AHIP 2024 FINAL EXAM
Mrs. Park is an elderly retiree. Mrs. Park She should contact her state Medicaid
has a low fixed income. What could you agency to see if she qualifies forpro-
tell Mrs. Park that might be of assis- grams that can help with Medicare costs
tance? for which she is responsible.
Madeline Martinez was widowed sev-
eral years ago. Her husband worked You should tell Madeline that she will
for many years and contributed into the be able to enroll in Medicare Part A
Medicare system. He also left a sub- without paying monthly premiums due
stantial estate which provides Madeline to her husband's long work record and
with an annual income of approximate- participation in the Medicare system. You
ly $130,000. Madeline, who has only should also tell Madeline that she will
worked part-time for the last three years, pay Part B premiums at more than the
will soon turn age 65 and hopes to enroll standard lowest rate but less than the
in Original Medicare. She comes to you highest rate due her substantial income.
for advice. What should you tell her?
Mr. Bauer is 49 years old, but eighteen
months ago he was declared disabled by
the Social Security Administration and After receiving such disability payments
has been receiving disability payments. for 24 months, he will be automatically
He is wondering whether he can obtain enrolled in Medicare, regardless of age.
coverage under Medicare. What should
you tell him
Part A, which covers hospital, skilled
Mr. Schmidt would like to plan for re-
nursing facility, hospice and home health
tirement and has asked you what is
services and Part B, which covers pro-
covered under Original Fee-for-Service
fessional services such as those provid-
(FFS) Medicare? What could you tell
ed by a doctor are covered under Origi-
him?
nal Medicare.
Mrs. PeHa is 66 years old, has coverage She may enroll at any time while she
under an employer plan, and will retire is covered under her employer plan, but
next year. She heard she must enroll in she will have a special eight month en-
Part B at the beginning of the year to rollment period that differs from the stan-
ensure no gap in coverage. What can dard general enrollment period, during
you tell her? 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
, AHIP 2024 FINAL EXAM
has also purchased a Medicare Supple-
Tell prospect Jerry Smith that he should
ment (Medigap) plan which he has had
consider adding a standalone Part D pre-
for several years. However, the plan does
scription drug coverage policy to his pre-
not provide drug benefits. How would you
sent coverage.
advise Agent John Miller to proceed?
Mr. Diaz continued working with his com-
pany and was insured under his employ-
The penalty will be a permanent 10%
er's group plan until he reached age 68.
increase in his Part B premium for
He has heard that there is a premium
every 12-month period that passed dur-
penalty for those who did not sign up for
ing which he could have enrolled and did
Part B when first eligible and wants to
not.
know how much he will have to pay. What
should you tell him?
Ms. Moore plans to retire when she turns
65 in a few months. She is in excel-
Medicare is a program for people age 65
lent health and will have considerable
or older and those under age 65 with cer-
income when she retires. She is con-
tain disabilities, end-stage renal disease,
cerned that her income will make it im-
and Lou Gehrig's disease so she will be
possible for her to qualify for Medicare.
eligible for Medicare.
What could you tell her to address her
concern?
Mildred Savage enrolled in Allcare
Medicare Advantage plan several years
ago. Mildred recently learned that she is Mildred may remain enrolled in Allcare
suffering from inoperable cancer and has and make a hospice election. Hospice
just a few months to live. She would like benefits will be paid for by Original
to spend these final months in hospice Medicare under Part A and Allcare will
care. Mildred's family asks you whether continue to pay for any non-hospice ser-
hospice benefits will be paid for under vices.
the Allcare Medicare Advantage plan.
What should you say?
Mr. Gomez notes that a Private He may receive health care services
Fee-for-Service (PFFS) plan available in from any doctor allowed to bill Medicare,
his area has an attractive premium. He as long as he shows the doctor the plan's
wants to know if he must use doctors identification card and the doctor agrees
in a network as his current HMO plan to accept the PFFS plan's payment terms
requires him to do. What should you tell and conditions, which could include bal-
him? ance billing.
