AHIP 2024 final exam Questions with
Correct Answers
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might
be of assistance? - correct answers:She should contact her state Medicaid agency to see if she qualifies
forprograms that can help with Medicare costs for which she is responsible.
Madeline Martinez was widowed several years ago. Her husband worked for many years and contributed
into the Medicare system. He also left a substantial 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? - correct answers: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.
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 - correct answers:After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare, regardless of age.
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? - correct answers: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.
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? -
correct answers: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.
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? - correct answers:Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present coverage.
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 wants to know how much he will have to pay. What should you tell him? - correct
answers: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.
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? - correct answers: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.
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? - correct answers: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.
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? - correct answers: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.
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 determine his eligibility? - correct answers: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.
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? - correct answers: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.
Correct Answers
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might
be of assistance? - correct answers:She should contact her state Medicaid agency to see if she qualifies
forprograms that can help with Medicare costs for which she is responsible.
Madeline Martinez was widowed several years ago. Her husband worked for many years and contributed
into the Medicare system. He also left a substantial 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? - correct answers: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.
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 - correct answers:After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare, regardless of age.
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? - correct answers: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.
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? -
correct answers: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.
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? - correct answers:Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present coverage.
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 wants to know how much he will have to pay. What should you tell him? - correct
answers: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.
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? - correct answers: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.
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? - correct answers: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.
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? - correct answers: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.
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 determine his eligibility? - correct answers: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.
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? - correct answers: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.
