AHIP module 1 exam
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. - ANS 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? - ANS 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? - ANS 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? - ANS 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? - ANS 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? -
ANS 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? - ANS 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? - ANS 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? - ANS a. Mr. Wu
may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program.
Correct
Mr. 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? - ANS d. Under 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 Correct
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. - ANS 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? - ANS 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? - ANS 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? - ANS 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? - ANS 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? -
ANS 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? - ANS 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? - ANS 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? - ANS a. Mr. Wu
may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program.
Correct
Mr. 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? - ANS d. Under 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 Correct
