AHIP EXAM QUESTIONS WITH COMPLETE
SOLUTIONS.
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?
Medicare is a program for people age 65 or older & those age under 65 with certain
disabilities; ESRD, & ALS so she will be eligible for Medicare.
Mrs. Chen will be 65 soon, has been a citizen for 12 years, has been employed
full-time, & paid taxes during the entire period. She is concerned that she will not
qualify for coverage under Part A because she was not born in the U.S. what
should you tell her?
Most people who are citizens & age 65 and older 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.
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 healthcare costs he
might be exposed under Medicare if he were to require hospitalization as a result
of an illness. What could you tell him about his costs for inpatient hospital
services under OG Medicare?
Under OG 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.
Mrs. Park is an elderly retiree and has a low fixed income. Would could you tell
Mrs. Park that may help her?
She could contact her state Medicaid to see if she qualifies for one of several programs
that can help with Medicare costs for which she is responsible.
Mr. Schmidt would like to plan for retirement and has asked you what is covered
under OG Medicare? What would you tell him?
Part A covers hospital, SNF, hospice, & home health services & Part B, which covers
professional services such as those provided by a doctor are covered under OG
Medicare
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through massage therapy. She is concerned whether or not
Medicare will cover these items. What should you tell her?
Medicare does not cover massage therapy or in general glasses or dentures
Mr. A receives some help paying for his 2 generic prescr. drugs from his
employer's retiree coverage, but he wants to compare it to Part D PDP. He asks
you what costs he would generally encounter when enrolling into a standard
Medicare Pt D drug plan? what should you tell him?
He would generally pay a monthly premium, annual ded., & prescr. cost-sharing.
, Mrs. P is 66 years old, has coverage under an employer plan, & will retire next
year. She heard she must enroll in Pt B at the beginning of the year to ensure no
gap in coverage. What can you tell her?
She may enroll at anytime while she is covered under her employer plan, but she will
have an 8 month enrollment period after the last month her employer plan that differs
from the standard GEP, during which she may enroll in Med Pt B
Mrs. G is enrolled in a OG med & has a Medigap policy as well, but it provides no
drug coverage. She would like to keep the coverage she has but keep the
coverage that she has but replace her existing Medigap with one that provides
drug coverage. What would you tell her?
Mrs. G can not purchase a Medigap plan that covers drugs, she she could keep her
medigap policy & enroll in a Pt D PDP
Mr. D is 52 years old & has recently been diagnosed with ESRD & will soon begin
dialysis. He is wondering if he can get coverage under Medicare. What should
you tell him?
He may sign up for Medicare at anytime, however coverage usually begins on the 4th
month after dialysis tx begins.
Mr. H believes that she will qualify for Medicare when she turns 65 without paying
any premiums bc she has worked 40 years & paid Medicare taxes. What should
you tell her?
To get Pt B coverage, she must pay a standard monthly premium, though it is higher for
people with higher incomes.
Mr. C would like to purchase a MA plan & a Medigap plan. what should you tell
him?
It is illegal for you to sell Mr. C a Medigap plan if he is enrolled in an MA plan. Plus
Medigap only works with OG Medicare
Mr. R has been experiencing delusions & his physician feels that he should be
hospitalized. What should you tell Mr. R/ his rep about the length of an inpatient
hospital stay that Medicare will cover?
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. R's entire
lifetime
Mr. M wants to understand what coverage Medicare Supplemental insurance
provides. What could you tell him?
Medicare Supplemental insurance would help coverage Part A & B deds or coinsurance
in Original FFS Medicare & possibly some services that Medicare does not cover.
Mr. B wants to know if Medicare covers cancer screening? What should you tell
him?
Medicare covers periodic ranges of screening tests that are meant to provide early
detection of diseases. Mr. B will have to check specific tests before getting them to see
if they will be covered
Mr. B if 49 years old, but 18 months ago he was declared disabled by SSA & has
been getting disability payments. He is wondering whether he can get coverage
under Medicare. What should you tell him?
After getting such disability payments for 24 months. he will be automatically enrolled in
Medicare, regardless of age
SOLUTIONS.
