TE ST BANK
AHIP F
2024 AHIP
Module 1, 2, 3,
4, 5 (ACTUAL
TEST )
Questions and
Answers
(Solved)
,2024 AHIP Module 1, 2, 3, 4, 5 (ACTUAL TEST ) Questions and Answers (Solved)
1. 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 ,answersMedicare Supplemental ,Insurance ,would ,help
,cover ,his ,Part ,A ,and ,Part ,B ,deductibles ,or coinsurance ,in ,Original ,Fee-for-
Service ,(FFS) ,Medicare ,as ,well ,as ,possibly ,some services ,that ,Medicare
,does ,not ,cover.
2. 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?correct
,answersShe ,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.
3. 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?correct
,answersMost ,individuals ,who ,are ,citizens ,and ,age ,65 ,or ,over ,are covered
,under ,Part ,A ,by ,virtue ,of ,having ,paid ,Medicare ,taxes ,while ,working,
,though some ,may ,be ,covered ,as ,a ,result ,of ,paying ,monthly ,premiums.
, 4. 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?correct ,answersMrs.
,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.
5. Mrs. ,West ,wears ,glasses ,and ,dentures ,and ,has ,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?correct ,answersMedicare does ,not ,cover ,massage ,therapy, ,or,
,in ,general, ,glasses ,or ,dentures.
6. Mr., Patel ,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
,as ,a ,result ,of ,an ,illness. ,In ,general terms, ,what ,could ,you ,tell ,him ,about
,his ,costs ,for ,inpatient ,hospital ,services
under ,Original ,Medicare?correct ,answersUnder ,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.
7. 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?correct
,,answersTo ,obtain ,Part ,B ,coverage, she ,must ,pay ,a ,standard ,monthly
,premium, ,though ,it ,is ,higher ,for ,individuals ,with ,higher,incomes.
, 8. Mr. f,Alonso f,receives f,some f,help f,paying f,for f,his f,two f,generic f,prescription
,drugs f,from f,his f employer's f,retiree f,coverage, f,but f,he f,wants f,to f,compare f,it f,to
,a f,Part f,D f,prescription f,drug f plan. f,He f,asks f,you f,what f,costs f,he f,would
,generally f,expect f,to f,encounter f,when f,enrolling f into f,a f,standard f,MedicarePart
,D f,prescription f,drug f,plan. f,What f,should f,you f,tell f,him?correct fanswers f,He
,generally f ,would f ,pay f ,a f ,monthly f ,premium, f ,annual f ,deductible, f ,and
f ,per- f prescription f,cost-sharing.
9. Mr. f,Davis f,is f,52 f,years f,old f,and f,has f,recently f,been f,diagnosed f,with
f,end- f stage
,renal f,disease,(ESRD) f,and f,will f,soon f,begin f,dialysis. f,He f,is f,wondering f,if f,he
,can f,obtain f,coverage f,under fMedicare. f,What f,should f,you f,tell f,him?correct
,answersHe f,may f,sign-up f,for f,Medicare f ,at fany f,time f,however f,coverage
,usually f,begins f,on f,the f,fourth f,month f,after f,dialysis f,treatments f start.
10. Juan f ,Perez, f ,who f ,is f ,turning f ,age f ,65 f ,next f ,month, f ,intends f ,to
f ,work f ,for
,several
,more f,years f,at,Smallcap, f,Incorporated. f,Smallcap f,has f,a f,workforce f,of15
,employees f,and f,offers
employer-sponsored f,healthcare f,coverage. f,Juan f,is f,a f,naturalized f,citizen f,and
,has f contributed f,to f,the f,Medicare f,system f,for f,over f,20 f,years. f,Juan f,asks f,you
,if f,he f,will f,be f entitled f,to f,Medicare f,and f,if f,he f,enrolls f,how f,that f,will f,impact
,his f,employer-sponsored f healthcare f,coverage. f,How f,would f,you
,respond?correct f,answersJuan f,is f,likely f,to f,be f eligible f,for f,Medicare f,once f,he
,turns f,age f,65 f,and f,if f,he f,enrolls f,Medicare f,would f,become f,the,primary f,payor
,of f,his f,healthcare f,claims f,and f,Smallcap f,does f,not f,have f,to f,continue f,to
f ,offer fhim f,coverage f,comparable f,to f,those f,under f,age f,65 f,under f,its
f ,employer- fsponsored f,group f health f,plan.
