AHIP Certification - Part
1
1. d: 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?
a. Eligibility for Medicare is based on whether or not a person has ever been
employed by the federal government. If she or her husband were ever
employed by the federal government, she can enroll in Medicare.
b. Medicare is a program for people of all ages with specific mental health
disabilities. Since she is in excellent health, she would not qualify, but should
instead look into her state's Medicaid program if she wants further coverage.
c. Medicare is a program for people who have incomes and assets below
specific limits, so you will have to find out her exact financial situation before
telling her whether she can obtain Medicare coverage.
d. 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.
2. b: 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?
a. Part D, which covers prescription drug services, is covered under
Original Medicare.
b. 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.
c. Part C, which always covers dental and vision services, is covered under
Original Medicare.
d. Part A, which covers long term custodial care services, is covered under
Original Medicare.
3. c: Mr. Hernandez is concerned that if he signs up for a Medicare Advantage
plan, the health plan may, at some time in the future, reduce his benefits below
what is available in Original Medicare. What should you tell him about his
concern?
a. He should not be concerned because Medicare health plans must cover all
IRS-approved health care expenses, which means that all of them provide substan
tially greater benefits than are available under Medicare Part A and Part B.
b. Medicare health plans offer a menu of benefits, from which he may choose, so
if he ever wants to increase his coverage, he need only contact the plan and
select other options.
, AHIP Certification - Part
1
c. Medicare health plans must cover all benefits available under Medicare Part
A and Part B. Many also cover Part D prescription drugs.
d. Medicare health plans have the option of deciding, each year, what services
they will cover. He is correct that the health plan could eliminate some benefits
covered by Medicare and he should think carefully before enrolling in a Medicare
health plan.
4. b: Mrs. Roberts has just received a new Medicare identity card in the mail. She
is concerned that it is a forgery since it does not have her Social Security number
on it. What should you tell her?
a. The card is indeed a forgery since newly issued Medicare cards will have both
a beneficiary's Social Security number and date of birth imprinted on them.
b. The card she received I valid, the change has been made to protect
Medicare beneficiaries from identity theft, and she should now destroy her old
card.
c. The card is indeed a forgery since all identity cards are being phased-out in
favor of a new electronic identity system developed by the Social Security
Administration.
d. The card she received is valid but she should keep her old card for at least
two years and present it whenever she receives health care.
5. a: Mrs. Willard wants to know generally how the benefits under Original
Medicare might compare to the benefit package of a Medicare Health Plan before
she starts looking at specific plans. What could you tell her?
a. Medicare Health Plans may offer extra benefits that Original Medicare does
not offer such as vision, hearing, and dental services and must include a
maximum out-of-pocket limit on Part A and Part B services.
b. Medicare Health Plans do not necessarily have to cover all of the Original
Medicare Part A and Part B services, but must include a maximum out-of-
pocket limit.
c. Medicare Health Plans are not permitted to offer any benefits beyond those
available under the Original Medicare program and must have the same
maximum out-of-pocket limit on Part A and Part B services as FFS Medicare.
d. All Medicare Health Plans offer cost-sharing that is lower than Original
Medicare for all Part A and Part B covered services, but the maximum out-of-
pocket limit is higher than in Original Medicare.
6. d: Mr. Meoni'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.Meoni?
, AHIP Certification - Part
1
a. Medicare Supplemental Insurance would cover all of his IRS approved
health care expenditures not covered under Original Fee-for-Service (FFS)
Medicare.
1
1. d: 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?
a. Eligibility for Medicare is based on whether or not a person has ever been
employed by the federal government. If she or her husband were ever
employed by the federal government, she can enroll in Medicare.
b. Medicare is a program for people of all ages with specific mental health
disabilities. Since she is in excellent health, she would not qualify, but should
instead look into her state's Medicaid program if she wants further coverage.
c. Medicare is a program for people who have incomes and assets below
specific limits, so you will have to find out her exact financial situation before
telling her whether she can obtain Medicare coverage.
d. 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.
2. b: 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?
a. Part D, which covers prescription drug services, is covered under
Original Medicare.
b. 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.
c. Part C, which always covers dental and vision services, is covered under
Original Medicare.
d. Part A, which covers long term custodial care services, is covered under
Original Medicare.
3. c: Mr. Hernandez is concerned that if he signs up for a Medicare Advantage
plan, the health plan may, at some time in the future, reduce his benefits below
what is available in Original Medicare. What should you tell him about his
concern?
a. He should not be concerned because Medicare health plans must cover all
IRS-approved health care expenses, which means that all of them provide substan
tially greater benefits than are available under Medicare Part A and Part B.
b. Medicare health plans offer a menu of benefits, from which he may choose, so
if he ever wants to increase his coverage, he need only contact the plan and
select other options.
, AHIP Certification - Part
1
c. Medicare health plans must cover all benefits available under Medicare Part
A and Part B. Many also cover Part D prescription drugs.
d. Medicare health plans have the option of deciding, each year, what services
they will cover. He is correct that the health plan could eliminate some benefits
covered by Medicare and he should think carefully before enrolling in a Medicare
health plan.
4. b: Mrs. Roberts has just received a new Medicare identity card in the mail. She
is concerned that it is a forgery since it does not have her Social Security number
on it. What should you tell her?
a. The card is indeed a forgery since newly issued Medicare cards will have both
a beneficiary's Social Security number and date of birth imprinted on them.
b. The card she received I valid, the change has been made to protect
Medicare beneficiaries from identity theft, and she should now destroy her old
card.
c. The card is indeed a forgery since all identity cards are being phased-out in
favor of a new electronic identity system developed by the Social Security
Administration.
d. The card she received is valid but she should keep her old card for at least
two years and present it whenever she receives health care.
5. a: Mrs. Willard wants to know generally how the benefits under Original
Medicare might compare to the benefit package of a Medicare Health Plan before
she starts looking at specific plans. What could you tell her?
a. Medicare Health Plans may offer extra benefits that Original Medicare does
not offer such as vision, hearing, and dental services and must include a
maximum out-of-pocket limit on Part A and Part B services.
b. Medicare Health Plans do not necessarily have to cover all of the Original
Medicare Part A and Part B services, but must include a maximum out-of-
pocket limit.
c. Medicare Health Plans are not permitted to offer any benefits beyond those
available under the Original Medicare program and must have the same
maximum out-of-pocket limit on Part A and Part B services as FFS Medicare.
d. All Medicare Health Plans offer cost-sharing that is lower than Original
Medicare for all Part A and Part B covered services, but the maximum out-of-
pocket limit is higher than in Original Medicare.
6. d: Mr. Meoni'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.Meoni?
, AHIP Certification - Part
1
a. Medicare Supplemental Insurance would cover all of his IRS approved
health care expenditures not covered under Original Fee-for-Service (FFS)
Medicare.
