AHIP CERTIFICATION EXAMINATION TEST
UPDATED ACTUAL QUESTIONS AND CORRECT
ANSWERS
◉ 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: 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? Answer: 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? Answer: 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? Answer:
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? Answer: Beneficiaries under Original
Medicare have no cost-sharing for most preventive services which
include immunizations such as annual flu shots.
◉ Mrs. Pena 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: 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? Answer: He may sign-up for Medicare at any time
however coverage usually begins on the fourth month after dialysis
treatments start.
◉ 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? Answer: 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.
◉ 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: 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.
Answer: 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.
◉ 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? Answer: Tell
prospect Jerry Smith that he should consider adding a standalone
Part D prescription drug coverage policy to his present coverage.
◉ 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? Answer: 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.
◉ 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? Answer: 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.
UPDATED ACTUAL QUESTIONS AND CORRECT
ANSWERS
◉ 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: 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? Answer: 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? Answer: 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? Answer:
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? Answer: Beneficiaries under Original
Medicare have no cost-sharing for most preventive services which
include immunizations such as annual flu shots.
◉ Mrs. Pena 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: 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? Answer: He may sign-up for Medicare at any time
however coverage usually begins on the fourth month after dialysis
treatments start.
◉ 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? Answer: 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.
◉ 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: 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.
Answer: 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.
◉ 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? Answer: Tell
prospect Jerry Smith that he should consider adding a standalone
Part D prescription drug coverage policy to his present coverage.
◉ 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? Answer: 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.
◉ 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? Answer: 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.
