2025 AHIP Module 1 – Actual Test Questions and Answers
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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?
Choose one answer.
a. Most individuals who are citizens and over age 65 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.
b. Most individuals who are citizens and over age 65 and wish to be covered under
Part A must enroll in a Medicare Health Plan.
c. Most individuals who are citizens and over age 65 and are covered under Part
A must pay a monthly premium for that coverage.
d. All individuals who are citizens and over age 65 will be covered under Part A. -
ANSWER-a. Most individuals who are citizens and over age 65 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. 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?
- ANSWER-d. After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
Mr. Denton 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-a. He may sign-up
for Medicare at any time however coverage usually begins on the fourth month after
dialysis treatments start. Correct
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? - ANSWER-a. In order to obtain Part
B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes. Correct
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? - ANSWER-b. Mr. Diaz will not pay any
penalty because he had continuous coverage under his employer's plan. Correct
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? - ANSWER-d. 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. Correct
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is
considering enrollment in a Medicare health plan (Part C). What should you advise her
to do before she will be able to enroll into a Medicare health plan? - ANSWER-Mrs.
Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is considering
enrollment in a Medicare health plan (Part C). What should you advise her to do before
she will be able to enroll into a Medicare health plan?
Mrs. Park is an elderly retiree. She has a low, fixed income. What could you tell Mrs.
Park that might be of assistance? - ANSWER-d. 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. Correct
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
qualify for the Part D low-income subsidy. Where might he turn for help with his
prescription drug costs? - ANSWER-a. Mr. Wu may still qualify for help in paying
Part D costs through his State Pharmaceutical Assistance Program. Correct
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? - ANSWER-d. Under 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 Correct
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being
successfully treated for that condition. However, she and her physicians feel that after
her lengthy hospital stay she will need a month or two of nursing and rehabilitative
care. What should you tell them about Original Medicare's coverage of care in a skilled
nursing facility? - ANSWER-b. Medicare will cover Mrs. Shields' skilled nursing
services provided during the first 20 days of her stay, after which she would have a
coinsurance until she has been in the facility for 100 days. Correct
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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?
Choose one answer.
a. Most individuals who are citizens and over age 65 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.
b. Most individuals who are citizens and over age 65 and wish to be covered under
Part A must enroll in a Medicare Health Plan.
c. Most individuals who are citizens and over age 65 and are covered under Part
A must pay a monthly premium for that coverage.
d. All individuals who are citizens and over age 65 will be covered under Part A. -
ANSWER-a. Most individuals who are citizens and over age 65 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. 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?
- ANSWER-d. After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
Mr. Denton 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-a. He may sign-up
for Medicare at any time however coverage usually begins on the fourth month after
dialysis treatments start. Correct
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? - ANSWER-a. In order to obtain Part
B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes. Correct
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? - ANSWER-b. Mr. Diaz will not pay any
penalty because he had continuous coverage under his employer's plan. Correct
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? - ANSWER-d. 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. Correct
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is
considering enrollment in a Medicare health plan (Part C). What should you advise her
to do before she will be able to enroll into a Medicare health plan? - ANSWER-Mrs.
Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is considering
enrollment in a Medicare health plan (Part C). What should you advise her to do before
she will be able to enroll into a Medicare health plan?
Mrs. Park is an elderly retiree. She has a low, fixed income. What could you tell Mrs.
Park that might be of assistance? - ANSWER-d. 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. Correct
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
qualify for the Part D low-income subsidy. Where might he turn for help with his
prescription drug costs? - ANSWER-a. Mr. Wu may still qualify for help in paying
Part D costs through his State Pharmaceutical Assistance Program. Correct
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? - ANSWER-d. Under 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 Correct
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being
successfully treated for that condition. However, she and her physicians feel that after
her lengthy hospital stay she will need a month or two of nursing and rehabilitative
care. What should you tell them about Original Medicare's coverage of care in a skilled
nursing facility? - ANSWER-b. Medicare will cover Mrs. Shields' skilled nursing
services provided during the first 20 days of her stay, after which she would have a
coinsurance until she has been in the facility for 100 days. Correct