,11. Ms. f,Moore f ,plans f ,to f ,retire f ,when f ,she f ,turns f ,65 f ,in f ,a f ,few f ,months.
f ,She f ,is
,in
, ,excellent f,health f and f,will f,have f,considerable f,income f,when f,she f,retires. f,She f,is
,concerned f,that f,her f,income f will f,make f,it f,impossible f,for f,her f,to f,qualify f,for
,Medicare. f,What f,could f,you f,tell f,her f,to f,address,her f,concern?correct
,answersMedicare f,is f,a f,program f,for f,people f,age f,65 f,or f,older f,and f those f,under
,age f,65 f,with f,certain f,disabilities, f,end-stage f,renal f,disease, f,and f,Lou f,Gehrig's
f disease f,so f,she f,will f,be f,eligible f,for f,Medicare.
12. Mr. f ,Xi f ,will f ,soon f ,turn f ,age f ,65 f ,and f ,has f ,come f ,to f ,you f ,for f ,advice
f ,as f ,to
,what
,services f,are f provided f,under f,Original f,Medicare. f,What f,should f,you f,tell f,Mr.
,Xi f,that f,best f,describes f,the f health f,coverage f,provided f,to f,Medicare
,beneficiaries?correct f,answersBeneficiaries f,under,Original f,Medicare f,have f,no
,cost-sharing f,for f,most f,preventive f,services f,which f,include f immunizations f,such
,as f,annual f,flu f,shots.
AHIP F
2024 AHIP
Module 1, 2, 3,
4, 5 (ACTUAL
TEST )
Questions and
Answers
(Solved)
,2024 AHIP Module 1, 2, 3, 4, 5 (ACTUAL TEST ) Questions and Answers (Solved)
1. 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 ,answersMedicare Supplemental ,Insurance ,would ,help
,cover ,his ,Part ,A ,and ,Part ,B ,deductibles ,or coinsurance ,in ,Original ,Fee-for-
Service ,(FFS) ,Medicare ,as ,well ,as ,possibly ,some services ,that ,Medicare
,does ,not ,cover.
2. 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?correct
,answersShe ,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.
3. 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?correct
,answersMost ,individuals ,who ,are ,citizens ,and ,age ,65 ,or ,over ,are covered
,under ,Part ,A ,by ,virtue ,of ,having ,paid ,Medicare ,taxes ,while ,working,
,though some ,may ,be ,covered ,as ,a ,result ,of ,paying ,monthly ,premiums.
, 4. 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?correct ,answersMrs.
,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.
5. Mrs. ,West ,wears ,glasses ,and ,dentures ,and ,has ,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?correct ,answersMedicare does ,not ,cover ,massage ,therapy, ,or,
,in ,general, ,glasses ,or ,dentures.
6. Mr., Patel ,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
,as ,a ,result ,of ,an ,illness. ,In ,general terms, ,what ,could ,you ,tell ,him ,about
,his ,costs ,for ,inpatient ,hospital ,services
under ,Original ,Medicare?correct ,answersUnder ,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.
7. 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?correct
,,answersTo ,obtain ,Part ,B ,coverage, she ,must ,pay ,a ,standard ,monthly
,premium, ,though ,it ,is ,higher ,for ,individuals ,with ,higher,incomes.
