AHIP Medicare Exam Questions and Answers
100% Pass
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? - ✔✔-Mr. Wu may
still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program.
What impact, if any, will recent regulatory changes have upon Medigap plans? - ✔✔-The Part B
deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know
which of the following services Original Medicare will cover if the appropriate criteria are met? What
could you tell her? - ✔✔-Original Medicare covers ambulance services.
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? - ✔✔-Tell prospect Jerry Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage.
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original Medicare.
What can you tell her about Medigap as an option to address this concern? - ✔✔-Medigap plans help
beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare Part A and Part
B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel
has told her about the Medigap Part F plan in which he is enrolled. It not only provides foreign travel
emergency benefits but also covers his Medicare Part B deductible. Anita comes to you for advice. What
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,should you tell her? - ✔✔-You are sorry to disappoint Anita but a Medigap Part F plan is no longer
available to those who turn age 65 after January 1,2020. Anita might instead consider other Medigap
plans that offer foreign travel benefits but do not cover the Part B deductible.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan.
What should you tell him? - ✔✔-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. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - ✔✔-Medicare will cover Mrs. Shield's skilled
nursing services provided during the first 20 days of her stay, after which she would have a copay until
she has been in the facility for 100 days.
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? - ✔✔-After receiving such disability payments for
24 months, he will be automatically enrolled in Medicare, regardless of age.
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security
benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been automatically
enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn?
- ✔✔-Part B primarily covers physician services. She will be paying a monthly premium and, with the
exception of many preventive and screening tests, generally will have 20% coinsurance for these services,
in addition to an annual deductible.
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? - ✔✔-Part A, which covers hospital, skilled nursing
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, 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.
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? - ✔✔-He may sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare
enrollment period because features of Part D might have changed. Mrs. Geisler can't remember what Part
D is so she called you to ask what her neighbor was talking about. What could you tell her? - ✔✔-Part D
covers prescription drugs and she should look at her premiums, formulary, and cost-sharing among
other factors to see if they have changed.
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? - ✔✔-Beneficiaries under Original Medicare have no cost-sharing for most
preventive services which include immunizations such as annual flu shots.
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? - ✔✔-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. 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? - ✔✔-Medicare Supplemental Insurance would help cover his Part A and Part B
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100% Pass
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? - ✔✔-Mr. Wu may
still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program.
What impact, if any, will recent regulatory changes have upon Medigap plans? - ✔✔-The Part B
deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know
which of the following services Original Medicare will cover if the appropriate criteria are met? What
could you tell her? - ✔✔-Original Medicare covers ambulance services.
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? - ✔✔-Tell prospect Jerry Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage.
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original Medicare.
What can you tell her about Medigap as an option to address this concern? - ✔✔-Medigap plans help
beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare Part A and Part
B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel
has told her about the Medigap Part F plan in which he is enrolled. It not only provides foreign travel
emergency benefits but also covers his Medicare Part B deductible. Anita comes to you for advice. What
Page 1/16
Crafted for Academic Insight by KatelynWhitman. All rights reserved © 2025
,should you tell her? - ✔✔-You are sorry to disappoint Anita but a Medigap Part F plan is no longer
available to those who turn age 65 after January 1,2020. Anita might instead consider other Medigap
plans that offer foreign travel benefits but do not cover the Part B deductible.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan.
What should you tell him? - ✔✔-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. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - ✔✔-Medicare will cover Mrs. Shield's skilled
nursing services provided during the first 20 days of her stay, after which she would have a copay until
she has been in the facility for 100 days.
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? - ✔✔-After receiving such disability payments for
24 months, he will be automatically enrolled in Medicare, regardless of age.
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security
benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been automatically
enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs. Quinn?
- ✔✔-Part B primarily covers physician services. She will be paying a monthly premium and, with the
exception of many preventive and screening tests, generally will have 20% coinsurance for these services,
in addition to an annual deductible.
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? - ✔✔-Part A, which covers hospital, skilled nursing
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Crafted for Academic Insight by KatelynWhitman. All rights reserved © 2025
, 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.
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? - ✔✔-He may sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare
enrollment period because features of Part D might have changed. Mrs. Geisler can't remember what Part
D is so she called you to ask what her neighbor was talking about. What could you tell her? - ✔✔-Part D
covers prescription drugs and she should look at her premiums, formulary, and cost-sharing among
other factors to see if they have changed.
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? - ✔✔-Beneficiaries under Original Medicare have no cost-sharing for most
preventive services which include immunizations such as annual flu shots.
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? - ✔✔-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. 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? - ✔✔-Medicare Supplemental Insurance would help cover his Part A and Part B
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