2024 AHIP MODULE 1 (1) ACUAL TEST QUESTION
AND ANSWERS SOLVED SOLUTION GRADED A+
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been... [Show More] 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?
Choose one answer.
a. 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.
b. Most individuals who are citizens and over age 65 and wish to be covered under Part
A must enroll in a Medicare Health Plan.
c. Most individuals who are citizens and over age 65 and are covered under Part A
must pay a monthly premium for that coverage.
d. All individuals who are citizens and over age 65 will be covered under Part A. -
ANSWER-a. 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.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled 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-d. After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
Mr. Denton is 52 years old and has recently been diagnosed with end-stage renal
disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage
under Medicare. What should you tell him? - ANSWER-a. He may sign-up for Medicare
at any time however coverage usually begins on the fourth month after dialysis
treatments start. Correct
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? - ANSWER-a. In order to obtain Part B
coverage, she must pay a standard monthly premium, though it is higher for individuals
with higher incomes. Correct
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-b. Mr. Diaz will not pay any
penalty because he had continuous coverage under his employer's plan. Correct
Mrs. Peňa is 66 years old, has coverage under an employer plan and will retire next
year. She heard she must enroll in Part B at the beginning of the year to ensure no gap
in coverage. What can you tell her? - ANSWER-d. She may enroll at any time while she
is covered under her employer plan, but she will have a special eight-month enrollment
period that differs from the standard general enrollment period, during which she may
enroll in Medicare Part B. Correct
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is
considering enrollment in a Medicare health plan (Part C). What should you advise her
to do before she will be able to enroll into a Medicare health plan? - ANSWER-Mrs.
Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is considering
enrollment in a Medicare health plan (Part C). What should you advise her to do before
she will be able to enroll into a Medicare health plan?
Mrs. Park is an elderly retiree. She has a low, fixed income. What could you tell Mrs.
Park that might be of assistance? - ANSWER-d. 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. Correct
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify
for the Part D low-income subsidy. Where might he turn for help with his prescription
drug costs? - ANSWER-a. Mr. Wu may still qualify for help in paying Part D costs
through his State Pharmaceutical Assistance Program. Correct
Mr. Patel is in good health and is preparing a budget in anticipation of his retirement
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 as a result of an illness. In general
terms, what could you tell him about his costs for inpatient hospital services under
Original Medicare? - ANSWER-d. Under Original Medicare, there is a single deductible
amount due for the first 60 days of any inpatient hospital 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, after which he would be responsible for all costs
Correct
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-b. Medicare will cover Mrs. Shields' skilled nursing services
provided during the first 20 days of her stay, after which she would have a coinsurance
until she has been in the facility for 100 days. Correct
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be
hospitalized. What should you tell Mr. Rainey (or his representative) about the length of
an inpatient psychiatric hospital stay that Medicare will cover? - ANSWER-a. Medicare
will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire
lifetime. Correct
Mrs. Quinn has recently turned 66 and decided after many years of work to begin
receiving Social Security benefits. Shortly thereafter Mrs. Quinn and 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-a. 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% co-payments
for these services, in addition to an annual deductible. Correct
Mr. Buck has several family members who died from different cancers. He wants to
know if Medicare covers cancer screening. What should you tell him? - ANSWER-c.
Medicare covers periodic performance of a range of screening tests that are meant to
provide early detection of disease. Mr. Buck will need to check specific tests before
obtaining them to see if they will be covered. Correct
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-a. Original Medicare
covers ambulance services. Correct
Mrs. Wolf 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? - ANSWER-c. Medicare does
not cover acupuncture, or, in general, glasses or dentures. Correct
Mr. Singh would like drug coverage, but does not want to be enrolled into a health plan.
What should you tell him? - ANSWER-b. 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. Correct
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? -
ANSWER-b. He generally would pay a monthly premium, annual deductible, and perprescription cost sharing. Correct
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-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. Correct [Show Less]
