AHIP FINAL EXAM | QUESTIONS AND ANSWERS | VERIFIED
ANSWERS | ALREADY GRADED A+ | LATEST UPDATE
Ms. Galindo will turn 65 on June 10th. She has never previously qualified for
Medicare. She is entitled to Medicare Part A and intends to enroll in Part B. She
wants to know if she is eligible to enroll in a Medicare Advantage plan that
includes prescription drug coverage. What do you tell her? - CORRECT
ANSWER - a. Ms. Galindo can enroll in an MA-PD plan now since her initial
election period (IEP) for Part D prescription drug coverage and initial coverage
election period (ICEP) are occurring together beginning March 1st and ending
September 30th.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare
Advantage (MA) and Part D plans that Agent Smith sells at the regular Tuesday
brunch the neighbors have for senior citizens. What should Agent Tom Smith
tell Mr. Moreno about the kinds of food that can be provided to potential
enrollees who attend the sales presentation? - CORRECT ANSWER - A meal
cannot be provided, but light snacks would be permitted.
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? - CORRECT ANSWER - 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.
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. 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 (SPAP).
Mr. Vasquez is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the health care costs he
might be exposed to under Medicare if he were to require hospitalization
because of an illness. In general terms, what could you tell him about his costs
for inpatient hospital services under Original Medicare? - CORRECT
ANSWER - Under Original Medicare, there is a single deductible amount due
for the first 60 days of any inpatient hospital stay, after which it converts into a
per-day coinsurance amount through day 90. After day 90, he would pay a daily
amount up to 60 days over his lifetime, after which he would be responsible for
all costs.
Mr. Moy will soon turn age 65. He is slightly younger than his wife. 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
deductible and Part B coinsurance or copayments in Original Fee-for-Service
(FFS) Medicare as well as possibly some services that Medicare does not cover.
Juan Perez, who is turning age 65 next month, intends to work for several more
years at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and
offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and
has contributed to the Medicare system for over 20 years. Juan asks you if he
will be entitled to Medicare and if he enrolls how that will impact his employer-
sponsored healthcare coverage. How would you respond? - CORRECT
ANSWER - Juan is likely to be eligible for Medicare once he turns age 65 and
if he enrolls, Medicare would become the primary payor of his healthcare
claims and Smallcap does not have to continue to offer him coverage
comparable to those under age 65 under its employer-sponsored group health
plan. Juan is likely to be eligible for Medicare once he turns age 65 and if he
enrolls, Medicare would become the primary payor of his healthcare claims but
,Smallcap must continue to offer him coverage under its employer-sponsored
group health plan and would become a secondary payor.
Ms. Kumar 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. Ellis recently turned 66 and decided after many years of work to retire and
begin receiving Social Security benefits. Shortly thereafter Mrs. Ellis received a
letter informing her that she had been automatically enrolled in Medicare Part
B. She wants to understand what this means. What should you tell Mrs. Ellis? -
CORRECT ANSWER - Part B primarily covers physician services. She will
be paying a monthly premium and, except for many preventive and screening
tests, generally will have 20% co-payments for these services, in addition to an
annual deductible.
Mr. Singh would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him? - CORRECT ANSWER
- Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be
covered for Part A and Part B services through Original Fee-for-Service
Medicare.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could
you tell Mrs. Cook that might be of assistance? - CORRECT ANSWER - To
obtain Part B coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher incomes.
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.
Anthony Boniface turned 65 in 2024. He was not receiving Social Security or
Railroad Retirement Benefits on his 65th birthday. He was interested in
obtaining Medicare coverage and is eligible for premium-free Part A. Before he
could enroll in Medicare, his entire area was impacted by a hurricane causing
massive flooding and severe wind damage. The Federal government declared
this to be a natural disaster which has recently ended. During this period
Anthony's initial enrollment period expired. Anthony asks you how he can now
obtain Medicare coverage. What should you say? - CORRECT ANSWER -
Anthony is eligible for a special enrollment period (SEP) because he missed an
enrollment period due to the impact of the Federally declared disaster. This SEP
will allow Anthony to enroll in Part B up to six months after the end of the
emergency declaration. Anthony may enroll in premium-free Part A at any time
and his Part A coverage will be retroactive for up to 6 months.
Ms. Lewis has aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her? -
CORRECT ANSWER - Medicare covers hospice services, and they will be
available for her.
