AHIP FINAL EXAM 2024 [100% PASS]
/VERIFIED/
Edward IP suffered from serious kidney disease. As a result. Edward became eligible for
Medicare coverage
... [Show More] due to end-stage renal disease (ESRD). A close relative donated their kidney
and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50
and asks you if his Medicare coverage will continue, what should you say? *Ans* Individuals
eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in
which the individual receives a kidney transplant unless they are eligible for Medicare on another
basis such as age or disability. Edward may, however, remain enrolled in Part B but solely for
coverage of immunosuppressive drugs if he has no other health care coverage that would cover
the drugs.
Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. Mildred recently
learned that she is suffering from inoperable cancer and has just a few months to live. She would
like to spend these final months in hospice care. Mildred's family asks you whether hospice
benefits will be paid for under the Allcare Medicare Advantage plan. What should you say?
*Ans* Mildred may remain enrolled in Allcare and make a hospice election. Hospice benefits
will be paid for by Original Medicare under Part A and Allcare will continue to pay for any nonhospice services.
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? *Ans* Mr. Diaz will not pay any penalty because he had continuous coverage
under his employer's plan.
Mr. Moy'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. Moy? *Ans* Medicare Supplemental Insurance would
help cover his Part A and Part B deductibles or coinsurance in Original Fee-for-Service (FFS)
Medicare as well as possibly some services that Medicare does not cover.
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? *Ans* 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.
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? *Ans* After receiving such
disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of
age.
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? *Ans* Beneficiaries under Original Medicare have no
cost-sharing for most preventive services which include immunizations such as annual flu shots.
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? *Ans* She may enroll at any time while she is covered under her employer
plan, but she will have a special eight-month enrollment period after the last month on her
employer plan that differs from the standard general enrollment period, during wh [Show Less]