AHIP EXAM SCRIPT SET 2 UPDATED ACTUAL
QUESTIONS AND CORRECT 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? Answer: He may sign-up for Medicare at any time
however coverage usually begins on the fourth month after dialysis
treatments start.
◉ 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? 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? 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? Answer: Individuals eligible for
Medicare based on ESRD generally lose eligibility 36 months after
the month in which the individual receives a kidney transplant
unless they are eligible for Medicare on another basis such as age or
disability. Edward may, however, remain enrolled in Part B but solely
for coverage of immunosuppressive drugs if he has no other health
care coverage that would cover the drugs.
◉ Mrs. Pena 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? 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.
,◉ 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? 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.
◉ Ms. Henderson believes that she will qualify for Medicare
Coverage when she turns 65, without paying any premiums, because
she has been working for 40 years and paying Medicare taxes. What
should you tell her? Answer: To obtain Part B coverage, she must pay
a standard monthly premium, though it is higher for individuals with
higher incomes.
◉ Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income.
What could you tell Mrs. Park that might be of assistance? Answer:
She should contact her state Medicaid agency to see if she qualifies
for one of several programs that can help with Medicare costs for
which she is responsible.
◉ Shirly Thomas was enrolled in Medicaid during the Public Health
Emergency (PHE). This coverage has recently been terminated due
to the end of the PHE. While Shirley was enrolled in Medicaid, she
missed an opportunity to enroll in Medicare and now wants Part B.
Which of the following statements best describes Shirley's ability to
now enroll in Medicare Part B? Answer: Shirley is eligible for a
Special Enrollment Period (SEP) for up to six months after the
termination of her Medicaid coverage. Under this SEP, Shirley can
, choose retroactive coverage back to the date of termination from
Medicaid or coverage beginning the month after the month of
enrollment.
◉ 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? 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. Gonzalez is enrolled in Original Medicare and has a Medigap
policy as well, but it provides no drug coverage. She would like to
keep the coverage she has but replace her existing Medigap plan
with one that provides drug coverage. What should you tell her?
Answer: Mrs. Gonzalez cannot purchase a Medigap plan that covers
drugs, but she could keep her Medigap policy and enroll in a Part D
prescription drug plan.
◉ 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? Answer: Most individuals who are citizens and age 65 or over
are covered under Part A by virtue of having paid Medicare taxes
QUESTIONS AND CORRECT 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? Answer: He may sign-up for Medicare at any time
however coverage usually begins on the fourth month after dialysis
treatments start.
◉ 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? 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? 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? Answer: Individuals eligible for
Medicare based on ESRD generally lose eligibility 36 months after
the month in which the individual receives a kidney transplant
unless they are eligible for Medicare on another basis such as age or
disability. Edward may, however, remain enrolled in Part B but solely
for coverage of immunosuppressive drugs if he has no other health
care coverage that would cover the drugs.
◉ Mrs. Pena 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? 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.
,◉ 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? 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.
◉ Ms. Henderson believes that she will qualify for Medicare
Coverage when she turns 65, without paying any premiums, because
she has been working for 40 years and paying Medicare taxes. What
should you tell her? Answer: To obtain Part B coverage, she must pay
a standard monthly premium, though it is higher for individuals with
higher incomes.
◉ Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income.
What could you tell Mrs. Park that might be of assistance? Answer:
She should contact her state Medicaid agency to see if she qualifies
for one of several programs that can help with Medicare costs for
which she is responsible.
◉ Shirly Thomas was enrolled in Medicaid during the Public Health
Emergency (PHE). This coverage has recently been terminated due
to the end of the PHE. While Shirley was enrolled in Medicaid, she
missed an opportunity to enroll in Medicare and now wants Part B.
Which of the following statements best describes Shirley's ability to
now enroll in Medicare Part B? Answer: Shirley is eligible for a
Special Enrollment Period (SEP) for up to six months after the
termination of her Medicaid coverage. Under this SEP, Shirley can
, choose retroactive coverage back to the date of termination from
Medicaid or coverage beginning the month after the month of
enrollment.
◉ 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? 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. Gonzalez is enrolled in Original Medicare and has a Medigap
policy as well, but it provides no drug coverage. She would like to
keep the coverage she has but replace her existing Medigap plan
with one that provides drug coverage. What should you tell her?
Answer: Mrs. Gonzalez cannot purchase a Medigap plan that covers
drugs, but she could keep her Medigap policy and enroll in a Part D
prescription drug plan.
◉ 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? Answer: Most individuals who are citizens and age 65 or over
are covered under Part A by virtue of having paid Medicare taxes
