AHIP CERTIFICATION EXAM UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
◉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?
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.
◉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? 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. 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? Answer: Mr. Diaz will not pay any penalty because
he had continuous coverage under his employer's 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? Answer: 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. 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?
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. 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? Answer: After receiving
such disability payments for 24 months, he will be automatically
enrolled in Medicare, regardless of age.
◉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? Answer: Beneficiaries under Original Medicare have no
cost-sharing for most preventive services which include immunizations
such as annual flu shots.
◉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?
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. 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? Answer: He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments
start.
, ◉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? 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.
◉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? Answer: To obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher
incomes.
◉To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes. 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.
QUESTIONS AND CORRECT ANSWERS
◉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?
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.
◉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? 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. 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? Answer: Mr. Diaz will not pay any penalty because
he had continuous coverage under his employer's 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? Answer: 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. 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?
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. 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? Answer: After receiving
such disability payments for 24 months, he will be automatically
enrolled in Medicare, regardless of age.
◉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? Answer: Beneficiaries under Original Medicare have no
cost-sharing for most preventive services which include immunizations
such as annual flu shots.
◉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?
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. 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? Answer: He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments
start.
, ◉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? 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.
◉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? Answer: To obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher
incomes.
◉To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes. 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.
