AHIP 2024 final exam
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1. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance?: She should contact her state
Medicaid agency to see if she qualifies forprograms that can help with Medicare
costs for which she is responsible.
2. Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a substan-
tial 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?: 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.
3. Mr. Bauer is 49 years old, but eighteen months ago he was declared dis-
abled 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.
4. 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 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.
5. Mrs. PeHa 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?: 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.
6. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is cur-
rently 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.
7. 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
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wants to know how much he will have to pay. What should you tell him?: The
penalty will be a permanent 10% increase in his Part B premium for every 12-month
period that passed during which he could have enrolled and did not.
8. Ms. 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?: 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.
9. 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?: 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.
10. Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his
area has an attractive premium. He wants to know if he must use doctors in
a network as his current HMO plan requires him to do. What should you tell
him?: He may receive health care services from any doctor allowed to bill Medicare,
as long as he shows the doctor the plan's identification card and the doctor agrees to
accept the PFFS plan's payment terms and conditions, which could include balance
billing.
11. Mr. Kelly wants to know whether he is eligible to sign up for a Private
fee-for-service (PFFS) plan. What questions would you need to ask to deter-
mine his eligibility?: You would need to ask Mr. Kelly if he is enrolled in Part A and
Part B and if he lives in the PFFS plan's service area.
12. Mrs. Wang wants to know generally how the benefits under Original
Medicare might compare to the benefits package of a Medicare Advantage
Plan before she starts looking at specific plans. What could you tell her?: -
Medicare Advantage Plans may offer extra benefits that Original Medicare does
not offer such as vision, hearing, and dental services. It must include a maximum
out-of-pocket limit on Part A and Part B services.
13. Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but
has recently stopped paying his Part B premium. Mr. Castillo is still covered
by Part A. He would like to enroll in a Medicare Advantage (MA) plan and is
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1. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance?: She should contact her state
Medicaid agency to see if she qualifies forprograms that can help with Medicare
costs for which she is responsible.
2. Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a substan-
tial 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?: 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.
3. Mr. Bauer is 49 years old, but eighteen months ago he was declared dis-
abled 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.
4. 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 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.
5. Mrs. PeHa 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?: 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.
6. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is cur-
rently 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.
7. 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
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, AHIP 2024 final exam
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wants to know how much he will have to pay. What should you tell him?: The
penalty will be a permanent 10% increase in his Part B premium for every 12-month
period that passed during which he could have enrolled and did not.
8. Ms. 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?: 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.
9. 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?: 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.
10. Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his
area has an attractive premium. He wants to know if he must use doctors in
a network as his current HMO plan requires him to do. What should you tell
him?: He may receive health care services from any doctor allowed to bill Medicare,
as long as he shows the doctor the plan's identification card and the doctor agrees to
accept the PFFS plan's payment terms and conditions, which could include balance
billing.
11. Mr. Kelly wants to know whether he is eligible to sign up for a Private
fee-for-service (PFFS) plan. What questions would you need to ask to deter-
mine his eligibility?: You would need to ask Mr. Kelly if he is enrolled in Part A and
Part B and if he lives in the PFFS plan's service area.
12. Mrs. Wang wants to know generally how the benefits under Original
Medicare might compare to the benefits package of a Medicare Advantage
Plan before she starts looking at specific plans. What could you tell her?: -
Medicare Advantage Plans may offer extra benefits that Original Medicare does
not offer such as vision, hearing, and dental services. It must include a maximum
out-of-pocket limit on Part A and Part B services.
13. Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but
has recently stopped paying his Part B premium. Mr. Castillo is still covered
by Part A. He would like to enroll in a Medicare Advantage (MA) plan and is
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https://www.coursehero.com/file/250039954/AHIP-2024-final-exampdf/
