Complete; AHIP 2024 Final Exams/Test/Practice/Modules| Questions and Answers (Verified Answer) Guarantee Pass
AHIP 2024 final Exam Solved 100% Correct With Verified Answers/2024-Guarantee Pass
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
AHIP 2024 final Exam Solved
100% Correct With Verified
Answers/2024-Guarantee Pass
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 Ans: -She should contact her state Medicaid agency to see if she qualifies
forprograms that can help with Medicare costs for which she is responsible.
Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a substantial
estate which provides Madeline with an annual income of approximately
$130,000. Madeline, who has only worked part-time for the last three years, will
soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for
advice. What should you tell her?
{Correct Ans: -You should tell Madeline that she will be able to enroll in Medicare
Part A without paying monthly premiums due to her husband’s long work record
and participation in the Medicare system. You should also tell Madeline that she
will pay Part B premiums at more than the standard lowest rate but less than the
highest rate due her substantial income.
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?
{Correct Ans: -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 covered
under Original Fee-for-Service (FFS) Medicare? What could you tell him?
{Correct Ans: -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.
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?
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
{Correct 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 that differs from
the standard general enrollment period, during which she may enroll in Medicare
Part B.
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently
enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare
Supplement (Medigap) plan which he has had for several years. However, the
plan does not provide drug benefits. How would you advise Agent John Miller to
proceed?
{Correct Ans: -Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present coverage.
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?
{Correct Ans: -The penalty will be a permanent 10% increase in his Part B premium
for every 12-month period that passed during which he could have enrolled and did
not.
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?
{Correct Ans: -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.
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?
{Correct 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 non-hospice services.
Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area
has an attractive premium. He wants to know if he must use doctors in a
network as his current HMO plan requires him to do. What should you tell him?
Powered by https://learnexams.com/search/study?query=
2024 AHIP Final Exam| Latest Updated |170 Questions Solved 100% Correct/ Verified Answers
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
2024 AHIP Final Exam| Latest
Updated |170 Questions Solved
100% Correct/ Verified Answers
- Edward IP suffered from serious kidney disease. As a result. Edward
became eligible for Medicare coverage 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?
{Correct 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?
{Correct 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 non-hospice 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
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
eligible and wants to know how much he will have to pay. What should
you tell him?
{Correct 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?
{Correct 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?
{Correct 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?
{Correct Ans: – After receiving such disability payments for 24 months, he
will be automatically enrolled in Medicare, regardless of age.
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
- 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?
{Correct 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?
{Correct 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 which she may enroll in Medicare Part B. - Mr. Davis 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?
{Correct Ans: – He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
10.Madeline Martinez was widowed several years ago. Her husband worked
for many years and contributed into the Medicare system. He also left a
substantial estate which provides Madeline with an annual income of
approximately $130,000. Madeline, who has only worked part-time for the
last three years, will soon turn age 65 and hopes to enroll in Original
Medicare. She comes to you for advice. What should you tell her?
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
{Correct Ans: – You should tell Madeline that she will be able to enroll in
Medicare Part A without paying monthly premiums due to her husband’s
long work record and participation in the Medicare system. You should also
tell Madeline that she will pay Part B premiums at more than the standard
lowest rate but less than the highest rate due her substantial income.
11.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?
{Correct Ans: – To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
- To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes.
{Correct Ans: – Mrs. Gonzalez cannot purchase a Medigap plan that covers
drugs, but she could keep her Medigap policy and enroll in a Part D
prescription drug plan.
13.Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is
currently enrolled in Medicare Parts A and B. Jerry has also purchased a
Medicare Supplement (Medigap) plan which he has had for several years.
However, the plan does not provide drug benefits. How would you advise
Agent John Miller to proceed?
{Correct Ans: – Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present coverage.
14.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
Powered by https://learnexams.com/search/study?query=
AHIP Final Exam Test 2024 Questions Solved 100% Correct (Verified Answers) 50Q&A
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
AHIP Final Exam Test 2024 Questions
Solved 100% Correct (Verified Answers)
50Q&A
- 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?
{Correct Ans: – Medicare is a program for people age 65 or older and those
under age 65 with certain disabilities, end stage renal disease or Lou Gehrig’s
disease, so she will be eligible for Medicare. - Agent Armstrong is employed by XYZ Agency, which is under contract with
ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in
multiple states. XYZ Agency maintains a website marketing the MA plans
with which it has contracts. Agent Armstrong follows up with individuals
who request more information about ABC MA plans via the website and tries
to persuade them to enroll in ABC plans. What statement best describes the
marketing and compliance rules that apply to Agent Armstrong?
