AHIP Exam | Questions & 100%
Correct Answers (Verified) | Latest
Update | Grade A+
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving
Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her
that she has been automatically enrolled in Medicare Part B. She wants to understand
what this means. What should you tell Mrs. Quinn?
Correct Answer: Part B primarily covers physician services. She will be paying a
monthly premium and, with the exception of many preventive and screening tests,
generally will have 20% coinsurance for these services, in addition to an annual
deductible.
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and
would like to know which of the following services Original Medicare will cover if the
appropriate criteria are met? What could you tell her?
Correct Answer: Original Medicare covers ambulance services.
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
1
,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.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare
Part A and Part B. She would also like to enroll in a Medicare Supplement (Medigap)
plan. Anita's older neighbor Mel has told her about the Medigap Part F plan in which he
is enrolled. It not only provides foreign travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for advice. What should you tell her?
Correct Answer: You are sorry to disappoint Anita but a Medigap Part F plan is no
longer available to those who turn age 65 after January 1,2020. Anita might instead
consider other Medigap plans that offer foreign travel benefits but do not cover the Part
B deductible.
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 cost sharing in Original Fee-for-Service (FFS) Medicare as well as possibly some
services that Medicare does not cover.
2
,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.
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.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being
successfully treated for that condition. However, she and her physicians feel that after
her lengthy hospital stay she will need a month or two of nursing and rehabilitative care.
3
, What should you tell them about Original Medicare's coverage of care in a skilled
nursing facility?
Correct Answer: Medicare will cover Mrs. Shield's skilled nursing services provided
during the first 20 days of her stay, after which she would have a copay until she has
been in the facility for 100 days.
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.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual
Medicare enrollment period because features of Part D might have changed. Mrs.
Geisler can't remember what Part D is so she called you to ask what her neighbor was
talking about. What could you tell her?
Correct Answer: Part D covers prescription drugs and she should look at her
premiums, formulary, and cost-sharing among other factors to see if they have
changed.
What impact, if any, will recent regulatory changes have upon Medigap plans?
Correct Answer: The Part B deductible will no longer be covered for individuals
newly eligible for Medicare starting January 1, 2020.
4
Correct Answers (Verified) | Latest
Update | Grade A+
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving
Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her
that she has been automatically enrolled in Medicare Part B. She wants to understand
what this means. What should you tell Mrs. Quinn?
Correct Answer: Part B primarily covers physician services. She will be paying a
monthly premium and, with the exception of many preventive and screening tests,
generally will have 20% coinsurance for these services, in addition to an annual
deductible.
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and
would like to know which of the following services Original Medicare will cover if the
appropriate criteria are met? What could you tell her?
Correct Answer: Original Medicare covers ambulance services.
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
1
,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.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare
Part A and Part B. She would also like to enroll in a Medicare Supplement (Medigap)
plan. Anita's older neighbor Mel has told her about the Medigap Part F plan in which he
is enrolled. It not only provides foreign travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for advice. What should you tell her?
Correct Answer: You are sorry to disappoint Anita but a Medigap Part F plan is no
longer available to those who turn age 65 after January 1,2020. Anita might instead
consider other Medigap plans that offer foreign travel benefits but do not cover the Part
B deductible.
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 cost sharing in Original Fee-for-Service (FFS) Medicare as well as possibly some
services that Medicare does not cover.
2
,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.
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.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being
successfully treated for that condition. However, she and her physicians feel that after
her lengthy hospital stay she will need a month or two of nursing and rehabilitative care.
3
, What should you tell them about Original Medicare's coverage of care in a skilled
nursing facility?
Correct Answer: Medicare will cover Mrs. Shield's skilled nursing services provided
during the first 20 days of her stay, after which she would have a copay until she has
been in the facility for 100 days.
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.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual
Medicare enrollment period because features of Part D might have changed. Mrs.
Geisler can't remember what Part D is so she called you to ask what her neighbor was
talking about. What could you tell her?
Correct Answer: Part D covers prescription drugs and she should look at her
premiums, formulary, and cost-sharing among other factors to see if they have
changed.
What impact, if any, will recent regulatory changes have upon Medigap plans?
Correct Answer: The Part B deductible will no longer be covered for individuals
newly eligible for Medicare starting January 1, 2020.
4
