AHIP EXAM SCRIPT SET 3 UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
◉ 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.
◉ 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? Answer: 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. 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? Answer: 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.
◉ 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.
◉ 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.
◉ 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.
,◉ 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.
◉ 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? Answer: 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.
◉ 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. 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.
◉ 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.
◉ Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income.
What could you tell Mrs. Park that might be of assistance? Answer:
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.
QUESTIONS AND CORRECT ANSWERS
◉ 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.
◉ 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? Answer: 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. 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? Answer: 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.
◉ 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.
◉ 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.
◉ 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.
,◉ 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.
◉ 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? Answer: 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.
◉ 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. 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.
◉ 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.
◉ Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income.
What could you tell Mrs. Park that might be of assistance? Answer:
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.
