AHIP Medicare Training 2024
(Brand New!!) All Q&As Included!! A++
- Ms. Jensen has heard about "Original Fee-for-Service Medicare" and "Private
Fee-for-Service" plans. She wants to know what the difference is if any. What should you tell her?
Answer: PFFS plans are a type of Medicare Advantage plan offered by private
companies.
- This year you decide to focus your efforts on marketing to employer and union
groups. Which of the following statements best describes what you can and cannot do in order to stay in compliance?
Answer: You are not required to submit communication and marketing materials
specific only to those employer plans to CMS at the time of use, but CMS may request and review copies if employee complaints occur.
- Agent Suma has recently had several clients request his assistance in completing
their paper enrollment form. What advice would you give him?Answer: Agent Suma is only permitted to fill out the applicant's name and contact information. The applicant must fill in the remaining information in order to protect his or her privacy.
- Mrs. Quinn recently turned 66 and decided after many years of work to begin
receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been automatically enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn?Answer: Part B primarily covers physician services. She will be paying a monthly premium and, with the exception of many preventive and screening tests, generally will have 20% coinsurance for these services, in addition to an annual deductible.
- Mrs. Turner is comparing her employer's retiree insurance to Original Medicare
and would like to know which of the following services Original Medicare will cover if the appropriate criteria are met? What could you tell her?
Answer: Original Medicare covers ambulance services.
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- 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 coverage
under his employer's plan.
- Anita Magri will turn age 65 in August 2020. 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 Part F plan 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 disappoint Anita but a Medigap Part 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.
- Mr. Moy's wife has a Medicare Advantage plan, but he wants to under- stand
what coverage Medicare Supplemental Insurance provides since his health care needs are different from his wife's needs. What could you tell Mr. Moy?
Answer: Medicare Supplemental Insurance would help cover his Part A and Part B
cost sharing in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover.
- Mr. Bauer is 49 years old, but eighteen months ago he was declared dis- abled by
the Social Security Administration and has been receiving disability payments. He is wondering whether he can obtain coverage under Medicare. What should you tell him?
Answer: After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
- Mr. Schmidt would like to plan for retirement and has asked you what is
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covered under Original Fee-for-Service (FFS) Medicare? What could you tell him?Answer: Part A, which covers hospital, skilled nursing facility, hospice, and home health services and Part B, which covers professional services such as those provided by a doctor are covered under Original Medicare.
- Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent
health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern?
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 she will be eligible for Medicare.
- Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is
being successfully treated for that condition. However, she and her physicians feel that after her lengthy hospital stay she will need a month or two of nursing and rehabilitative care. What should you tell them about Original 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.
- 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 describes the health coverage provided to Medicare beneficiaries?
Answer: Ben eficiaries under Original Medicare have no cost-sharing for most
preventive services which include immunizations such as annual flu shots.
- 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?
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.
- What impact, if any, will recent regulatory changes have upon Medigap plans?
Answer: The Part B deductible will no longer be covered for individuals newly
eligible for Medicare starting January 1, 2020.
- Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
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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