{Correct Ans: – Agent Armstrong needs to be licensed and appointed in every
state in which beneficiaries to whom he markets ABC MA plans are located.
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
- Mr. Schmidt 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?
{Correct Ans: – 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. - You are seeking to represent an individual Medicare Advantage plan and an
individual Part D plan in your state. You have completed the required
training for each plan, but you did not achieve a passing score on the tests
that came after the training. What can you do in this situation?
{Correct Ans: – You will not be able to represent any Medicare Advantage or
Part D plan until you complete the training and achieve an adequate score,
although you will not have to take a test if you exclusively market
employer/union group plans and the companies do not require testing. - Mr. Chen is enrolled in his employer’s group health plan and will be retiring
soon. He would like to know his options since he has decided to drop his
retiree coverage and is eligible for Medicare. What should you tell him?
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
{Correct Ans: – Mr. Chen can disenroll from his employer-sponsored coverage
to elect a Medicare Advantage or Part D plan within 2 months of his
disenrollment, but he should revaluate if he really wants to drop his
employer coverage.
- Mrs. West 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?
{Correct Ans: – Medicare does not cover acupuncture, or, in general, glasses
or dentures. - Mr. Bickford did not quite qualify for the extra help low-income subsidy
under the Medicare Part D Prescription Drug program and he is wondering if
there is any other option he has for obtaining help with his considerable
drug costs. What should you tell him?
{Correct Ans: – He could check with the manufacturers of his medications to
see if they offer an assistance program to help people with limited means
obtain the medications they need. Alternatively, he could check to see
whether his state has a pharmacy assistance program to help him with his
expenses.
Powered by https://learnexams.com/search/study?query=
AHIP Latest Questions 2024 Final Exam Practice Test #1| 200 Questions Solved 100% Correct 2024 with Verified Answers/Guarantee Pass 2024
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
AHIP Latest Questions 2024 Final Exam
Practice Test #1| 200 Questions Solved
100% Correct 2024 with Verified
Answers/Guarantee Pass 2024
- Mrs. Quinn has just turned 65 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?
[Correct Ans: – 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. - 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?
[Correct Ans: – 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. - 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?
[Correct Ans: – Original Medicare covers ambulance services - 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?
[Correct Ans: – Medicare does not cover acupuncture, or, in general, glasses
or dentures - Mr. Singh would like drug coverage, but does not want to be enrolled into
a health plan. What should you tell him?
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
[Correct Ans: – 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.
- 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?
[Correct Ans: – He generally would pay a monthly premium, annual
deductible, and per-prescription cost sharing - 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?
[Correct Ans: – 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. - 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?
[Correct Ans: – Medigap plans help beneficiaries cover coinsurance, copayments, and/or deductibles for medically necessary services. - Mrs. Gonzalez 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?
[Correct Ans: – Mrs. Gonzalez cannot purchase a Medigap plan that covers
drugs, but she could keep her Medigap policy and enroll in a Part D
prescription drug plan.
10.Mr. Kelly has substantial financial means. He enrolled in Original Medicare
and purchased a Medigap policy many years ago that offered prescription
drug coverage. The prescription drug coverage has not been comparable
to that offered by Medicare Part D for several years and despite
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
notification, Mr. Kelly took no action. Which of the following statements
best describes what will occur if Mr. Kelly now decides to enroll in
Medicare Part D?
[Correct Ans: – He will incur a late enrollment penalty
11.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?
[Correct Ans: – 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
12.What impact, if any, will the Medicare Access and CHIP Reauthorization
Act of 2015 (MACRA) have upon Medigap plans?
[Correct Ans: – The Part B deductible will no longer be covered for individuals
newly eligible for Medicare starting January 1, 2020
13.Mrs. Raskin is a widow who will attain aged 65 and enroll in Medicare in
just a few weeks. She concerned about having prescription drug coverage.
Which of the following statements provides the best advice?
[Correct Ans: – Prescription drug coverage can be obtained by enrolling in a
Medicare Advantage plan that includes Part D coverage.
14.Mrs. Willard wants to know generally how the benefits under Original
Medicare might compare to the benefit package of a Medicare Health Plan
before she starts looking at specific plans. What could you tell her?
