AHIP 2025 Final Exam Questions and 100% verified Answers |guaranteed pass!!

1.Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided under
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Original Medicare. What should you tell Mr. Xi that best describes the health coverage provided to
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Medicare beneficiaries?
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a.Beneficiaries under Original Medicare have no cost-sharing for most preventive services
which
include immunizations such as annual flu hots.


a. Medicare Part A generally covers medically necessary physician and other health care professional
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qu services.

b. Benefits covered by Medicare Parts A and B include routine dental care, hearing aids, and routine eye
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qu care.

c. Medicare Part B generally provides prescription drug coverage.
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2. Mr. Buck has several family members who died from different cancers. He wants to know if
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Medicare covers cancer screening. What should you tell him?
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a. Medicare covers all screening tests that have been approved by the FDA on a frequency determined
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by the treating physician.
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b. Medicare covers treatments for existing disease, injury, and malformed limbs or body parts. As
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such, it does not cover any screening tests and these must be paid for by the beneficiary out-of-
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pocket.
c. Medicare covers some screening tests that must be performed within the first year after
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qu enrollment. Beyond that point expenses for screening tests are the responsibility of the
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, qu beneficiary.


d. Medicare covers the periodic performance of a range of screening tests that are meant to provide
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qu early detection of disease. Mr. Buck will need to check specific tests before obtaining them to see if
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qu they will be covered.
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Source: Module 1, Slide - Medicare Part B Benefits - Preventive Services and
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qScreenings
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3. Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original
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Fee- for- Service (FFS) Medicare? What could you tell him?
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a. Part C, which always covers dental and vision services, is covered under Original Medicare.
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b. Part A, which covers hospital, skilled nursing facility, hospice, and home health services and
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Part B,
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which covers professional services such as those provided by a doctor are covered
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under Original
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q Medic
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,q areu




c. Part A, which covers long-term custodial care services, is covered under Original Medicare.
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d. Part D, which covers prescription drug services, is covered under Original Medicare.
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Source: Module 1, Slide - Overview of Medicare Benefits and Coverage - Parts A, B,
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q u C, and Slide - Overview of Different Ways to Get Medicare
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4. Juan Perez, who is turning age 65 next month, intends to work for several more years
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at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and offers
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employer-sponsored healthcare coverage. Juan is a naturalized citizen and has
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contributed to the Medicare system for over 20 years. Juan asks you if he will be
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entitled to Medicare and if he enrolls how that will impact his employer- sponsored
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healthcare coverage. How would you respond?
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a. Juan is likely to be ineligible for Medicare since he was born outside the United States
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qu and has only contributed to the Medicare system for 20 years.
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, b. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls
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Medicare would become the primary payor of his healthcare claims but
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Smallcap must continue to offer him coverage under its employer-sponsored
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group health plan and would become a secondary payor.
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c. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls his
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qu employer- sponsored coverage would continue to be the primary payor while Medicare
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qu would be considered a secondary payor of his healthcare claims.
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Incorrect: Medicare is the primary payor for individuals who have group health
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qu coverage due to their continued employment with a small employer. A small group
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qu health plan is one offered by a company with fewer than 20 employees.
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d. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls
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Medicare would become the primary payor of his healthcare claims and Smallcap does
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not have to continue to offer him coverage comparable to those under age 65 under its
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employer-sponsored group health plan.
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Source: Module 1, Slide - Eligibility for Part A and Part B Benefits and Slide - Medicare for
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Individuals Who Are Still Working - Small GHPs and Slide - Medicare Coordination
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with Employer Group Health
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Plans Question 4 qu qu




5. Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the
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Social Security Administration and has been receiving disability payments. He is
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wondering whether he can obtain coverage under Medicare. What should you tell
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him?
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a. After receiving such disability payments for 24 months, he will be
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automatically enrolled in Medicare,
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regardless
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f age.qu




b. Individuals who become eligible for such disability payments only have to wait 12 qu q u q u q u q u q u q u q u q u q u q u q u




months before
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they can apply for coverage under Medicare.
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c. Individuals receiving such disability payments from the Social Security q u q u q u q u q u q u q u q u




q u Administration continue to receive those payments but only become eligible for q u q u qu qu qu qu qu qu qu qu




qu Medicare upon reaching age 65. qu qu qu qu




d. He became eligible for Medicare when his disability eligibility determination was
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first made. Source: Module 1, Slide - Medicare Enrollment Part A & B
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