➢AHIP Exam Latest (2024/2025) | 50 Verified
Questions and Correct Answers | A+ Graded
Mr. Lee was intending to enroll in MaxCare's Medicare Advantage plan
this year. However, due to his current medical condition, his daughter
Debbie has been appointed as his legal representative over both health
and financial matters. Debbie would like to ensure that her father is still
able to enroll in MaxCare's plan, but she is unsure what her role is to
help with his enrollment request. What advice can you give her?
<<<100%CorreCtanswers>>Legal representatives are only
permitted to submit a paper enrollment request. ???????????
Last year Agent Melanie Meyers marketed and enrolled several clients
in Medicare Advantage (MA) health plans. This year she has decided to
focus on non-MA products. What advice would you give Melanie if she
wishes to continue to receive renewal fees?
<<<100%CorreCtanswers>>Melanie must remain trained, tested,
licensed, and appointed, regardless of whether she is actively selling
MA products.
Alice is enrolled in a MA-PD plan. She makes a permanent move across
the country and wonders what her options are for continuing MA-PD
coverage. What would you say to her in regard to a special enrollment
period (SEP)? <<<100%CorreCtanswers>>She is likely to qualify
for a SEP. She can choose an effective date of up to three months after
the month in which the enrollment form is received by the new plan,
,but the effective date may not be earlier than the date of her
permanent move.
You work for a Sponsor. Last month, while reviewing a Centers for
Medicare & Medicaid Services (CMS) monthly report, you identified
multiple individuals not enrolled in the plan but for whom the Sponsor
is paid. You spoke to your supervisor who said don't worry about it. This
month, you identify the same enrollees on the report again. What
should you do? <<<100%CorreCtanswers>>Although you know
about the Sponsor's non-retaliation policy, you are still nervous about
reporting—to be safe, you submit a report through your compliance
department's anonymous tip line to avoid identification
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?
<<<100%CorreCtanswers>>He 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?
<<<100%CorreCtanswers>>Juan 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.
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? <<<100%CorreCtanswers>>Medicare
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.
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?
<<<100%CorreCtanswers>>She 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.
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?
<<<100%CorreCtanswers>>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.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy
as well, but it provides no drug coverage. She would like to keep the
, coverage she has but replace her existing Medigap plan with one that
provides drug coverage. What should you tell her?
<<<100%CorreCtanswers>>Mrs. Gonzalez cannot purchase a
Medigap plan that covers drugs, but she could keep her Medigap policy
and enroll in a Part D prescription drug plan.
Mrs. 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? <<<100%CorreCtanswers>>Medicare
does not cover massage therapy, or, in general, glasses or dentures.
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? <<<100%CorreCtanswers>>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.
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? <<<100%CorreCtanswers>>To obtain Part B coverage,
Questions and Correct Answers | A+ Graded
Mr. Lee was intending to enroll in MaxCare's Medicare Advantage plan
this year. However, due to his current medical condition, his daughter
Debbie has been appointed as his legal representative over both health
and financial matters. Debbie would like to ensure that her father is still
able to enroll in MaxCare's plan, but she is unsure what her role is to
help with his enrollment request. What advice can you give her?
<<<100%CorreCtanswers>>Legal representatives are only
permitted to submit a paper enrollment request. ???????????
Last year Agent Melanie Meyers marketed and enrolled several clients
in Medicare Advantage (MA) health plans. This year she has decided to
focus on non-MA products. What advice would you give Melanie if she
wishes to continue to receive renewal fees?
<<<100%CorreCtanswers>>Melanie must remain trained, tested,
licensed, and appointed, regardless of whether she is actively selling
MA products.
Alice is enrolled in a MA-PD plan. She makes a permanent move across
the country and wonders what her options are for continuing MA-PD
coverage. What would you say to her in regard to a special enrollment
period (SEP)? <<<100%CorreCtanswers>>She is likely to qualify
for a SEP. She can choose an effective date of up to three months after
the month in which the enrollment form is received by the new plan,
,but the effective date may not be earlier than the date of her
permanent move.
You work for a Sponsor. Last month, while reviewing a Centers for
Medicare & Medicaid Services (CMS) monthly report, you identified
multiple individuals not enrolled in the plan but for whom the Sponsor
is paid. You spoke to your supervisor who said don't worry about it. This
month, you identify the same enrollees on the report again. What
should you do? <<<100%CorreCtanswers>>Although you know
about the Sponsor's non-retaliation policy, you are still nervous about
reporting—to be safe, you submit a report through your compliance
department's anonymous tip line to avoid identification
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?
<<<100%CorreCtanswers>>He 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?
<<<100%CorreCtanswers>>Juan 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.
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? <<<100%CorreCtanswers>>Medicare
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.
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?
<<<100%CorreCtanswers>>She 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.
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?
<<<100%CorreCtanswers>>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.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy
as well, but it provides no drug coverage. She would like to keep the
, coverage she has but replace her existing Medigap plan with one that
provides drug coverage. What should you tell her?
<<<100%CorreCtanswers>>Mrs. Gonzalez cannot purchase a
Medigap plan that covers drugs, but she could keep her Medigap policy
and enroll in a Part D prescription drug plan.
Mrs. 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? <<<100%CorreCtanswers>>Medicare
does not cover massage therapy, or, in general, glasses or dentures.
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? <<<100%CorreCtanswers>>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.
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? <<<100%CorreCtanswers>>To obtain Part B coverage,
