AHIP FINAL EXAM | QUESTIONS AND ANSWERS | VERIFIED AND
WELL DETAILED ANSWERS | ALREADY GRADED A+ | LATEST
UPDATE
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
qualify for the Part D low-income subsidy. Where might he turn for help with his
prescription drug costs? - CORRECT ANSWER - Mr. Wu may still qualify for help in
paying Part D costs through his State Pharmaceutical Assistance Program.
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 ANSWER - After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare, regardless
of age.
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 ANSWER -
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. 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 ANSWER - 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.
,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 ANSWER - Tell prospect Jerry Smith that he should
consider adding a standalone Part D prescription drug coverage policy to his
present coverage.
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? - CORRECT ANSWER - He may
sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
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
ANSWER - Mr. Diaz will not pay any penalty because he had continuous coverage
under his employer's plan.
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 ANSWER - 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.
Edward IP suffered from serious kidney disease. As a result. Edward became eligible
for Medicare coverage due to end-stage renal disease (ESRD). A close relative
donated their kidney and Edward successfully underwent transplant
,surgery 12 months ago. Edward is now age 50 and asks you if his Medicare
coverage will continue, what should you say? - CORRECT ANSWER - Individuals
eligible for Medicare based on ESRD generally lose eligibility 36 months after the
month in which the individual receives a kidney transplant unless they are eligible
for Medicare on another basis such as age or disability.
Edward may, however, remain enrolled in Part B but solely for coverage of
immunosuppressive drugs if he has no other health care coverage that would cover
the drugs.
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 ANSWER - 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.
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a
Medigap plan to pick up costs not covered by that plan. What should you tell him? -
CORRECT ANSWER - It is illegal for you to sell Mr. Capadona a Medigap plan if he is
enrolled in an MA plan, and besides, Medigap only works with Original Medicare.
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? - CORRECT ANSWER - To obtain
Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
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 ANSWER - She should contact her
state Medicaid agency to see if she qualifies for one of
several programs that can help with Medicare costs for which she is responsible.
, Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE).
This coverage has recently been terminated due to the end of the PHE. While Shirley
was enrolled in Medicaid, she missed an opportunity to enroll in Medicare and now
wants Part B. Which of the following statements best
describes Shirley's ability to now enroll in Medicare Part B? - CORRECT ANSWER -
Shirley is eligible for a Special Enrollment Period (SEP) for up to six months after the
termination of her Medicaid coverage. Under this SEP, Shirley can choose retroactive
coverage back to the date of termination from Medicaid or coverage beginning the
month after the month of enrollment.
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 ANSWER - 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.
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? - CORRECT ANSWER - 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. 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 ANSWER - 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.
Mr. 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
WELL DETAILED ANSWERS | ALREADY GRADED A+ | LATEST
UPDATE
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
qualify for the Part D low-income subsidy. Where might he turn for help with his
prescription drug costs? - CORRECT ANSWER - Mr. Wu may still qualify for help in
paying Part D costs through his State Pharmaceutical Assistance Program.
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 ANSWER - After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare, regardless
of age.
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 ANSWER -
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. 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 ANSWER - 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.
,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 ANSWER - Tell prospect Jerry Smith that he should
consider adding a standalone Part D prescription drug coverage policy to his
present coverage.
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? - CORRECT ANSWER - He may
sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
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
ANSWER - Mr. Diaz will not pay any penalty because he had continuous coverage
under his employer's plan.
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 ANSWER - 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.
Edward IP suffered from serious kidney disease. As a result. Edward became eligible
for Medicare coverage due to end-stage renal disease (ESRD). A close relative
donated their kidney and Edward successfully underwent transplant
,surgery 12 months ago. Edward is now age 50 and asks you if his Medicare
coverage will continue, what should you say? - CORRECT ANSWER - Individuals
eligible for Medicare based on ESRD generally lose eligibility 36 months after the
month in which the individual receives a kidney transplant unless they are eligible
for Medicare on another basis such as age or disability.
Edward may, however, remain enrolled in Part B but solely for coverage of
immunosuppressive drugs if he has no other health care coverage that would cover
the drugs.
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 ANSWER - 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.
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a
Medigap plan to pick up costs not covered by that plan. What should you tell him? -
CORRECT ANSWER - It is illegal for you to sell Mr. Capadona a Medigap plan if he is
enrolled in an MA plan, and besides, Medigap only works with Original Medicare.
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? - CORRECT ANSWER - To obtain
Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
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 ANSWER - She should contact her
state Medicaid agency to see if she qualifies for one of
several programs that can help with Medicare costs for which she is responsible.
, Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE).
This coverage has recently been terminated due to the end of the PHE. While Shirley
was enrolled in Medicaid, she missed an opportunity to enroll in Medicare and now
wants Part B. Which of the following statements best
describes Shirley's ability to now enroll in Medicare Part B? - CORRECT ANSWER -
Shirley is eligible for a Special Enrollment Period (SEP) for up to six months after the
termination of her Medicaid coverage. Under this SEP, Shirley can choose retroactive
coverage back to the date of termination from Medicaid or coverage beginning the
month after the month of enrollment.
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 ANSWER - 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.
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? - CORRECT ANSWER - 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. 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 ANSWER - 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.
Mr. 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
