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AHIP Medicare Training Modules 1–5 Certification
Examination||Verified Exam!!!||, 2026/2027-Question
Medicare Advantage and Part D Compliance
Competency Assessment||Newest Exam!!!
Mrs. Ellis recently turned 66 and decided after many years
of work to retire and begin receiving Social Security
benefits. Shortly thereafter Mrs. Ellis received a letter
informing her that she had been automatically enrolled in
Medicare Part B. She wants to understand what this
means. What should you tell Mrs. Ellis? - Answer-Part B
primarily covers physician services. She will be paying a
monthly premium and, except for many preventive and
screening tests, generally will have 20% co-payments for
these services, in addition to an annual deductible.
Mr. Singh would like drug coverage but does not want to
be enrolled in a Medicare Advantage plan. What should
you tell him? - Answer-Mr. Singh 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.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed
income. What could you tell Mrs. Cook that might be of
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assistance? - Answer-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.
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-To obtain Part B coverage, she must pay a
standard monthly premium, though it is higher for
individuals with higher incomes.
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-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? - Answer-Part A,
which covers hospital, skilled nursing facility, hospice, and
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home health services and Part B, which covers
professional services such as those provided by a doctor
are covered under Original Medicare.
Anthony Boniface turned 65 in 2024. He was not receiving
Social Security or Railroad Retirement Benefits on his
65th birthday. He was interested in obtaining Medicare
coverage and is eligible for premium-free Part A. Before
he could enroll in Medicare, his entire area was impacted
by a hurricane causing massive flooding and severe wind
damage. The Federal government declared this to be a
natural disaster which has recently ended. During this
period Anthony's initial enrollment period expired. Anthony
asks you how he can now obtain Medicare coverage.
What should you say? - Answer-Anthony is eligible for a
special enrollment period (SEP) because he missed an
enrollment period due to the impact of the Federally
declared disaster. This SEP will allow Anthony to enroll in
Part B up to six months after the end of the emergency
declaration. Anthony may enroll in premium-free Part A at
any time and his Part A coverage will be retroactive for up
to 6 months.
Ms. Lewis has aggressive cancer and would like to know if
Medicare will cover hospice services in case she needs
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them. What should you tell her? - Answer-Medicare covers
hospice services, and they will be available for her.
Edward suffered from serious kidney disease. As a result,
Edward became eligible for Medicare coverage due to
end-stage renal disease (ESRD). A close relative donated
their kidney and Edward successfully underwent
transplant surgery 12 months ago. Edward is now age 50
and asks you if his Medicare coverage will continue, what
should you say? - Answer-Individuals eligible for Medicare
based on ESRD generally lose eligibility 36 months after
the month in which the individual receives a kidney
transplant unless they are eligible for Medicare on another
basis such as age or disability. Edward may, however,
remain enrolled in Part B but solely for coverage of
immunosuppressive drugs if he has no other health care
coverage that would cover the drugs.
Mrs. Foster 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-Medicare will cover Mrs.
AHIP Medicare Training Modules 1–5 Certification
Examination||Verified Exam!!!||, 2026/2027-Question
Medicare Advantage and Part D Compliance
Competency Assessment||Newest Exam!!!
Mrs. Ellis recently turned 66 and decided after many years
of work to retire and begin receiving Social Security
benefits. Shortly thereafter Mrs. Ellis received a letter
informing her that she had been automatically enrolled in
Medicare Part B. She wants to understand what this
means. What should you tell Mrs. Ellis? - Answer-Part B
primarily covers physician services. She will be paying a
monthly premium and, except for many preventive and
screening tests, generally will have 20% co-payments for
these services, in addition to an annual deductible.
Mr. Singh would like drug coverage but does not want to
be enrolled in a Medicare Advantage plan. What should
you tell him? - Answer-Mr. Singh 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.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed
income. What could you tell Mrs. Cook that might be of
,2|Page
assistance? - Answer-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.
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-To obtain Part B coverage, she must pay a
standard monthly premium, though it is higher for
individuals with higher incomes.
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-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? - Answer-Part A,
which covers hospital, skilled nursing facility, hospice, and
,3|Page
home health services and Part B, which covers
professional services such as those provided by a doctor
are covered under Original Medicare.
Anthony Boniface turned 65 in 2024. He was not receiving
Social Security or Railroad Retirement Benefits on his
65th birthday. He was interested in obtaining Medicare
coverage and is eligible for premium-free Part A. Before
he could enroll in Medicare, his entire area was impacted
by a hurricane causing massive flooding and severe wind
damage. The Federal government declared this to be a
natural disaster which has recently ended. During this
period Anthony's initial enrollment period expired. Anthony
asks you how he can now obtain Medicare coverage.
What should you say? - Answer-Anthony is eligible for a
special enrollment period (SEP) because he missed an
enrollment period due to the impact of the Federally
declared disaster. This SEP will allow Anthony to enroll in
Part B up to six months after the end of the emergency
declaration. Anthony may enroll in premium-free Part A at
any time and his Part A coverage will be retroactive for up
to 6 months.
Ms. Lewis has aggressive cancer and would like to know if
Medicare will cover hospice services in case she needs
, 4|Page
them. What should you tell her? - Answer-Medicare covers
hospice services, and they will be available for her.
Edward suffered from serious kidney disease. As a result,
Edward became eligible for Medicare coverage due to
end-stage renal disease (ESRD). A close relative donated
their kidney and Edward successfully underwent
transplant surgery 12 months ago. Edward is now age 50
and asks you if his Medicare coverage will continue, what
should you say? - Answer-Individuals eligible for Medicare
based on ESRD generally lose eligibility 36 months after
the month in which the individual receives a kidney
transplant unless they are eligible for Medicare on another
basis such as age or disability. Edward may, however,
remain enrolled in Part B but solely for coverage of
immunosuppressive drugs if he has no other health care
coverage that would cover the drugs.
Mrs. Foster 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-Medicare will cover Mrs.
