AHIP Final Exam Test 2023
Questions with 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 ANSWER✅
-He may sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
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.
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 ANSWER✅
-Beneficiaries under Original Medicare have no cost-sharing for most preventive services
which include immunizations such as annual flu shots.
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?
- ✔️CORRECT 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.
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. 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?
Questions with 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 ANSWER✅
-He may sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
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.
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 ANSWER✅
-Beneficiaries under Original Medicare have no cost-sharing for most preventive services
which include immunizations such as annual flu shots.
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?
- ✔️CORRECT 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.
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. 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?
