AHIP MODULES 1 5 MEDICARE CERTIFICATION
ACTUAL QUESTIONS WITH VERIFIED
SOLUTIONS
◉ Ms. Kumar 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.
◉ Mrs. Ellis recently turned 66 and decided after many years of
work to retire and begin receiving Social Security benefits. Shortly
thereafter Mrs. Ellis received a letter informing her that she had
been automatically enrolled in Medicare Part B. She wants to
understand what this means. What should you tell Mrs. Ellis?
Answer: Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive and
screening tests, generally will have 20% co-payments for these
services, in addition to an annual deductible.
,◉ Mr. Singh would like drug coverage but does not want to be
enrolled in a Medicare Advantage plan. What should you tell him?
Answer: Mr. 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. Cook is an elderly retiree. Mrs. Cook has a low fixed income.
What could you tell Mrs. Cook 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.
◉ 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.
◉ 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. 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.
◉ Anthony Boniface turned 65 in 2024. He was not receiving Social
Security or Railroad Retirement Benefits on his 65th birthday. He
was interested in obtaining Medicare coverage and is eligible for
premium-free Part A. Before he could enroll in Medicare, his entire
area was impacted by a hurricane causing massive flooding and
severe wind damage. The Federal government declared this to be a
natural disaster which has recently ended. During this period
Anthony's initial enrollment period expired. Anthony asks you how
he can now obtain Medicare coverage. What should you say?
Answer: Anthony is eligible for a special enrollment period (SEP)
because he missed an enrollment period due to the impact of the
Federally declared disaster. This SEP will allow Anthony to enroll in
Part B up to six months after the end of the emergency declaration.
Anthony may enroll in premium-free Part A at any time and his Part
A coverage will be retroactive for up to 6 months.
ACTUAL QUESTIONS WITH VERIFIED
SOLUTIONS
◉ Ms. Kumar 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.
◉ Mrs. Ellis recently turned 66 and decided after many years of
work to retire and begin receiving Social Security benefits. Shortly
thereafter Mrs. Ellis received a letter informing her that she had
been automatically enrolled in Medicare Part B. She wants to
understand what this means. What should you tell Mrs. Ellis?
Answer: Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive and
screening tests, generally will have 20% co-payments for these
services, in addition to an annual deductible.
,◉ Mr. Singh would like drug coverage but does not want to be
enrolled in a Medicare Advantage plan. What should you tell him?
Answer: Mr. 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. Cook is an elderly retiree. Mrs. Cook has a low fixed income.
What could you tell Mrs. Cook 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.
◉ 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.
◉ 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. 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.
◉ Anthony Boniface turned 65 in 2024. He was not receiving Social
Security or Railroad Retirement Benefits on his 65th birthday. He
was interested in obtaining Medicare coverage and is eligible for
premium-free Part A. Before he could enroll in Medicare, his entire
area was impacted by a hurricane causing massive flooding and
severe wind damage. The Federal government declared this to be a
natural disaster which has recently ended. During this period
Anthony's initial enrollment period expired. Anthony asks you how
he can now obtain Medicare coverage. What should you say?
Answer: Anthony is eligible for a special enrollment period (SEP)
because he missed an enrollment period due to the impact of the
Federally declared disaster. This SEP will allow Anthony to enroll in
Part B up to six months after the end of the emergency declaration.
Anthony may enroll in premium-free Part A at any time and his Part
A coverage will be retroactive for up to 6 months.
