AHIP 2024 final exam questions and
100% verified 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 Answer 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 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.;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.;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.;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 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 Answer
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 Answer 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 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.;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. 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 Answer 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 Answer 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 Answer 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.;Mr. Castillo, a naturalized citizen, previously enrolled in
Medicare Part B but has recently stopped paying his Part B premium. Mr. Castillo is still
covered by Part A. He would like to enroll in a Medicare Advantage (MA) plan and is still
covered by Part A. What should you tell him? - Correct Answer He is not eligible to
enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B.;Mr. Barker
enjoys a comfortable retirement income. He recently had surgery and expected that he
would have certain services and items covered by the plan with minimal out-of-pocket
costs because his MA-PD coverage has been very good. However, when he received
the bill, he was surprised to see large charges in excess of his maximum out-of-pocket
limit that included some services and items he thought would be fully covered. He called
you to ask what he could do? What could you tell him? - Correct Answer You can offer
to review the plans appeal process to help him ask the plan to review the coverage
decision.;Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income
level. She wishes to enroll in a MA MSA plan that she heard about from her neighbor.
She also wants to have prescription drug coverage since her doctor recently prescribed
several expensive medications. Currently, she is enrolled in Original Medicare and a
standalone Part D plan. How would you advise Mrs. Chi? - Correct Answer Mrs. Chi
may enroll in a MA MSA plan and remain in her current standalone Part D prescription
drug plan.;Mrs. Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should you tell her? -
Correct Answer Mrs. Ramos can obtain care from any provider who participates in
Original Medicare, but generally will have a higher cost-sharing amount if she sees a
100% verified 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 Answer 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 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.;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.;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.;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 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 Answer
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 Answer 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 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.;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. 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 Answer 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 Answer 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 Answer 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.;Mr. Castillo, a naturalized citizen, previously enrolled in
Medicare Part B but has recently stopped paying his Part B premium. Mr. Castillo is still
covered by Part A. He would like to enroll in a Medicare Advantage (MA) plan and is still
covered by Part A. What should you tell him? - Correct Answer He is not eligible to
enroll in a Medicare Advantage plan until he re-enrolls in Medicare Part B.;Mr. Barker
enjoys a comfortable retirement income. He recently had surgery and expected that he
would have certain services and items covered by the plan with minimal out-of-pocket
costs because his MA-PD coverage has been very good. However, when he received
the bill, he was surprised to see large charges in excess of his maximum out-of-pocket
limit that included some services and items he thought would be fully covered. He called
you to ask what he could do? What could you tell him? - Correct Answer You can offer
to review the plans appeal process to help him ask the plan to review the coverage
decision.;Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income
level. She wishes to enroll in a MA MSA plan that she heard about from her neighbor.
She also wants to have prescription drug coverage since her doctor recently prescribed
several expensive medications. Currently, she is enrolled in Original Medicare and a
standalone Part D plan. How would you advise Mrs. Chi? - Correct Answer Mrs. Chi
may enroll in a MA MSA plan and remain in her current standalone Part D prescription
drug plan.;Mrs. Ramos is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should you tell her? -
Correct Answer Mrs. Ramos can obtain care from any provider who participates in
Original Medicare, but generally will have a higher cost-sharing amount if she sees a
