AHIP 2025 MODULE 1 EXAM Q’S AND
A’S
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare. What should you tell Mr. Xi that best describes the
health coverage provided to Medicare beneficiaries? - Answer- Beneficiaries under
Original Medicare have no cost-sharing for most preventive services
Mrs. Quinn recently turned 66 and decided after many years of work to begin
receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a letter
informing her that she has been automatically enrolled in Medicare Part B. She
wants to understand what this means. What should you tell Mrs. Quinn? - Answer-
Part B primarily covers physician services. She will be paying a monthly premium
and, except for many preventive screening and tests, generally will have 20 percent
co-payments for these services in addition to an annual deductible
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 treatment
Mr. Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug
plan. He asks you what costs he would generally expect to encounter when enrolling
into a standard Medicare Part D prescription drug plan. What should you tell him? -
Answer- He generally would pay a monthly premium, annual deductible, and per-
prescription cost sharing.
Ms. Brooks has an aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her? - Answer-
Medicare covers hospice services and they will be available to her.
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.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a determination
that partially denied one of her claims for services. What advice would you give her?
- Answer- Mrs. Duarte should file an appeal of this initial determination within 120
days of the date she received the MSN in the mail.
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.
A’S
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare. What should you tell Mr. Xi that best describes the
health coverage provided to Medicare beneficiaries? - Answer- Beneficiaries under
Original Medicare have no cost-sharing for most preventive services
Mrs. Quinn recently turned 66 and decided after many years of work to begin
receiving Social Security benefits. Shortly thereafter Mrs. Quinn received a letter
informing her that she has been automatically enrolled in Medicare Part B. She
wants to understand what this means. What should you tell Mrs. Quinn? - Answer-
Part B primarily covers physician services. She will be paying a monthly premium
and, except for many preventive screening and tests, generally will have 20 percent
co-payments for these services in addition to an annual deductible
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 treatment
Mr. Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug
plan. He asks you what costs he would generally expect to encounter when enrolling
into a standard Medicare Part D prescription drug plan. What should you tell him? -
Answer- He generally would pay a monthly premium, annual deductible, and per-
prescription cost sharing.
Ms. Brooks has an aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her? - Answer-
Medicare covers hospice services and they will be available to her.
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.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a determination
that partially denied one of her claims for services. What advice would you give her?
- Answer- Mrs. Duarte should file an appeal of this initial determination within 120
days of the date she received the MSN in the mail.
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.
