America's Health Insurance Plans CERTIFICATION.
AHIP EXAM QUESTIONS AND ANSWERS.
100% CORRECT
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? - CORRECT ANS>>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? - correct answer
- CORRECT ANS>>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.
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? - correct answer
- CORRECT ANS>>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.
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?
- CORRECT ANS>>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.
,America's Health Insurance Plans CERTIFICATION.
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? - CORRECT ANS>>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.
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? - CORRECT ANS>>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.
,America's Health Insurance Plans CERTIFICATION.
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? - CORRECT ANS>>Medicare does not cover massage therapy, or, in
general, glasses or dentures.
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? - CORRECT ANS>>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.
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? - CORRECT ANS>>To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes.
Alonso receives some help paying for his two generic prescription drugs from his employer's retiree
coverage, but he wants to compare it to a Part D prescription drug plan. He asks you what costs he
would generally expect to encounter when enrolling into a standard Medicare Part D prescription
drug plan. What should you tell him? - CORRECT ANS>>He generally would pay a monthly premium,
annual deductible, and per-prescription cost-sharing.
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? - CORRECT
ANS>>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.
, America's Health Insurance Plans CERTIFICATION.
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? - CORRECT ANS>>Beneficiaries under Original Medicare have no cost-sharing
for most preventive services which include immunizations such as annual flu shots.
AHIP EXAM QUESTIONS AND ANSWERS.
100% CORRECT
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? - CORRECT ANS>>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? - correct answer
- CORRECT ANS>>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.
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? - correct answer
- CORRECT ANS>>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.
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?
- CORRECT ANS>>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.
,America's Health Insurance Plans CERTIFICATION.
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? - CORRECT ANS>>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.
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? - CORRECT ANS>>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.
,America's Health Insurance Plans CERTIFICATION.
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? - CORRECT ANS>>Medicare does not cover massage therapy, or, in
general, glasses or dentures.
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? - CORRECT ANS>>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.
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? - CORRECT ANS>>To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes.
Alonso receives some help paying for his two generic prescription drugs from his employer's retiree
coverage, but he wants to compare it to a Part D prescription drug plan. He asks you what costs he
would generally expect to encounter when enrolling into a standard Medicare Part D prescription
drug plan. What should you tell him? - CORRECT ANS>>He generally would pay a monthly premium,
annual deductible, and per-prescription cost-sharing.
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? - CORRECT
ANS>>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.
, America's Health Insurance Plans CERTIFICATION.
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? - CORRECT ANS>>Beneficiaries under Original Medicare have no cost-sharing
for most preventive services which include immunizations such as annual flu shots.