[Correct Ans: – Medicare Health Plans may offer extra benefits that Original
Medicare does not offer such as vision, hearing, and dental services and must
include a maximum out-of-pocket limit on Part A and Part B services
15.Mr. Hernandez is concerned that if he signs up for a Medicare Advantage
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?
[Correct Ans: – Medicare health plans must cover all benefits available under
Medicare Part A and Part B. Many also cover Part D prescription drugs
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
16.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?
[Correct Ans: – Medicare is a program for people age 65 or older and those
under age 65 with certain disabilities, end stage renal disease or Lou Gehrig’s
disease, so she will be eligible for Medicare.
17.Mr. Schmidt 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?
[Correct Ans: – 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
18.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?
[Correct Ans: – 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
19.Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his
area has an attractive premium. He wants to know if he must use doctors
in a network like his current HMO plan requires him to do. What should
you tell him?
[Correct Ans: – He may receive health care services from any doctor allowed
to bill Medicare, as long as he shows the doctor the plan’s identification card
and the doctor agrees to accept the PFFS plan’s payment terms and
conditions, which could include balance billing.
20.Mrs. Lee is discussing with you the possibility of enrolling in a Private
Fee-for-Service (PFFS) plan. As part of that discussion, what should you be
sure to tell her?
[Correct Ans: – If she uses non-network providers, her doctors and hospital
could decide whether to treat her on a visit-by-visit basis
Powered by https://learnexams.com/search/study?query=
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
AHIP 2024 Final Latest Questions Solved
100% Correct /Verified Answers
- Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area
that does not include drug coverage. She wants to enroll in the plan and
enroll in a stand-alone prescription drug plan. What should you tell her?
[Correct Ans: – She could enroll in a PFFS plan and a stand-alone Medicare
prescription drug plan. - Mrs. Roswell is a new Medicare beneficiary who has just retired from
retail work. She is interested in selecting a Medicare Part D prescription
drug plan. She takes a number of medications and is concerned that she
has not been able to identify a plan that covers all of her medications. She
does not want to make an abrupt change to new drugs that would be
covered and asks what she should do. What should you tell her?
[Correct Ans: – Every Part D drug plan is required to cover a single one-month
fill of her existing medications sometime during a 90-day transition period. - Mr. Robinson was quite ill recently and forgot to pay his monthly
premium for his MA-PD plan. He is worried that he will lose his coverage
now when he needs it the most. He is certain his plan will disenroll him
because that is what happened to a friend of his in a similar type of plan.
What can you tell Mr. Robinson about his situation?
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
[Correct Ans: – Plan sponsors have the option to do nothing when a plan
member does not pay their premiums or disenroll the member after a grace
period and notice.
- Mrs. Allen has a rare condition for which two different brand name drugs
are the only available treatment. She is concerned that since no generic
prescription drug is available and these drugs are very high cost, she will
not be able to find a Medicare Part D prescription drug plan that covers
either one of them. What should you tell her?
[Correct Ans: – Medicare prescription drug plans are required to cover drugs
in each therapeutic category. She should be able to enroll in a Medicare
prescription drug plan that covers the medications she needs. - One of your clients, Lauren Nichols, has heard about a Medicare concept
from one of her neighbors called TrOOP. She asks you to explain it. What
do you say?
[Correct Ans: – TrOOP stands for true out-of-pocket expenses that count
toward the Medicare Part D catastrophic limit and include not only expenses
paid by a beneficiary but also in some instances drug manufacturer
discounts. - Mrs. Fiore is a retired federal worker with coverage under a Federal
Employee Health Benefits (FEHB) plan that includes creditable drug
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
coverage. She is ready to turn 65 and become Medicare eligible for the
first time. What issues might she consider about whether to enroll in a
Medicare prescription drug plan?
[Correct Ans: – She could compare the coverage to see if the Medicare Part D
plan offers better benefits and coverage than the FEHB plan for the specific
medications she needs and whether any additional benefits are worth the
Part D premium costs on top of her FEHB contribution.
- 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?
[Correct Ans: – 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. - Madeline Martinez was widowed several years ago. Her husband worked
for many years and contributed into the Medicare system. He also left a
substantial estate which provides Madeline with an annual income of
approximately $130,000. Madeline, who has only worked part-time for the
last three years, will soon turn age 65 and hopes to enroll in Original
Medicare. She comes to you for advice. What should you tell her?
