AHIP MODULES 1-5, FINAL, AND FW A EXAM
Questions and Answ ers
1. What happens after Mr. Bauer has received disability payments for 24
months?
Answer He will be automatically enrolled in Medicare, regardless of age.
2. Why did Edward become eligible for Medicare coverage?
Answer Due to end-stage renal
disease (ESRD).
3. How long does Medicare coverage generally last for individuals eligible based on
ESRD after a kidney transplant?
Answer Eligibility generally lasts for 36 months after the month in which the individual receives a kidney
transplant.
4. What can Edward do regarding Part B coverage after his kidney transplant?
Answer He may remain enrolled in Part B solely for coverage of immunosuppressive drugs if he has no other health
care coverage for those drugs.
5. What special enrollment option does Anthony have after missing his initial
enrollment period due to a disaster?
,Answer He is eligible for a special enrollment period (SEP) to enroll in Part B up to six months after the
end of the emergency declaration.
6. When can Anthony enroll in premium-free Part A?
Answer He may enroll in premium-free Part A at any time, with coverage retroactive for up to 6 months.
7. What should you tell Mr. Capadona about purchasing a Medigap plan while enrolled
in a Medicare Advantage plan?
Answer It is illegal to sell him a Medigap plan if he is enrolled in an MA plan, as Medigap only works with
Original Medicare.
8. Will Mildred's hospice care be covered under her Allcare Medicare Advantage plan?
Answer Yes, hospice benefits will be paid for by Original Medicare under Part A, and Allcare will continue to pay for any
non-hospice services.
9. What must Ms. Henderson do to obtain Part B coverage?
Answer She must pay a standard monthly premium, which may be higher for individuals with higher
incomes.
10. What assistance can Mrs. Cook seek due to her low fixed income?
Answer She should contact her state Medicaid agency to see if she qualifies for programs that help with
Medicare costs.
,11. What does Medicare Supplemental Insurance cover for Mr. Moy?
Answer It helps cover his Part A deductible and Part B coinsurance or copayments in Original Fee-for-Service
(FFS) Medicare.
12. What is Juan Perez's situation regarding Medicare as he turns 65?
Answer He intends to work for several more years at Smallcap, which otters employer-sponsored healthcare
coverage.
13. What is the eligibility requirement for premium-free Part A?
Answer Individuals must have worked and paid Medicare taxes for a sufficient period, typically 40 quarters.
14. What happens if an individual does not enroll in Medicare during their initial
enrollment period?
Answer They may qualify for a special enrollment period if they missed it due to certain circumstances, such as
a natural disaster.
15. How does Medicare coverage differ for individuals based on age versus
disability?
Answer Individuals under 65 can qualify for Medicare due to disability after 24 months of receiving disability
payments, while those 65 and older qualify based on age.
16. What is the role of Medigap insurance?
, Answer Medigap insurance helps cover costs not covered by Original Medicare, such as deductibles and
coinsurance.
17. What is the maximum duration of Medicare coverage after a kidney trans-
plant for those eligible due to ESRD?
Answer 36 months after the month of the transplant.
18. What should individuals do if they are unsure about their Medicare
eligibility?
Answer They should contact the Social Security Administration or their state Medicaid agency for guidance.
19. What is the significance of a Federally declared disaster in relation to
Medicare enrollment?
Answer It allows individuals who missed their enrollment period to qualify for a special
enrollment period.
20. What is the difference between Medicare Advantage and Original Medicare
regarding coverage?
Answer Medicare Advantage plans may otter additional benefits but cannot be combined with Medigap plans.
21. What is the importance of immunosuppressive drug coverage for kidney
transplant patients?
Answer It is critical for preventing organ rejection and maintaining health post-transplant.
Questions and Answ ers
1. What happens after Mr. Bauer has received disability payments for 24
months?
Answer He will be automatically enrolled in Medicare, regardless of age.
2. Why did Edward become eligible for Medicare coverage?
Answer Due to end-stage renal
disease (ESRD).
3. How long does Medicare coverage generally last for individuals eligible based on
ESRD after a kidney transplant?
Answer Eligibility generally lasts for 36 months after the month in which the individual receives a kidney
transplant.
4. What can Edward do regarding Part B coverage after his kidney transplant?
Answer He may remain enrolled in Part B solely for coverage of immunosuppressive drugs if he has no other health
care coverage for those drugs.
5. What special enrollment option does Anthony have after missing his initial
enrollment period due to a disaster?
,Answer He is eligible for a special enrollment period (SEP) to enroll in Part B up to six months after the
end of the emergency declaration.
6. When can Anthony enroll in premium-free Part A?
Answer He may enroll in premium-free Part A at any time, with coverage retroactive for up to 6 months.
7. What should you tell Mr. Capadona about purchasing a Medigap plan while enrolled
in a Medicare Advantage plan?
Answer It is illegal to sell him a Medigap plan if he is enrolled in an MA plan, as Medigap only works with
Original Medicare.
8. Will Mildred's hospice care be covered under her Allcare Medicare Advantage plan?
Answer Yes, hospice benefits will be paid for by Original Medicare under Part A, and Allcare will continue to pay for any
non-hospice services.
9. What must Ms. Henderson do to obtain Part B coverage?
Answer She must pay a standard monthly premium, which may be higher for individuals with higher
incomes.
10. What assistance can Mrs. Cook seek due to her low fixed income?
Answer She should contact her state Medicaid agency to see if she qualifies for programs that help with
Medicare costs.
,11. What does Medicare Supplemental Insurance cover for Mr. Moy?
Answer It helps cover his Part A deductible and Part B coinsurance or copayments in Original Fee-for-Service
(FFS) Medicare.
12. What is Juan Perez's situation regarding Medicare as he turns 65?
Answer He intends to work for several more years at Smallcap, which otters employer-sponsored healthcare
coverage.
13. What is the eligibility requirement for premium-free Part A?
Answer Individuals must have worked and paid Medicare taxes for a sufficient period, typically 40 quarters.
14. What happens if an individual does not enroll in Medicare during their initial
enrollment period?
Answer They may qualify for a special enrollment period if they missed it due to certain circumstances, such as
a natural disaster.
15. How does Medicare coverage differ for individuals based on age versus
disability?
Answer Individuals under 65 can qualify for Medicare due to disability after 24 months of receiving disability
payments, while those 65 and older qualify based on age.
16. What is the role of Medigap insurance?
, Answer Medigap insurance helps cover costs not covered by Original Medicare, such as deductibles and
coinsurance.
17. What is the maximum duration of Medicare coverage after a kidney trans-
plant for those eligible due to ESRD?
Answer 36 months after the month of the transplant.
18. What should individuals do if they are unsure about their Medicare
eligibility?
Answer They should contact the Social Security Administration or their state Medicaid agency for guidance.
19. What is the significance of a Federally declared disaster in relation to
Medicare enrollment?
Answer It allows individuals who missed their enrollment period to qualify for a special
enrollment period.
20. What is the difference between Medicare Advantage and Original Medicare
regarding coverage?
Answer Medicare Advantage plans may otter additional benefits but cannot be combined with Medigap plans.
21. What is the importance of immunosuppressive drug coverage for kidney
transplant patients?
Answer It is critical for preventing organ rejection and maintaining health post-transplant.
