AHIP - Modules 1-5 Exam Updated Questions
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Terms in this set (105)
Agent John Miller is meeting with Tell prospect Jerry Smith that he should consider
Jerry Smith, a new prospect. Jerry is adding a standalone Part D prescription drug
currently enrolled in Medicare Parts coverage policy to his present coverage.
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?
Ms. Kumar plans to retire when she Medicare is a program for people age 65 or
turns 65 in a few months. She is in older and those under age 65 with certain
excellent health and will have disabilities, end-stage renal disease, and Lou
considerable income when she Gehrig's disease so she will be eligible for
retires. She is concerned that her Medicare.
income will make it impossible for
her to qualify for Medicare. What
could you tell her to address her
concern?
,Anthony Boniface turned 65 in Anthony is eligible for a special enrollment
2024. He was not receiving Social period (SEP) because he missed an enrollment
Security or Railroad Retirement period due to the impact of the Federally
Benefits on his 65th birthday. He declared disaster. This SEP will allow Anthony to
was interested in obtaining enroll in Part B up to six months after the end of
Medicare coverage and is eligible the emergency declaration. Anthony may enroll
for premium-free Part A. Before he in premium-free Part A at any time and his Part A
could enroll in Medicare, his entire coverage will be retroactive for up to 6 months.
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?
Mrs. Ellis recently turned 66 and Part B primarily covers physician services. She
decided after many years of work will be paying a monthly premium and, except for
to retire and begin receiving Social many preventive and screening tests, generally
Security benefits. Shortly thereafter will have 20% co-payments for these services, in
Mrs. Ellis received a letter informing addition to an annual deductible.
her that she had been automatically
enrolled in Medicare Part B. She
wants to understand what this
means. What should you tell Mrs.
Ellis?
Mr. Wu is eligible for Medicare. He Mr. Wu may still qualify for help in paying Part D
has limited financial resources but costs through his State Pharmaceutical
failed to qualify for the Part D low- Assistance Program (SPAP)
income subsidy. Where might he
turn for help with his prescription
drug costs?
,Ms. Lewis has aggressive cancer Medicare covers hospice services, and they will
and would like to know if Medicare be available for her.
will cover hospice services in case
she needs them. What should you
tell her?
Mr. Capadona would like to It is illegal for you to sell Mr. Capadona a
purchase a Medicare Advantage Medigap plan if he is enrolled in an MA plan, and
(MA) plan and a Medigap plan to besides, Medigap only works with Original
pick up costs not covered by that Medicare.
plan. What should you tell him?
Juan Perez, who is turning age 65 Juan is likely to be eligible for Medicare once he
next month, intends to work for turns age 65 and if he enrolls, Medicare would
several more years at Smallcap, become the primary payor of his healthcare
Incorporated. Smallcap has a claims and Smallcap does not have to continue
workforce of 15 employees and to offer him coverage comparable to those under
offers employer-sponsored age 65 under its employer-sponsored group
healthcare coverage. Juan is a health plan and would become a secondary
naturalized citizen and has payor.
contributed to the Medicare system
for over 20 years. Juan asks you if
he will be entitled to Medicare and
if he enrolls how that will impact his
employer- sponsored healthcare
coverage. How would you
respond?
Ms. Henderson believes that she To obtain Part B coverage, she must pay a
will qualify for Medicare Coverage standard monthly premium, though it is higher for
when she turns 65, without paying individuals with higher incomes.
any premiums, because she has
been working for 40 years and
paying Medicare taxes. What
should you tell her?
, Mr. Schmidt would like to plan for Part A, which covers hospital, skilled nursing
retirement and has asked you what facility, hospice, and home health services and
is covered under Original Fee-for- Part B, which covers professional services such as
Service (FFS) Medicare. What could those provided by a doctor are covered under
you tell him? Original Medicare.
Mildred Savage enrolled in Allcare Mildred may remain enrolled in Allcare and make
Medicare Advantage plan several a hospice election. Hospice benefits will be paid
years ago. Mildred recently learned for by Original Medicare under Part A and Allcare
that she is suffering from will continue to pay for any non-hospice services.
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?
Madeline Martinez was widowed You should tell Madeline that she will be able to
several years ago. Her husband enroll in Medicare Part A without paying monthly
worked for many years and premiums due to her husband's long work record
contributed into the Medicare and participation in the Medicare system. You
system. He also left a substantial should also tell Madeline that she will pay Part B
estate which provides Madeline premiums at more than the standard lowest rate
with an annual income of but less than the highest rate due her substantial
approximately $130,000. Madeline, income.