, 8. Mr. f,Alonso f,receives f,some f,help f,paying f,for f,his f,two f,generic f,prescription
,drugs f,from f,his f employer's f,retiree f,coverage, f,but f,he f,wants f,to f,compare f,it f,to
,a f,Part f,D f,prescription f,drug f plan. f,He f,asks f,you f,what f,costs f,he f,would
,generally f,expect f,to f,encounter f,when f,enrolling f into f,a f,standard f,MedicarePart
,D f,prescription f,drug f,plan. f,What f,should f,you f,tell f,him?correct fanswers f,He
,generally f ,would f ,pay f ,a f ,monthly f ,premium, f ,annual f ,deductible, f ,and
f ,per- f prescription f,cost-sharing.
9. Mr. f,Davis f,is f,52 f,years f,old f,and f,has f,recently f,been f,diagnosed f,with
f,end- f stage
,renal f,disease,(ESRD) f,and f,will f,soon f,begin f,dialysis. f,He f,is f,wondering f,if f,he
,can f,obtain f,coverage f,under fMedicare. f,What f,should f,you f,tell f,him?correct
,answersHe f,may f,sign-up f,for f,Medicare f ,at fany f,time f,however f,coverage
,usually f,begins f,on f,the f,fourth f,month f,after f,dialysis f,treatments f start.
10. Juan f ,Perez, f ,who f ,is f ,turning f ,age f ,65 f ,next f ,month, f ,intends f ,to
f ,work f ,for
,several
,more f,years f,at,Smallcap, f,Incorporated. f,Smallcap f,has f,a f,workforce f,of15
,employees f,and f,offers
employer-sponsored f,healthcare f,coverage. f,Juan f,is f,a f,naturalized f,citizen f,and
,has f contributed f,to f,the f,Medicare f,system f,for f,over f,20 f,years. f,Juan f,asks f,you
,if f,he f,will f,be f entitled f,to f,Medicare f,and f,if f,he f,enrolls f,how f,that f,will f,impact
,his f,employer-sponsored f healthcare f,coverage. f,How f,would f,you
,respond?correct f,answersJuan f,is f,likely f,to f,be f eligible f,for f,Medicare f,once f,he
,turns f,age f,65 f,and f,if f,he f,enrolls f,Medicare f,would f,become f,the,primary f,payor
,of f,his f,healthcare f,claims f,and f,Smallcap f,does f,not f,have f,to f,continue f,to
f ,offer fhim f,coverage f,comparable f,to f,those f,under f,age f,65 f,under f,its
f ,employer- fsponsored f,group f health f,plan.
,11. Ms. f,Moore f ,plans f ,to f ,retire f ,when f ,she f ,turns f ,65 f ,in f ,a f ,few f ,months.
f ,She f ,is
,in
, ,excellent f,health f and f,will f,have f,considerable f,income f,when f,she f,retires. f,She f,is
,concerned f,that f,her f,income f will f,make f,it f,impossible f,for f,her f,to f,qualify f,for
,Medicare. f,What f,could f,you f,tell f,her f,to f,address,her f,concern?correct
,answersMedicare f,is f,a f,program f,for f,people f,age f,65 f,or f,older f,and f those f,under
,age f,65 f,with f,certain f,disabilities, f,end-stage f,renal f,disease, f,and f,Lou f,Gehrig's
f disease f,so f,she f,will f,be f,eligible f,for f,Medicare.
12. Mr. f ,Xi f ,will f ,soon f ,turn f ,age f ,65 f ,and f ,has f ,come f ,to f ,you f ,for f ,advice
f ,as f ,to
,what
,services f,are f provided f,under f,Original f,Medicare. f,What f,should f,you f,tell f,Mr.
,Xi f,that f,best f,describes f,the f health f,coverage f,provided f,to f,Medicare
,beneficiaries?correct f,answersBeneficiaries f,under,Original f,Medicare f,have f,no
,cost-sharing f,for f,most f,preventive f,services f,which f,include f immunizations f,such
,as f,annual f,flu f,shots.
