AHIP FINAL EXAMS QUESTIONS WITH
CORRECT ANSWERS
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you
tell Mrs. Park that might be of assistance? - CORRECT ANSWER-She should
contact her state Medicaid agency to see if she qualifies forprograms that can
help with Medicare costs for which she is responsible.
Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a substantial
estate which provides Madeline with an annual income of approximately
$130,000. Madeline, who has only worked part-time for the last three years, will
soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for
advice. What should you tell her? - CORRECT ANSWER-You should tell
Madeline that she will be able to enroll in Medicare Part A without paying monthly
premiums due to her husband's long work record and participation in the
Medicare system. You should also tell Madeline that she will pay Part B
premiums at more than the standard lowest rate but less than the highest rate
due her substantial income.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by
the Social Security Administration and has been receiving disability payments. He
is wondering whether he can obtain coverage under Medicare. What should you
tell him - CORRECT ANSWER-After receiving such disability payments for 24
months, he will be automatically enrolled in Medicare, regardless of age.
Mr. Schmidt would like to plan for retirement and has asked you what is covered
under Original Fee-for-Service (FFS) Medicare? What could you tell him? -
CORRECT ANSWER-Part A, which covers hospital, skilled nursing facility,
hospice and home health services and Part B, which covers professional services
such as those provided by a doctor are covered under Original Medicare.
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 ANSWER-She
may enroll at any time while she is covered under her employer plan, but she will
have a special eight month enrollment period that differs from the standard
general enrollment period, during which she may enroll in Medicare Part B.
, Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently
enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare
Supplement (Medigap) plan which he has had for several years. However, the
plan does not provide drug benefits. How would you advise Agent John Miller to
proceed? - CORRECT ANSWER-Tell prospect Jerry Smith that he should
consider adding a standalone Part D prescription drug coverage policy to his
present coverage.
Mr. Diaz continued working with his company and was insured under his
employer's group plan until he reached age 68. He has heard that there is a
premium penalty for those who did not sign up for Part B when first eligible and
wants to know how much he will have to pay. What should you tell him? -
CORRECT ANSWER-The penalty will be a permanent 10% increase in his Part
B premium for every 12-month period that passed during which he could have
enrolled and did not.
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 to address her concern? - CORRECT ANSWER-Medicare is a program
for people age 65 or older and those under age 65 with certain disabilities, end-
stage renal disease, and Lou Gehrig's disease so she will be eligible for
Medicare.
Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago.
Mildred recently learned that she is suffering from inoperable cancer and has just
a few months to live. She would like to spend these final months in hospice care.
Mildred's family asks you whether hospice benefits will be paid for under the
Allcare Medicare Advantage plan. What should you say? - CORRECT ANSWER-
Mildred may remain enrolled in Allcare and make a hospice election. Hospice
benefits will be paid for by Original Medicare under Part A and Allcare will
continue to pay for any non-hospice services.
Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area
has an attractive premium. He wants to know if he must use doctors in a network
as his current HMO plan requires him to do. What should you tell him? -
CORRECT ANSWER-He may receive health care services from any doctor
allowed to bill Medicare, as long as he shows the doctor the plan's identification
card and the doctor agrees to accept the PFFS plan's payment terms and
conditions, which could include balance billing.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility? - CORRECT ANSWER-You would need to ask Mr. Kelly if he is
enrolled in Part A and Part B and if he lives in the PFFS plan's service area.
Mrs. Wang wants to know generally how the benefits under Original Medicare
might compare to the benefits package of a Medicare Advantage Plan before she
CORRECT ANSWERS
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you
tell Mrs. Park that might be of assistance? - CORRECT ANSWER-She should
contact her state Medicaid agency to see if she qualifies forprograms that can
help with Medicare costs for which she is responsible.
Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a substantial
estate which provides Madeline with an annual income of approximately
$130,000. Madeline, who has only worked part-time for the last three years, will
soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for
advice. What should you tell her? - CORRECT ANSWER-You should tell
Madeline that she will be able to enroll in Medicare Part A without paying monthly
premiums due to her husband's long work record and participation in the
Medicare system. You should also tell Madeline that she will pay Part B
premiums at more than the standard lowest rate but less than the highest rate
due her substantial income.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by
the Social Security Administration and has been receiving disability payments. He
is wondering whether he can obtain coverage under Medicare. What should you
tell him - CORRECT ANSWER-After receiving such disability payments for 24
months, he will be automatically enrolled in Medicare, regardless of age.
Mr. Schmidt would like to plan for retirement and has asked you what is covered
under Original Fee-for-Service (FFS) Medicare? What could you tell him? -
CORRECT ANSWER-Part A, which covers hospital, skilled nursing facility,
hospice and home health services and Part B, which covers professional services
such as those provided by a doctor are covered under Original Medicare.
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 ANSWER-She
may enroll at any time while she is covered under her employer plan, but she will
have a special eight month enrollment period that differs from the standard
general enrollment period, during which she may enroll in Medicare Part B.
, Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently
enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare
Supplement (Medigap) plan which he has had for several years. However, the
plan does not provide drug benefits. How would you advise Agent John Miller to
proceed? - CORRECT ANSWER-Tell prospect Jerry Smith that he should
consider adding a standalone Part D prescription drug coverage policy to his
present coverage.
Mr. Diaz continued working with his company and was insured under his
employer's group plan until he reached age 68. He has heard that there is a
premium penalty for those who did not sign up for Part B when first eligible and
wants to know how much he will have to pay. What should you tell him? -
CORRECT ANSWER-The penalty will be a permanent 10% increase in his Part
B premium for every 12-month period that passed during which he could have
enrolled and did not.
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 to address her concern? - CORRECT ANSWER-Medicare is a program
for people age 65 or older and those under age 65 with certain disabilities, end-
stage renal disease, and Lou Gehrig's disease so she will be eligible for
Medicare.
Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago.
Mildred recently learned that she is suffering from inoperable cancer and has just
a few months to live. She would like to spend these final months in hospice care.
Mildred's family asks you whether hospice benefits will be paid for under the
Allcare Medicare Advantage plan. What should you say? - CORRECT ANSWER-
Mildred may remain enrolled in Allcare and make a hospice election. Hospice
benefits will be paid for by Original Medicare under Part A and Allcare will
continue to pay for any non-hospice services.
Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area
has an attractive premium. He wants to know if he must use doctors in a network
as his current HMO plan requires him to do. What should you tell him? -
CORRECT ANSWER-He may receive health care services from any doctor
allowed to bill Medicare, as long as he shows the doctor the plan's identification
card and the doctor agrees to accept the PFFS plan's payment terms and
conditions, which could include balance billing.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility? - CORRECT ANSWER-You would need to ask Mr. Kelly if he is
enrolled in Part A and Part B and if he lives in the PFFS plan's service area.
Mrs. Wang wants to know generally how the benefits under Original Medicare
might compare to the benefits package of a Medicare Advantage Plan before she
