AHIP Module 1

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Author:
Tron
ID:
236039
Filename:
AHIP Module 1
Updated:
2013-09-20 15:21:13
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AHIP MODULE
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AHIP MODULE 1
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  1. 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?
    • ¬†Medigap plans help beneficiaries cover
    • coinsurance, co-payments, and/or deductibles for medically necessary services
  2. Mrs. Schlick is enrolled in
    Original Medicare and has a Medigap policy as well, but it provides no drug
    coverage. She would like to keep the coverage she has, but replace her existing
    Medigap plan with one that provides drug coverage. What should you tell her?
    • Mrs. Schlick cannot purchase a
    • Medigap plan that covers drugs, but she could keep her Medigap policy and
    • enroll in a Part D prescription drug plan.
  3. Mr. Capadona would like to
    purchase a Medicare Advantage (MA) plan and a Medigap plan to pick up costs not
    covered by that plan. What should you tell him?
    • It is illegal for you to sell
    • Mr. Capadona a Medigap plan if he is enrolled in an MA plan, and besides,
    • Medigap only works with Original Medicare
  4. 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?
     Original Medicare covers ambulance services.
  5. 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?
    • Part D covers prescription drugs and she should look at her premiums, formulary, and
    • cost sharing to see if they have changed
  6. Mrs. McNamara 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?
    • Most individuals who are
    • citizens and over age 65 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
  7. 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?
    • In order to obtain Part B coverage, she must
    • pay a standard monthly premium, though it is higher for individuals with higher
    • incomes
  8. Mr. Alonso receives some help paying for his two generic
    prescription drugs from his employer's retiree coverage, but he wants to
    compare it to a Part D prescription drug plan. He asks you what costs he would
    generally expect to encounter when enrolling into a standard Medicare Part D
    prescription drug plan. What should you tell him?
    • He generally would pay a monthly premium,
    • annual deductible, and per-prescription cost sharing
  9. Mr. Meoni's wife has a Medicare Advantage plan, but he wants
    to understand what coverage Medicare Supplemental Insurance provides since his
    health care needs are different from his wife's needs. What could you tell Mr.
    Meoni?
    • 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
  10. Mr. Singh would like drug coverage, but does
    not want to be enrolled into a health plan. What should you tell him?
    • 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
  11. Mr.
    Styles would like to plan for retirement and has asked you what is covered
    under Original Fee-for-Service (FFS) Medicare? What could you tell him?
    • 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
  12. Mr. Hudson is concerned that if he signs up for a Medicare
    health plan, the health plan may, at some time in the future, reduce his
    benefits below what is available in Original Medicare. What should you tell him
    about his concern?






    Medicare health plans must cover
    all benefits available under Medicare Part A and Part B. Many also cover Part D
    prescription drugs






    Medicare health plans must cover
    all benefits available under Medicare Part A and Part B. Many also cover Part D
    prescription drugs
    • Medicare health plans must cover
    • all benefits available under Medicare Part A and Part B. Many also cover Part D
    • prescription drugs
  13. Mr. Bush is 49 years old and has been receiving disability
    benefits from the Social Security Administration for 12 months. Can you sell
    him a Medicare Advantage or Part D Prescription Drug policy?
    • No, he cannot purchase a Medicare Advantage or Part D policy
    • because he has not received Social Security or Railroad Retirement disability
    • benefits for 24 months

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