Powered by https://learnexams.com/search/study?query=
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
AHIP 2024 Final Exam Practice Test #2
|80 Questions Solved 100% Correct
(Verified Answers) Guarantee Pass 2024
- Mr. Sinclair has diabetes and heart trouble and is generally satisfied with
the care he has received under Original Medicare, but he would like to
know more about Medicare Advantage Special Needs Plans (SNPs). What
could you tell him?
[Correct Ans: – SNPs have special programs for enrollees with chronic
conditions, like Mr. Sinclair, and they provide prescription drug coverage that
could be very helpful as well. - Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis,
putting him at severe risk for pneumonia. Otherwise, he has no problems
functioning. Which type of SNP is likely to be most appropriate for him?
[Correct Ans: – C-SNP - Mr. Kumar is considering a Medicare Advantage HMO and has questions
about his ability to access providers. What should you tell him?
[Correct Ans: – In most Medicare Advantage HMOs, Mr. Kumar must generally
obtain his services only from providers within the plan’s network (except in
an emergency or where care is unavailable within the network).
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
- Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his
area has an attractive premium. He wants to know if he must use doctors
in a network as his current HMO plan requires him to do. What should you
tell him?
[Correct Ans: – He may receive health care services from any doctor allowed
to bill Medicare, as long as he shows the doctor the plan’s identification card
and the doctor agrees to accept the PFFS plan’s payment terms and
conditions, which could include balance billing. - Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that
you represent. It is one of three plans operated by the same organization
in Mr. Lombardi’s area. The MA PPO plan does not include drug coverage,
but the other two plans do. Mr. Lombardi likes the PPO plan that does not
include drug coverage and intends to obtain his drug coverage through a
stand-alone Medicare prescription drug plan. What should you tell him
about this situation?
[Correct Ans: – He could enroll either in one of the MA plans that include
prescription drug coverage or Original Medicare with a Medigap plan and
standalone Part D prescription drug coverage, but he cannot enroll in the
MA-only PPO plan and a stand-alone prescription drug plan. - Mrs. Radford asks whether there are any special eligibility requirements
for Medicare Advantage. What should you tell her?
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
[Correct Ans: – Mrs. Radford must be entitled to Part A and enrolled in Part B
to enroll in Medicare Advantage.
- One of your clients, Lauren Nichols, has heard about a Medicare concept
from one of her neighbors called TrOOP. She asks you to explain it. What
do you say?
[Correct Ans: – TrOOP stands for true out-of-pocket expenses that count
toward the Medicare Part D catastrophic limit and include not only expenses
paid by a beneficiary but also in some instances drug manufacturer
discounts. - Mrs. Mulcahy, age 65, is concerned that she may not qualify for
enrollment in a Medicare prescription drug plan because, although she is
entitled to Part A, she is not enrolled under Medicare Part B. What should
you tell her?
[Correct Ans: – An individual who is entitled to Part A or enrolled under Part
B is eligible to enroll in a Medicare prescription drug plan. As long as Mrs.
Mulcahy is entitled to Part A, she does not need to enroll under Part B before
enrolling in a prescription drug plan. - Mrs. Roberts has Original Medicare and would like to enroll in a Private
Fee-for-Service (PFFS) plan. All types of PFFS plans are available in her
area. Which options could Mrs. Roberts consider before selecting a PFFS
plan?
Powered by https://learnexams.com/search/study?query=
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
AHIP Practice Exam 2024 Final
Questions Solved 100% Correct
With Verified Answers
- Mrs. Valentino is currently enrolled in a Medicare Cost plan. This plan is
no longer meeting her needs, but it is now mid-year and past the annual
election period (AEP). What would you say to Mrs. Valentino regarding her
options?
[Correct Ans: – Mrs. Valentino can submit a written request to Medicare to be
disenrolled from the Cost plan and enroll in Original Medicare. - When Myra first became eligible for Medicare, she enrolled in Original
Medicare (Parts A and B). She is now 67 and will turn 68 on July 1. She
would now like to enroll in a Medicare Advantage (MA) plan and
approaches you about her options. What advice would you give her?
[Correct Ans: – She should remain in Original Medicare until the annual
election period running from October 15 to December 7, during which she
can select an MA plan. - Mrs. Tanner is enrolled in a Medicare Advantage HMO that offers a point
of service options. This allows Mrs. Tanner to do which of the following?
