AHIP 2022 Final Exam Questions with Verified
Correct Answers (2024/2025)
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Mr. Davis is 52 years old He may sign-up for Medicare at any time however
and has recently been coverage usually begins on the fourth month after
diagnosed with end-stage dialysis treatments start.
renal disease (ESRD) and
will soon begin dialysis.
He is wondering if he can
obtain coverage under
Medicare. What should
you tell him?
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Juan Perez, who is turning Juan is likely to be eligible for Medicare once he turns
age 65 next month, age 65 and if he enrolls Medicare would become the
intends to work for several primary payor of his healthcare claims and Smallcap
more years at Smallcap, does not have to continue to offer him coverage
Incorporated. Smallcap comparable to those under age 65 under its
has a workforce of15 employer-sponsored group health plan.
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?
Mr. Moy's wife has a Medicare Supplemental Insurance would help cover
Medicare Advantage plan, his Part A and Part B deductibles or coinsurance in
but he wants to Original Fee-for-Service (FFS) Medicare as well as
understand what possibly some services that Medicare does not cover.
coverage Medicare
Supplemental Insurance
provides since his health
care needs are different
from his wife's needs. What
could you tell Mr. Moy?
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Mrs. Peňa is 66 years old, She may enroll at any time while she is covered under
has coverage under an her employer plan, but she will have a special eight-
employer plan, and will month enrollment period after the last month on her
retire next year. She heard employer plan that differs from the standard general
she must enroll in Part B at enrollment period, during which she may enroll in
the beginning of the year Medicare Part B.
to ensure no gap in
coverage. What can you
tell her?
Mrs. Chen will be 65 soon, Most individuals who are citizens and age 65 or over
has been a citizen for are covered under Part A by virtue of having paid
twelve years, has been Medicare taxes while working, though some may be
employed full time, and covered as a result of paying monthly premiums.
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?
Mrs. Gonzalez is enrolled Mrs. Gonzalez cannot purchase a Medigap plan that
in Original Medicare and covers drugs, but she could keep her Medigap policy
has a Medigap policy as and enroll in a Part D prescription drug plan.
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?
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Mrs. West wears glasses Medicare does not cover massage therapy, or, in
and dentures and has general, glasses or dentures.
enjoyed considerable pain
relief from arthritis
through massage therapy.
She is concerned about
whether or not Medicare
will cover these items and
services. What should you
tell her?
Mr. Patel is in good health Under Original Medicare, there is a single deductible
and is preparing a budget amount due for the first 60 days of any inpatient
in anticipation of his hospital stay, after which it converts into a per-day
retirement when he turns coinsurance amount through day 90. After day 90, he
66. He wants to would pay a daily amount up to 60 days over his
understand the health lifetime, after which he would be responsible for all
care costs he might be costs.
exposed to under
Medicare if he were to
require hospitalization as a
result of an illness. In
general terms, what could
you tell him about his
costs for inpatient hospital
services
under Original Medicare?
Ms. Henderson believes To obtain Part B coverage, she must pay a standard
that she will qualify for monthly premium, though it is higher for individuals
Medicare Coverage when with higher incomes.
she turns 65, without
paying any premiums,
because she has been
working for 40 years and
paying Medicare taxes.
What should you tell her?
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