AHIP 2024 Final Exam with Complete
Solutions
She should contact her state Medicaid agency to see if she qualifies forprograms that
can help with Medicare costs for which she is responsible. - ANSWER-Mrs. Park is an
elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that
might be of assistance?
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. - ANSWER-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?
After receiving such disability payments for 24 months, he will be automatically enrolled
in Medicare, regardless of age. - ANSWER-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
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. - ANSWER-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?
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. - ANSWER-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?
Tell prospect Jerry Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage. - ANSWER-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?
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. - ANSWER-
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?
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. - ANSWER-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?
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. - ANSWER-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?
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. -
ANSWER-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?
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. - ANSWER-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?
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. - ANSWER-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?
Solutions
She should contact her state Medicaid agency to see if she qualifies forprograms that
can help with Medicare costs for which she is responsible. - ANSWER-Mrs. Park is an
elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that
might be of assistance?
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. - ANSWER-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?
After receiving such disability payments for 24 months, he will be automatically enrolled
in Medicare, regardless of age. - ANSWER-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
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. - ANSWER-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?
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. - ANSWER-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?
Tell prospect Jerry Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage. - ANSWER-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?
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. - ANSWER-
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?
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. - ANSWER-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?
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. - ANSWER-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?
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. -
ANSWER-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?
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. - ANSWER-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?
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. - ANSWER-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?