[Correct Ans: – Mrs. Tanner can go to non-plan doctors for certain services
without receiving prior approval
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
- Agent Harriet Walker has recently begun marketing Medicare Advantage
and related products aimed at meeting the needs of senior citizens. Client
Mildred Jones has expressed interest in a Medicare Advantage plan. It is
now the beginning of September. If you were in Agent Walker’s position,
what would you do?
[Correct Ans: – Inquire whether the client qualifies for a special enrollment
period, and if not, solicit an enrollment application once the annual open
enrollment election period begins on October 15th. - 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 Ans: – 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. Katz reached the Part D coverage gap in August last year. His
prescriptions have not been changed, he is keeping the same Part D plan
and the benefits, cost-sharing, and coverage of his drugs are all the same
as last year. He asked what to expect for this year about his out-of-pocket
costs. What could you tell him?
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
[Correct Ans: – Because he reached the coverage gap last year, he will
probably reah it again this year close to the same time.
- ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its
enrollees’ protected health information to market non-health related
products such as life insurance and annuities. To do so it must obtain
authorization from the enrollees. Which statement best describes the
authorization process?
[Correct Ans: – Authorization may be obtained by directing a beneficiary to a
website to provide consent - Mrs. 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?
[Correct Ans: – In order to obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher incomes. - 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?
Powered by https://learnexams.com/search/study?query=
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
2024 AHIP Final Exam Practice Test # 3
Questions Solved 100% Correct /
Verified Answers /Guarantee Pass 2024
- Mr. Wong is a single individual. He has a successful business career and is
now able to retire with a comfortable income. Mr. Wong’s taxable income
is in excess of $80,000. Mr. Wong has health coverage through his
employer but will sign-up for Medicare Part A, Part B and Part D when he
leaves the workforce. How would you advise him as he budgets for
Medicare premiums?
[Correct Ans: – Due to his participation in the workforce he will not have to
pay a premium for Part A but he will pay higher premiums for Part B and
Part D due to the amount of his income. - During an appointment scheduled to discuss a Medicare Advantage
Prescription Drug plan (MA-PD), Mr. Peters asked his agent to describe a
stand-alone prescription drug plan (Part D plan) that his neighbor told him
about. What should his agent do?
[Correct Ans: – Since Mr. Peters requested a description of the Part D plan, his
agent must have Mr. Peters sign a new scope of appointment form that
includes Part D, and then the agent may discuss the Part D plan so Mr. Peters
can compare plans and make an informed enrollment choice during the
appointment.
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
- By contacting plans available in your area, you have learned that the plan
you represent has a significantly lower monthly premium than the others.
Furthermore, you see that the plan you represent has a unique benefit
package. What should you do to make sure your clients know about these
pieces of information?
[Correct Ans: – You may make comparisons between plans if you can support
them by studies or statistical data and such comparisons are factually based. - Mrs. Fields wants to know whether applying for the Part D low income
subsidy will be worth the time to fill out the paperwork. What could you
tell her?
[Correct Ans: – The Part D low income subsidy could substantially lower her
overall costs. She can apply by contacting her state Medicaid office or calling
the Social Security Administration. - Mr. Decaro has looked a Medicare prescription drug plans available in his
area and noted a wide range in premiums. He thought that all drug plans
were required to offer the same standard benefits and would like you to
explain why there is such a range in premiums. What should you tell him?
[Correct Ans: – Some prescription drug plans may have higher operating
costs and/or may offer enhanced coverage in return for an additional
premium amount. He could look at plan designs to see if one of the
enhanced plans would serve his needs better than a plan based on the
standard design.
AHIP CERTIFICATION (AMERICA’S HEALTH INSURANCE PLANS)
- Mrs. Wellington is enrolled in Parts A and B of Original Medicare. A friend
recently told her that there is an excellent Medicare Advantage (MA) plan
with a five-star rating serving her area. On January 5 she comes to you for
advise as to what options, if any, she has. What should you say regarding
special enrollment periods (SEPs)?
[Correct Ans: – Mrs. Wellington is eligible for a SEP that may be used once
until November 30 to enroll in the five-star plan. - Mr. Landry is approaching his 65th birthday. He has signed up for
Medicare Part A, but he did not enroll in Part B because he has employersponsored coverage and intends to keep working for several more years.
