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AHIP Module 1, Medicare Basics and Health Insurance Overview, Certification Study Material

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This document covers AHIP Module 1 and provides an overview of Medicare fundamentals and the U.S. health insurance system. It focuses on Medicare Parts A, B, C, and D, eligibility requirements, enrollment periods, and the role of private insurance in Medicare, making it suitable for AHIP certification study and review. Keywords: AHIP Module 1 Medicare basics Medicare overview AHIP certification study Medicare parts A B C D Medicare eligibility Medicare enrollment periods health insurance fundamentals AHIP training material

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AHIP MODULE 1 | QUESTIONS AND VERIFIED 100%
CORRECT ANSWERS| LATEST UPDATE 2026/2027 |
GRADED A+

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?

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

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January 27, 2026
Number of pages
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