Mrs. Park is an elderly retiree. Mrs. Park She should contact her state Medicaid
has a low fixed income. What could you agency to see if she qualifies forpro-
tell Mrs. Park that might be of assis- grams that can help with Medicare costs
tance? for which she is responsible.
Madeline Martinez was widowed sev-
eral years ago. Her husband worked You should tell Madeline that she will
for many years and contributed into the be able to enroll in Medicare Part A
Medicare system. He also left a sub- without paying monthly premiums due
stantial estate which provides Madeline to her husband's long work record and
with an annual income of approximate- participation in the Medicare system. You
ly $130,000. Madeline, who has only should also tell Madeline that she will
worked part-time for the last three years, pay Part B premiums at more than the
will soon turn age 65 and hopes to enroll standard lowest rate but less than the
in Original Medicare. She comes to you highest rate due her substantial income.
for advice. What should you tell her?
Mr. Bauer is 49 years old, but eighteen
months ago he was declared disabled by
the Social Security Administration and After receiving such disability payments
has been receiving disability payments. for 24 months, he will be automatically
He is wondering whether he can obtain enrolled in Medicare, regardless of age.
coverage under Medicare. What should
you tell him
Part A, which covers hospital, skilled
Mr. Schmidt would like to plan for re-
nursing facility, hospice and home health
tirement and has asked you what is
services and Part B, which covers pro-
covered under Original Fee-for-Service
fessional services such as those provid-
(FFS) Medicare? What could you tell
ed by a doctor are covered under Origi-
him?
nal Medicare.
Mrs. PeHa is 66 years old, has coverage She may enroll at any time while she
under an employer plan, and will retire is covered under her employer plan, but
next year. She heard she must enroll in she will have a special eight month en-
Part B at the beginning of the year to rollment period that differs from the stan-
ensure no gap in coverage. What can dard general enrollment period, during
you tell her? 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
, AHIP 2024 FINAL EXAM
has also purchased a Medicare Supple-
Tell prospect Jerry Smith that he should
ment (Medigap) plan which he has had
consider adding a standalone Part D pre-
for several years. However, the plan does
scription drug coverage policy to his pre-
not provide drug benefits. How would you
sent coverage.
advise Agent John Miller to proceed?
Mr. Diaz continued working with his com-
pany and was insured under his employ-
The penalty will be a permanent 10%
er's group plan until he reached age 68.
increase in his Part B premium for
He has heard that there is a premium
every 12-month period that passed dur-
penalty for those who did not sign up for
ing which he could have enrolled and did
Part B when first eligible and wants to
not.
know how much he will have to pay. What
should you tell him?
Ms. Moore plans to retire when she turns
65 in a few months. She is in excel-
Medicare is a program for people age 65
lent health and will have considerable
or older and those under age 65 with cer-
income when she retires. She is con-
tain disabilities, end-stage renal disease,
cerned that her income will make it im-
and Lou Gehrig's disease so she will be
possible for her to qualify for Medicare.
eligible for Medicare.
What could you tell her to address her
concern?
Mildred Savage enrolled in Allcare
Medicare Advantage plan several years
ago. Mildred recently learned that she is Mildred may remain enrolled in Allcare
suffering from inoperable cancer and has and make a hospice election. Hospice
just a few months to live. She would like benefits will be paid for by Original
to spend these final months in hospice Medicare under Part A and Allcare will
care. Mildred's family asks you whether continue to pay for any non-hospice ser-
hospice benefits will be paid for under vices.
the Allcare Medicare Advantage plan.
What should you say?
Mr. Gomez notes that a Private He may receive health care services
Fee-for-Service (PFFS) plan available in from any doctor allowed to bill Medicare,
his area has an attractive premium. He as long as he shows the doctor the plan's
wants to know if he must use doctors identification card and the doctor agrees
in a network as his current HMO plan to accept the PFFS plan's payment terms
requires him to do. What should you tell and conditions, which could include bal-
him? ance billing.