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?
Medicare is a program for people age 65 or older & those age under 65 with certain
disabilities; ESRD, & ALS so she will be eligible for Medicare.
Mrs. Chen will be 65 soon, has been a citizen for 12 years, has been employed
full-time, & paid taxes during the entire period. She is concerned that she will not
qualify for coverage under Part A because she was not born in the U.S. what
should you tell her?
Most people who are citizens & age 65 and older 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.
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 healthcare costs he
might be exposed under Medicare if he were to require hospitalization as a result
of an illness. What could you tell him about his costs for inpatient hospital
services under OG Medicare?
Under OG 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.
Mrs. Park is an elderly retiree and has a low fixed income. Would could you tell
Mrs. Park that may help her?
She could contact her state Medicaid to see if she qualifies for one of several programs
that can help with Medicare costs for which she is responsible.
Mr. Schmidt would like to plan for retirement and has asked you what is covered
under OG Medicare? What would you tell him?
Part A covers hospital, SNF, hospice, & home health services & Part B, which covers
professional services such as those provided by a doctor are covered under OG
Medicare
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through massage therapy. She is concerned whether or not
Medicare will cover these items. What should you tell her?
Medicare does not cover massage therapy or in general glasses or dentures
Mr. A receives some help paying for his 2 generic prescr. drugs from his
employer's retiree coverage, but he wants to compare it to Part D PDP. He asks
you what costs he would generally encounter when enrolling into a standard
Medicare Pt D drug plan? what should you tell him?
He would generally pay a monthly premium, annual ded., & prescr. cost-sharing.
, Mrs. P is 66 years old, has coverage under an employer plan, & will retire next
year. She heard she must enroll in Pt B at the beginning of the year to ensure no
gap in coverage. What can you tell her?
She may enroll at anytime while she is covered under her employer plan, but she will
have an 8 month enrollment period after the last month her employer plan that differs
from the standard GEP, during which she may enroll in Med Pt B
Mrs. G is enrolled in a OG med & has a Medigap policy as well, but it provides no
drug coverage. She would like to keep the coverage she has but keep the
coverage that she has but replace her existing Medigap with one that provides
drug coverage. What would you tell her?
Mrs. G can not purchase a Medigap plan that covers drugs, she she could keep her
medigap policy & enroll in a Pt D PDP
Mr. D is 52 years old & has recently been diagnosed with ESRD & will soon begin
dialysis. He is wondering if he can get coverage under Medicare. What should
you tell him?
He may sign up for Medicare at anytime, however coverage usually begins on the 4th
month after dialysis tx begins.
Mr. H believes that she will qualify for Medicare when she turns 65 without paying
any premiums bc she has worked 40 years & paid Medicare taxes. What should
you tell her?
To get Pt B coverage, she must pay a standard monthly premium, though it is higher for
people with higher incomes.
Mr. C would like to purchase a MA plan & a Medigap plan. what should you tell
him?
It is illegal for you to sell Mr. C a Medigap plan if he is enrolled in an MA plan. Plus
Medigap only works with OG Medicare
Mr. R has been experiencing delusions & his physician feels that he should be
hospitalized. What should you tell Mr. R/ his rep about the length of an inpatient
hospital stay that Medicare will cover?
Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. R's entire
lifetime
Mr. M wants to understand what coverage Medicare Supplemental insurance
provides. What could you tell him?
Medicare Supplemental insurance would help coverage Part A & B deds or coinsurance
in Original FFS Medicare & possibly some services that Medicare does not cover.
Mr. B wants to know if Medicare covers cancer screening? What should you tell
him?
Medicare covers periodic ranges of screening tests that are meant to provide early
detection of diseases. Mr. B will have to check specific tests before getting them to see
if they will be covered
Mr. B if 49 years old, but 18 months ago he was declared disabled by SSA & has
been getting disability payments. He is wondering whether he can get coverage
under Medicare. What should you tell him?
After getting such disability payments for 24 months. he will be automatically enrolled in
Medicare, regardless of age