But he is considering enrolling in Part D prescription drug coverage
because he believes it is superior to his employer plan. How would you
advise him?
[Correct Ans: – Mr. Landry is eligible for Part D since he has Part A, and his
initial enrollment period (IEP) for Part D will continue for three months after
his 65th birthday. - Ms. Gates is dually eligible for Medicare and Medicaid. She is very
concerned about being locked into a specific Medicare prescription drug
plan for the entire year. what should you tell her?
[Correct Ans: – Individuals who are enrolled in Medicaid can change their Part
D plans throughout the year, so if she is not satisfied with her prescription
Powered by https://learnexams.com/search/study?query=
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
AHIP 2024 Module 1 Latest| New
Questions With 100% Verified Answers
- 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 Ans: – C.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. 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?
[Correct Ans: – c. Beneficiaries under Original Medicare have no cost-sharing
for most preventive services which include immunizations such as annual flu
shots. - 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?
[Correct Ans: – D?
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
- Mrs. Gonzalez 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?
[Correct Ans: – Mrs. Gonzalez cannot purchase a Medigap plan that covers
drugs, but she could keep her Medigap policy and enroll in a Part D
prescription drug plan. - Mr. Davis 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?
[Correct Ans: – B .He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start. - Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is
currently enrolled in Medicare Parts A and B. Jerry has also purchased a
Medicare Supplement (Medigap) plan which he has had for several years.
However, the plan does not provide drug benefits. How would you advise
Agent John Miller to proceed?
[Correct Ans: – d. Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present coverage.
Powered by https://learnexams.com/search/study?query=
AHIP 2024 MODULE 2 Latest| New Questions With 100% Verified Answers
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
AHIP 2024 MODULE 2 Latest| New
Questions With 100% Verified Answers
- Mr. Kumar is considering a Medicare Advantage HMO and has questions
about his ability to access providers. What should you tell him?
[Correct Ans: – In Medicare Advantage HMO plans, services provided by
primary care physicians are covered at 100%, but those of specialists are
covered at 80% ? - Mrs. Chi is age 75 and enjoys a comfortable but not extremely highincome level. She wishes to enroll in a MA MSA plan that she heard about
from her neighbor. She also wants to have prescription drug coverage
since her doctor recently prescribed several expensive medications.
Currently, she is enrolled in Original Medicare and a standalone Part D
plan. How would you advise Mrs. Chi?
[Correct Ans: – Mrs. Chi may enroll in a MA MSA plan and remain in her
current standalone Part D prescription drug plan. - Mr. Wells is trying to understand the difference between Original
Medicare and Medicare Advantage. What would be a correct description?
[Correct Ans: – Medicare Advantage is a way of covering all the Original
Medicare benefits through private health insurance companies.
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
- Mr. Sinclair has diabetes and heart trouble and is generally satisfied with
the care he has received under Original Medicare, but he would like to
know more about Medicare Advantage Special Needs Plans (SNPs). What
could you tell him?
[Correct Ans: – SNPs have special programs for enrollees w chronic
conditions like mr.sinclair and they provide script drug coverage that could
be very helpful as well - Mr. Romero is 64, retiring soon, and considering enrollment in his
employer-sponsored retiree group health plan that includes drug coverage
with nominal copays. He heard about a neighbor’s MA-PD plan that you
represent and because he takes numerous prescription drugs, he is
considering signing up for it. What should you tell him?
[Correct Ans: – He should compare the benefits in his employer-sponsored
retiree group health plan with the benefits in his neighbor’s MA-PD plan to
determine which one will provide sufficient coverage for his prescription
needs. - Mrs. Wang wants to know generally how the benefits under Original
Medicare might compare to the benefits package of a Medicare Advantage
Plan before she starts looking at specific plans. What could you tell her?
[Correct Ans: – Medicare Advantage Plans may offer extra benefits that
Original Medicare does not offer such as vision, hearing, and dental services.
It must include a maximum out-of-pocket limit on Part A and Part B services.
Powered by https://learnexams.com/search/study?query=
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
AHIP 2024 Module 3 Latest| New
Questions With Verified Answers
- Mr. Torres has a small savings account. He would like to pay for his
monthly Part D premiums with an automatic monthly withdrawal from his
savings account until it is exhausted, and then have his premiums
withheld from his Social Security check. What should you tell him?
