AHIP – 1 Complete Solutions
Question 1: Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. Can Medigap help her address this concern?
Answer: Yes, Medigap plans can help beneficiaries cover Original Medicare benefits, and they
coordinate with Original Medicare coverage.
Question 2: Mr. Singh wants drug coverage without enrolling in a Medicare Advantage plan. What
option should he consider?
Answer: He can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and
Part B services through Original Fee-for-Service Medicare.
Question 3: Ms. Moore is concerned that her income will make it impossible for her to qualify for
Medicare. What can you tell her?
Answer: As a 65-year-old, she will be eligible for Medicare regardless of her income level, which is a
program for people age 65 or older and those under 65 with certain disabilities, end-stage renal disease,
and Lou Gehrig's disease.
Question 4: Mr. Diaz has heard that there is a premium penalty for those who didn't sign up for Part B
when first eligible. What should you tell him?
Answer: Since he had continuous coverage under his employer's plan, he won't pay any penalty.
Question 5: Agent John Miller is meeting with Jerry Smith, who has a Medigap plan that doesn't provide
drug benefits. How should Agent John Miller advise Jerry?
Answer: He should consider adding a standalone Part D prescription drug coverage policy to his present
coverage.
, Question 6: Madeline Martinez will soon turn 65 and has an annual income of approximately $130,000.
What should you tell her about Medicare enrollment?
Answer: 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. She will also pay Part B premiums
at more than the standard lowest rate but less than the highest rate due to her substantial income.
Question 7: Mr. Bauer was declared disabled by the Social Security Administration 18 months ago and
has been receiving disability payments. When can he obtain coverage under Medicare?
Answer: After receiving disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age.
Question 8: Mrs. Chen is concerned that she won't qualify for coverage under Part A because she wasn't
born in the United States. What can you tell her?
Answer: Most 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.
Question 9: What impact will recent regulatory changes have on Medigap plans?
Answer: The Part B deductible will no longer be covered for individuals newly eligible for Medicare
starting January 1, 2020.
Question 10: Juan Perez intends to work several more years at Smallcap, Incorporated and asks if he will
be entitled to Medicare and how it will impact his employer-sponsored healthcare coverage if he enrolls.
How would you respond?
Answer: Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls, Medicare would
become the primary payor of his healthcare claims, and Smallcap does not have to continue to offer him
coverage comparable to those under age 65 under its employer-sponsored group health plan.
Question 1: Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. Can Medigap help her address this concern?
Answer: Yes, Medigap plans can help beneficiaries cover Original Medicare benefits, and they
coordinate with Original Medicare coverage.
Question 2: Mr. Singh wants drug coverage without enrolling in a Medicare Advantage plan. What
option should he consider?
Answer: He can enroll in a stand-alone prescription drug plan and continue to be covered for Part A and
Part B services through Original Fee-for-Service Medicare.
Question 3: Ms. Moore is concerned that her income will make it impossible for her to qualify for
Medicare. What can you tell her?
Answer: As a 65-year-old, she will be eligible for Medicare regardless of her income level, which is a
program for people age 65 or older and those under 65 with certain disabilities, end-stage renal disease,
and Lou Gehrig's disease.
Question 4: Mr. Diaz has heard that there is a premium penalty for those who didn't sign up for Part B
when first eligible. What should you tell him?
Answer: Since he had continuous coverage under his employer's plan, he won't pay any penalty.
Question 5: Agent John Miller is meeting with Jerry Smith, who has a Medigap plan that doesn't provide
drug benefits. How should Agent John Miller advise Jerry?
Answer: He should consider adding a standalone Part D prescription drug coverage policy to his present
coverage.
, Question 6: Madeline Martinez will soon turn 65 and has an annual income of approximately $130,000.
What should you tell her about Medicare enrollment?
Answer: 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. She will also pay Part B premiums
at more than the standard lowest rate but less than the highest rate due to her substantial income.
Question 7: Mr. Bauer was declared disabled by the Social Security Administration 18 months ago and
has been receiving disability payments. When can he obtain coverage under Medicare?
Answer: After receiving disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age.
Question 8: Mrs. Chen is concerned that she won't qualify for coverage under Part A because she wasn't
born in the United States. What can you tell her?
Answer: Most 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.
Question 9: What impact will recent regulatory changes have on Medigap plans?
Answer: The Part B deductible will no longer be covered for individuals newly eligible for Medicare
starting January 1, 2020.
Question 10: Juan Perez intends to work several more years at Smallcap, Incorporated and asks if he will
be entitled to Medicare and how it will impact his employer-sponsored healthcare coverage if he enrolls.
How would you respond?
Answer: Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls, Medicare would
become the primary payor of his healthcare claims, and Smallcap does not have to continue to offer him
coverage comparable to those under age 65 under its employer-sponsored group health plan.
