AHIP 2025 final exam with Correct Answers.

AHIP 2025 final exam with 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 ,for ,programs
,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 ,to ,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.