[Correct Ans: – In general, he must select a single Part D premium payment
mechanism that will be used throughout the year. - Mrs. Berkowitz wants to enroll in a Medicare Advantage plan that does not
include drug coverage and also enroll in a stand-alone Medicare
prescription drug plan. Under what circumstances can she do this?
[Correct Ans: – If the Medicare Advantage plan is a Private Fee-for-Service
(PFFS) plan that does not offer drug coverage or a Medical Savings Account,
Mrs. Berkowitz can do this. - Mrs. Lopez is enrolled in a cost plan for her Medicare benefits. She has
recently lost creditable coverage previously available through her
husband’s employer. She is interested in enrolling in a Medicare Part D
prescription drug plan (PDP). What should you tell her?
[Correct Ans: – If a Part D benefit is offered through her plan she may choose
to enroll in that plan or a standalone PDP.
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
- Mr. Shapiro gets by on a very small amount of fixed income. He has heard
there may be extra help paying for Part D prescription drugs for Medicare
beneficiaries with limited income. He wants to know whether he might
qualify. What should you tell him?
[Correct Ans: – The extra help is available to beneficiaries whose income and
assets do not exceed annual limits specified by the government. Correct - Mrs. Imelda Diaz is a Medicare beneficiary enrolled in a MA-PD plan you
represent. Her neighbor recently suffered from a painful case of shingles.
Mrs. Diaz hopes to avoid such an illness through vaccination. She asks
you whether the cost of shingles vaccination will be covered under the
plan you represent. What should you say?
[Correct Ans: – Yes, there is no cost sharing for the shingles vaccine even in
the deductible phase of her prescription drug plan because it is an adult
vaccine recommended by the Advisory Committee on Immunization Practices
(AICP). - Mrs. McIntire is enrolled in her state’s Medicaid plan and has just become
eligible for Medicare as well. What can she expect will happen to her drug
coverage?
[Correct Ans: – Unless she chooses a Medicare Part D prescription drug plan
on her own, she will be automatically enrolled in one available in
Powered by https://learnexams.com/search/study?query=
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
AHIP 2024 Module 4 Latest|
New Questions With Verified
Answers 100% Correct
- Agent Daniel Webber has properly set up a sales appointment to meet
with client Edward Young at Agent Webber’s office. At the agreed upon
appointment time, Mr. Young arrives with his elderly neighbor – Clara
Burton, who wants to learn about her Medicare Advantage options. What
should Agent Daniel Webber do?
{Correct Ans: – After executing a scope of appointment (SOA) with Clara
Burton, meet with Edward Young and Clara Burton to discuss their Medicare
Advantage options. - You have been providing a pre-Thanksgiving meal during sales
presentations in November for many years and your clients look forward
to attending this annual event. When marketing Medicare Advantage and
Part D plans, what are you permitted to do with respect to meals?
{Correct Ans: – You may provide light snacks, but a Thanksgiving style meal
would be prohibited, regardless of who provides or pays for the meal. - Wendy Park becomes eligible for Medicare for the first time in July. With
the help of Agent James Chan, she enrolls in FeelBetter Medicare
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
Advantage plan with an effective date of July 1st. Which statement best
describes how Agent Chan may be compensated under CMS rules?
{Correct Ans: – FeelBetter will pay Agent Chan initial year compensation for
the months July through December. Renewal amounts will be paid starting in
January if Ms. Park remains enrolled the following year.
- You are working several plans and community organizations to sponsor
an educational event. When putting together advertisements for this
event, what should you do?
{Correct Ans: – You must ensure that the advertisements indicate it is an
educational event, otherwise it will be considered a marketing event. - Linda Sanchez is conducting a previously agreed upon appointment with
client, Maria Gomez about a MA-Part D plan she represents. Before an
enrollment form is completed, Linda needs to provide Maria with
information about __
{Correct Ans: – I, II, and III only - Your client, Alexis Jones, calls you on December 4th about changing her
Medicare Advantage plan during the annual election period which ends
December 7th. What should you do?
Powered by https://learnexams.com/search/study?query=
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
2024 AHIP Module 5 Latest| New
Questions With 100% Correct
Verified Answers
- Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her
MA Initial Coverage Election Period (ICEP) has just begun. Which of the
following can she not do during the ICEP?
