AHIP Final Exam with verified Questions & Answers Latest
Question 1
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?
To obtain Part B coverage, she must pay a standard monthly premium, though it
is higher for individuals with higher incomes.
Question 2
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?
d.
Beneficiaries under Original Medicare have no cost-sharing for most preventive
services which include immunizations such as annual flu shots.
Question 3
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?
b.
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.
Question 4
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?
,b.
He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
Question 5
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?
b.
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.
Question 6
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?
d.
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.
Question 7
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?
d.
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.
Question 8
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?
a.
After receiving such disability payments for 24 months, he will be automatically
enrolled in Medicare, regardless of age.
Question 9
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?
a.
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.
Question 10
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?
d.
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.
Question 11
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?
a.
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.
Question 12
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?
d.
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.
Question 13
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?
c.
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.
Question 14
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?
d.
Mr. Wu may still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program.
Question 15
Question 1
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?
To obtain Part B coverage, she must pay a standard monthly premium, though it
is higher for individuals with higher incomes.
Question 2
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?
d.
Beneficiaries under Original Medicare have no cost-sharing for most preventive
services which include immunizations such as annual flu shots.
Question 3
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?
b.
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.
Question 4
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?
,b.
He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
Question 5
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?
b.
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.
Question 6
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?
d.
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.
Question 7
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?
d.
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.
Question 8
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?
a.
After receiving such disability payments for 24 months, he will be automatically
enrolled in Medicare, regardless of age.
Question 9
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?
a.
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.
Question 10
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?
d.
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.
Question 11
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?
a.
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.
Question 12
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?
d.
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.
Question 13
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?
c.
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.
Question 14
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?
d.
Mr. Wu may still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program.
Question 15
