,2023 AHIP EXAM QUESTIONS AND
ANSWERS 100% CORRECT!
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? - ANSWERHe may sign-up for Medicare at any
time however coverage usually begins on the fourth month after dialysis treatments
start.
Juan Perez, who is turning age 65 next month, intends to work for several more years at
Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers
employer-sponsored healthcare coverage. Juan is a naturalized citizen and has
contributed to the Medicare system for over 20 years. Juan asks you if he will be
entitled to Medicare and if he enrolls how that will impact his employer-sponsored
healthcare coverage. How would you respond? - ANSWERJuan is likely to be eligible
for Medicare once he turns age 65 and if he enrolls Medicare would become the primary
payor of his healthcare claims and Smallcap does not have to continue to offer him
coverage comparable to those under age 65 under its employer-sponsored group health
plan.
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? - ANSWERMedicare 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.
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? - ANSWERShe 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.
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? - ANSWERMost 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.
West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through massage therapy. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her? - ANSWERMedicare does
not cover massage therapy, or, in general, glasses or dentures.
Patel is in good health and is preparing a budget in anticipation of his retirement when
he turns 66. He wants to understand the health care costs he might be exposed to
under Medicare if he were to require hospitalization as a result of an illness. In general
terms, what could you tell him about his costs for inpatient hospital services
under Original Medicare? - ANSWERUnder Original Medicare, there is a single
deductible amount due for the first 60 days of any inpatient hospital stay, after which it
converts into a per-day coinsurance amount through day 90. After day 90, he would pay
a daily amount up to 60 days over his lifetime, after which he would be responsible for
all costs.
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? - ANSWERTo obtain Part B coverage, she
must pay a standard monthly premium, though it is higher for individuals with higher
incomes.
Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug
plan. He asks you what costs he would generally expect to encounter when enrolling
into a standard MedicarePart D prescription drug plan. What should you tell him? -
ANSWERHe generally would pay a monthly premium, annual deductible, and per-
prescription cost-sharing.
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? - ANSWERMedicare 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.
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
ANSWERS 100% CORRECT!
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? - ANSWERHe may sign-up for Medicare at any
time however coverage usually begins on the fourth month after dialysis treatments
start.
Juan Perez, who is turning age 65 next month, intends to work for several more years at
Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers
employer-sponsored healthcare coverage. Juan is a naturalized citizen and has
contributed to the Medicare system for over 20 years. Juan asks you if he will be
entitled to Medicare and if he enrolls how that will impact his employer-sponsored
healthcare coverage. How would you respond? - ANSWERJuan is likely to be eligible
for Medicare once he turns age 65 and if he enrolls Medicare would become the primary
payor of his healthcare claims and Smallcap does not have to continue to offer him
coverage comparable to those under age 65 under its employer-sponsored group health
plan.
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? - ANSWERMedicare 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.
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? - ANSWERShe 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.
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? - ANSWERMost 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.
West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through massage therapy. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her? - ANSWERMedicare does
not cover massage therapy, or, in general, glasses or dentures.
Patel is in good health and is preparing a budget in anticipation of his retirement when
he turns 66. He wants to understand the health care costs he might be exposed to
under Medicare if he were to require hospitalization as a result of an illness. In general
terms, what could you tell him about his costs for inpatient hospital services
under Original Medicare? - ANSWERUnder Original Medicare, there is a single
deductible amount due for the first 60 days of any inpatient hospital stay, after which it
converts into a per-day coinsurance amount through day 90. After day 90, he would pay
a daily amount up to 60 days over his lifetime, after which he would be responsible for
all costs.
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? - ANSWERTo obtain Part B coverage, she
must pay a standard monthly premium, though it is higher for individuals with higher
incomes.
Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug
plan. He asks you what costs he would generally expect to encounter when enrolling
into a standard MedicarePart D prescription drug plan. What should you tell him? -
ANSWERHe generally would pay a monthly premium, annual deductible, and per-
prescription cost-sharing.
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? - ANSWERMedicare 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.
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
