- | Page
AHIP - FINAL EXAMINATION
ALREADY GRADED A+
Question :(a) Which of the following services Original
Medicare will cover if the appropriate criteria are met.What could you tell her?
Correct answer:Original Medicare covers ambulance
services.
Question :Mrs. Duarte is enrolled in Original Medicare
Parts A and B. She has recently reviewed her Medicare Summary Notice (MSN) and disagrees with a determination that partially denied one of her claims for services. What advice would you give her?
Correct answer:Mrs. Duarte should file an appeal of this
initial determination within 120 days of the date she received the MSN in the mail.
Question :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 D might have changed. Mrs. Geisler can't remember what Part D is
- | Page
so she called you to ask what her neighbor was talking about. What could you tell her?
Correct 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 :Mrs. Park is an elderly retiree. Mrs. Park has a
low fixed income. What could you tell Mrs. Park that might be of assistance?
Correct answer:She should contact her state Medicaid
agency to see if she qualifies for one of several programs that can help with Medicare costs for which she is responsible.
Question :Mrs. Quinn recently turned 66 and decided
after many years of work to retire and begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she had been automatically enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs.Quinn?
- | Page
Correct answer:Part B primarily covers physician
services. She will be paying a monthly premium and, except for many preventive and screening tests, generally will have 20% co-payments for these services, in addition to an annual deductible.
Question :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 Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has told her about the Medigap 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?
Correct answer:You are sorry to disappoint Anita, 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 foreign travel benefits but do not cover the Part B deductible.
- | Page
Question :Mr. Singh would like drug coverage but does
not want to be enrolled in a Medicare Advantage plan.What should you tell him?
Correct answer:Mr. Singh can enroll in a stand-alone
prescription drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare.
Question :Mrs. Chen will be 65 soon, has been a citizen
for twelve years, has been employed full time, and paid taxes during that entire period. She is concerned that she will not qualify for coverage under part A because she was not born in the United States. What should you tell her?
Correct answer:Most individuals who are citizens and age
65 or over are covered under Part A by virtue of having paid Medicare taxes while working, though some may be covered as a result of paying monthly premiums.
Question :(b) 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 that best