[Correct Ans: – She can enroll in a Medigap plan to supplement the benefits
of the MA plan that she’s also enrolling in. - Mr. White has Medicare Parts A and B with a Part D plan. Last year, he
received a notice that his plan sponsor identified him as a “potential at-risk”
beneficiary. This month, he started receiving assistance from Medicaid. He
wants to find a different Part D plan that’s more suitable to his current
prescription drug needs. He believes he’s entitled to a SEP since he is now a
dual eligible. Is he able to change to a different Part D plan during a SEP for
dual eligible individuals?
[Correct Ans: – No. Once he is identified by the plan sponsor as a “potential
at-risk” beneficiary, he cannot use the dual eligible SEP to change plans while
this designation is in place. - Ms. Gonzales decided to remain in Original Medicare (Parts A and B) and Part
D during the Annual Enrollment Period (AEP). At the beginning of January,
her neighbor told her about the Medicare Advantage (MA) plan he selected.
He also told her there was an open enrollment period that she might be able
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
to use to enroll in a MA plan. Ms. Gonzales comes to you for advice shortly
after speaking to her neighbor. What should you tell her?
[Correct Ans: – There is a MA Open Enrollment Period (OEP) that takes place
between January 1 and March 31, but Ms. Gonzales cannot use it because
eligibility to use the OEP is available only to MA enrollees.
- Mr. Ziegler is turning 65 next month and has asked you what he can do, and
when he must do it, with respect to enrolling in Part D. What could you tell
him?
[Correct Ans: – He is currently in the Part D Initial Enrollment Period (IEP)
and, during this time, he may make one Part D enrollment choice, including
enrollment in a stand-alone Part D plan or an MA-PD plan. - Mrs. Parker likes to handle most of her business matters through telephone
calls. She currently is enrolled in Original Medicare Parts A and B but has
heard about a Medicare Advantage plan offered by Senior Health from a
neighbor. Mrs. Parker asks you whether she can enroll in Senior Health’s MA
plan over the telephone. What can you tell her?
I. Enrollment requests can only be made in face-to-face interviews or
by mail.
II. Telephone enrollment request calls must be recorded.
Powered by https://learnexams.com/search/study?query=
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
AHIP (Medicare) 2024 Exam
Questions And Answers updated
latest (Verified Answers)
- 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?
a. Medicare Supplemental Insurance would cover his long-term care
services.
b. 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.
c. Medicare Supplemental Insurance would cover all of his IRS
approved health care expenditures not covered under Original Feefor-Service (FFS) Medicare.
d. Medicare Supplemental Insurance would cover his dental, vision
and hearing services only. - 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?
a. He became eligible for Medicare when his disability eligibility
determination was first made.
b. Individuals receiving such disability payments from the Social
Security Administration continue to receive those payments but
only become eligible for Medicare upon reaching age 65.
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
c. Individuals who become eligible for such disability payments only
have to wait 12 months before they can apply for coverage under
Medicare.
d. After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
- 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?
a. 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.
b. Eligibility for Medicare is based on whether or not a person has
ever been employed by the federal government. If she or her
husband were ever employed by the federal government, she can
enroll in Medicare.
c. Medicare is a program for people who have incomes and assets
below specific limits, so you will have to find out her exact
financial situation before telling her whether she can obtain
Medicare coverage.
d. Medicare is a program for people of all ages w - Mrs. Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should you
tell her?
AHIP (AMERICA’S HEALTH INSURANCE PLANS)
a. Mrs. Ramos should be aware that generally plan providers can
decide, on a case-by-case basis, whether they will treat her.
b. Mrs. Ramos can obtain care from any provider who participates in
Original Medicare, but generally will have a higher cost-sharing
amount if she sees a provider who/that is not a part of the PPO
network.
c. In general, Mrs. Ramos will need a referral to see specialists.
d. In general, Mrs. Ramos can obtain care from any provider who
participates in Original Medicare but will have to pay the difference
between the plan’s allowed amount and the provider’s usual and
customary charge.
- 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?
a. Mr. Wu may still qualify for help in paying Part D costs through his
State Pharmaceutical Assistance Program.
b. Mr. Wu may still qualify for help in paying for Part D costs through
the Federal Pharmaceutical Assistance Program.
c. Mr. Wu may still qualify for help in paying for Part D costs through
the local Office of the Aging.
d. Mr. Wu has no alternative but to liquidate his remaining assets and
apply for coverage through his state’s Medicaid program. - 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
Powered by https://learnexams.com/search/study?query=