Edward 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? - CORRECT ANSWER -
Individuals eligible for Medicare based on ESRD generally lose eligibility 36
months after the month in which the individual receives a kidney transplant
ANSWERS | ALREADY GRADED A+ | LATEST UPDATE
Ms. Galindo will turn 65 on June 10th. She has never previously qualified for
Medicare. She is entitled to Medicare Part A and intends to enroll in Part B. She
wants to know if she is eligible to enroll in a Medicare Advantage plan that
includes prescription drug coverage. What do you tell her? - CORRECT
ANSWER - a. Ms. Galindo can enroll in an MA-PD plan now since her initial
election period (IEP) for Part D prescription drug coverage and initial coverage
election period (ICEP) are occurring together beginning March 1st and ending
September 30th.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare
Advantage (MA) and Part D plans that Agent Smith sells at the regular Tuesday
brunch the neighbors have for senior citizens. What should Agent Tom Smith
tell Mr. Moreno about the kinds of food that can be provided to potential
enrollees who attend the sales presentation? - CORRECT ANSWER - A meal
cannot be provided, but light snacks would be permitted.
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? - CORRECT ANSWER - 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.
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. 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 (SPAP).
Mr. Vasquez is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the health care costs he
might be exposed to under Medicare if he were to require hospitalization
because of an illness. In general terms, what could you tell him about his costs
for inpatient hospital services under Original Medicare? - CORRECT
ANSWER - Under Original Medicare, there is a single deductible amount due
for the first 60 days of any inpatient hospital stay, after which it converts into a
per-day coinsurance amount through day 90. After day 90, he would pay a daily
amount up to 60 days over his lifetime, after which he would be responsible for
all costs.
Mr. Moy will soon turn age 65. He is slightly younger than his wife. 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
deductible and Part B coinsurance or copayments in Original Fee-for-Service
(FFS) Medicare as well as possibly some services that Medicare does not cover.
Juan Perez, who is turning age 65 next month, intends to work for several more
years at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and
offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and
has contributed to the Medicare system for over 20 years. Juan asks you if he
will be entitled to Medicare and if he enrolls how that will impact his employer-
sponsored healthcare coverage. How would you respond? - CORRECT
ANSWER - Juan is likely to be eligible for Medicare once he turns age 65 and
if he enrolls, Medicare would become the primary payor of his healthcare
claims and Smallcap does not have to continue to offer him coverage
comparable to those under age 65 under its employer-sponsored group health
plan. Juan is likely to be eligible for Medicare once he turns age 65 and if he
enrolls, Medicare would become the primary payor of his healthcare claims but
,Smallcap must continue to offer him coverage under its employer-sponsored
group health plan and would become a secondary payor.
Ms. Kumar 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. Ellis recently turned 66 and decided after many years of work to retire and
begin receiving Social Security benefits. Shortly thereafter Mrs. Ellis received a
letter informing her that she had been automatically enrolled in Medicare Part
B. She wants to understand what this means. What should you tell Mrs. Ellis? -
CORRECT ANSWER - Part B primarily covers physician services. She will
be paying a monthly premium and, except for many preventive and screening
tests, generally will have 20% co-payments for these services, in addition to an
annual deductible.
Mr. Singh would like drug coverage but does not want to be enrolled in a
Medicare Advantage plan. What should you tell him? - CORRECT ANSWER
- Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be
covered for Part A and Part B services through Original Fee-for-Service
Medicare.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could
you tell Mrs. Cook that might be of assistance? - CORRECT ANSWER - To
obtain Part B coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher incomes.
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.
Anthony Boniface turned 65 in 2024. He was not receiving Social Security or
Railroad Retirement Benefits on his 65th birthday. He was interested in
obtaining Medicare coverage and is eligible for premium-free Part A. Before he
could enroll in Medicare, his entire area was impacted by a hurricane causing
massive flooding and severe wind damage. The Federal government declared
this to be a natural disaster which has recently ended. During this period
Anthony's initial enrollment period expired. Anthony asks you how he can now
obtain Medicare coverage. What should you say? - CORRECT ANSWER -
Anthony is eligible for a special enrollment period (SEP) because he missed an
enrollment period due to the impact of the Federally declared disaster. This SEP
will allow Anthony to enroll in Part B up to six months after the end of the
emergency declaration. Anthony may enroll in premium-free Part A at any time
and his Part A coverage will be retroactive for up to 6 months.
Ms. Lewis has aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her? -
CORRECT ANSWER - Medicare covers hospice services, and they will be
available for her.
Edward 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? - CORRECT ANSWER -
Individuals eligible for Medicare based on ESRD generally lose eligibility 36
months after the month in which the individual receives a kidney transplant
