact, if any, have recent regulatory changes had upon Medigap plans?
A. The Part A deductible is no longer covered under Medigap plans for all enrollees
starting January 1, 2020.
B. The Part A deductible is no longer covered for individuals newly eligible for Medicare
starting January 1, 2020.
C. The Part B deductible is no longer covered for individuals newly eligible for Medicare
starting January 1, 2020.
D. The Part B deductible is now covered for some newly eligible individuals depending
on their financial status. - ANSWER-C. The Part B deductible is no longer covered for
individuals newly eligible for Medicare starting January 1, 2020.
Explanation: Starting January 1, 2020, Medigap plans sold to individuals who are newly
eligible to Medicare are no longer allowed to cover the Part B deductible. If an individual
already had one of the plans before January 1, 2020, they can keep their plan. If an
individual was eligible for Medicare before January 1, 2020, but are not yet enrolled, he
or she may be able to purchase one of these plans.
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. - ANSWER-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. - ANSWER-C. To obtain Part B coverage, she must
pay a standard monthly premium, though it is higher for individuals with higher incomes.
Explanation: Typically, people eligible for Medicare pay the standard monthly premium
rate for Part B. However, this amount may vary based on an individual's income.
Mrs. Paterson is concerned about the deductibles and co-payments associated with
Original Medicare. What can you tell her about Medigap as an option to address this
concern?
A. Medigap plans help beneficiaries cover Original Medicare benefits, but they
coordinate with Original Medicare coverage.
B. Medigap plans are not sold by private companies and are a government insurance
product.
C. All costs not covered by Medicare are covered by some Medigap plans.
D. If Mrs. Paterson applies during the Medigap open enrollment period, she will have to
undergo a medical review to determine if
she has a pre-existing condition that would increase the premium for a Medigap policy. -
ANSWER-A. Medigap plans help beneficiaries cover Original Medicare benefits, but
they coordinate with Original Medicare coverage.
Explanation: Medigap plans coordinate coverage and works only with Original
Medicare.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual
Medicare enrollment period because features of Part D might have changed. Mrs.
Geisler can't remember what Part D is so she called you to ask what her neighbor was
talking about. What could you tell her?
A. Part D covers hospital and home health services and the cost-sharing has changed
this year.
B. Part D covers physician and non-physician practitioner services and the deductible
has not changed this year, but the physician charges may go up.
C. 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.
D. Part D covers long-term care services and she shouldn't worry because there has
been no change in coverage. - ANSWER-C. 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.
Explanation: Part D provides prescription drug coverage. Premiums, plan formularies,
and cost-sharing, among other factors, may change from one plan year to another.
