AHIP FINAL EXAM 2025<\/p>\n\n\n\n
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? – Precise Answer \u2714\u2714Medicare 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.
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through massage therapy. She is concerned about
whether or not Medicare will cover these items and services. What
should you tell her? – Precise Answer \u2714\u2714Medicare does not cover
massage therapy, or, in general, glasses or dentures.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance? – Precise Answer
\u2714\u2714She 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.
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<\/p>\n\n\n\n
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? – Precise
Answer \u2714\u2714He generally would pay a monthly premium, annual
deductible, and per-prescription cost-sharing.
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? – Precise Answer
\u2714\u2714Mrs. 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\u0002stage renal disease (ESRD) and will soon begin dialysis. He is
wondering if he can obtain coverage under Medicare. What should you
tell him? – Precise Answer \u2714\u2714He may sign-up for Medicare at any time
however coverage usually begins on the fourth month after dialysis
treatments start.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and disagrees
with a determination that partially denied one of her claims for services.
What advice would you give her? – Precise Answer \u2714\u2714Mrs. Duarte
should file an appeal of this initial determination within 120 days of the
date she received the MSN in the mail.<\/p>\n\n\n\n
Mrs. Geisler’s neighbor told her she should look at her Part D options
during the annual Medicare enrollment period because the 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? – Precise Answer \u2714\u2714Part D covers prescription
drugs and she should look at her premiums, formulary, and cost-sharing
among other factors to see if they have changed.
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? – Precise Answer \u2714\u2714Medicare will cover a
total of 190 days of inpatient psychiatric care during Mr. Rainey’s entire
lifetime.
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? – Precise Answer \u2714\u2714Beneficiaries under Original
Medicare have no cost-sharing for most preventive services.
Mr. Singh would like drug coverage but does not want to be enrolled in
a Medicare Advantage plan. What should you tell him? – Precise Answer
\u2714\u2714Mr. 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.
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<\/p>\n\n\n\n