AHIP Final Exam Test
Questions and Answers (2022/2023) (Verified Answers)
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 answersHe 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 answersJuan 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
aredifferent from his wife's needs. What could you tell Mr. Moy?correct
answersMedicare 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?correct answersShe 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 qualifyfor coverage under part A because she was not born in the United
States. What should you tell her?correct answersMost 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?correct answersMrs. 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 willcover these items and services. What should you tell her?correct
answersMedicare 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 tounder 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 answersUnder 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 paya 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?correct answersTo obtain
Part B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes.
Mr. 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 MedicarePart D prescription drug plan. What should you
tell him?correct answersHe generally would pay a monthly premium, annual
deductible, and per- prescription cost-sharing.
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 answersMedicare 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.
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
answersBeneficiaries under Original Medicare have no cost-sharing for most
preventive services which include immunizations such as annual flu shots.
Questions and Answers (2022/2023) (Verified Answers)
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 answersHe 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 answersJuan 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
aredifferent from his wife's needs. What could you tell Mr. Moy?correct
answersMedicare 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?correct answersShe 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 qualifyfor coverage under part A because she was not born in the United
States. What should you tell her?correct answersMost 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?correct answersMrs. 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 willcover these items and services. What should you tell her?correct
answersMedicare 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 tounder 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 answersUnder 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 paya 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?correct answersTo obtain
Part B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes.
Mr. 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 MedicarePart D prescription drug plan. What should you
tell him?correct answersHe generally would pay a monthly premium, annual
deductible, and per- prescription cost-sharing.
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 answersMedicare 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.
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
answersBeneficiaries under Original Medicare have no cost-sharing for most
preventive services which include immunizations such as annual flu shots.