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?
Mr. Singh would like drug coverage Mr. Singh can enroll in a stand-alone prescription
but does not want to be enrolled in drug plan and continue to be covered for Part A
a Medicare Advantage plan. What and Part B services through Original Fee-for-
should you tell him? Service Medicare.
and Answers (Latest Update)
(Verified Answers by Expert)
Save
Terms in this set (105)
Agent John Miller is meeting with Tell prospect Jerry Smith that he should consider
Jerry Smith, a new prospect. Jerry is adding a standalone Part D prescription drug
currently enrolled in Medicare Parts coverage policy to his present coverage.
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?
Ms. Kumar plans to retire when she Medicare is a program for people age 65 or
turns 65 in a few months. She is in older and those under age 65 with certain
excellent health and will have disabilities, end-stage renal disease, and Lou
considerable income when she Gehrig's disease so she will be eligible for
retires. She is concerned that her Medicare.
income will make it impossible for
her to qualify for Medicare. What
could you tell her to address her
concern?
,Anthony Boniface turned 65 in Anthony is eligible for a special enrollment
2024. He was not receiving Social period (SEP) because he missed an enrollment
Security or Railroad Retirement period due to the impact of the Federally
Benefits on his 65th birthday. He declared disaster. This SEP will allow Anthony to
was interested in obtaining enroll in Part B up to six months after the end of
Medicare coverage and is eligible the emergency declaration. Anthony may enroll
for premium-free Part A. Before he in premium-free Part A at any time and his Part A
could enroll in Medicare, his entire coverage will be retroactive for up to 6 months.
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?
Mrs. Ellis recently turned 66 and Part B primarily covers physician services. She
decided after many years of work will be paying a monthly premium and, except for
to retire and begin receiving Social many preventive and screening tests, generally
Security benefits. Shortly thereafter will have 20% co-payments for these services, in
Mrs. Ellis received a letter informing addition to an annual deductible.
her that she had been automatically
enrolled in Medicare Part B. She
wants to understand what this
means. What should you tell Mrs.
Ellis?
Mr. Wu is eligible for Medicare. He Mr. Wu may still qualify for help in paying Part D
has limited financial resources but costs through his State Pharmaceutical
failed to qualify for the Part D low- Assistance Program (SPAP)
income subsidy. Where might he
turn for help with his prescription
drug costs?
,Ms. Lewis has aggressive cancer Medicare covers hospice services, and they will
and would like to know if Medicare be available for her.
will cover hospice services in case
she needs them. What should you
tell her?
Mr. Capadona would like to It is illegal for you to sell Mr. Capadona a
purchase a Medicare Advantage Medigap plan if he is enrolled in an MA plan, and
(MA) plan and a Medigap plan to besides, Medigap only works with Original
pick up costs not covered by that Medicare.
plan. What should you tell him?
Juan Perez, who is turning age 65 Juan is likely to be eligible for Medicare once he
next month, intends to work for turns age 65 and if he enrolls, Medicare would
several more years at Smallcap, become the primary payor of his healthcare
Incorporated. Smallcap has a claims and Smallcap does not have to continue
workforce of 15 employees and to offer him coverage comparable to those under
offers employer-sponsored age 65 under its employer-sponsored group
healthcare coverage. Juan is a health plan and would become a secondary
naturalized citizen and has payor.
contributed to the Medicare system
for over 20 years. Juan asks you if
he will be entitled to Medicare and
if he enrolls how that will impact his
employer- sponsored healthcare
coverage. How would you
respond?
Ms. Henderson believes that she To obtain Part B coverage, she must pay a
will qualify for Medicare Coverage standard monthly premium, though it is higher for
when she turns 65, without paying individuals with higher incomes.
any premiums, because she has
been working for 40 years and
paying Medicare taxes. What
should you tell her?
, Mr. Schmidt would like to plan for Part A, which covers hospital, skilled nursing
retirement and has asked you what facility, hospice, and home health services and
is covered under Original Fee-for- Part B, which covers professional services such as
Service (FFS) Medicare. What could those provided by a doctor are covered under
you tell him? Original Medicare.
Mildred Savage enrolled in Allcare Mildred may remain enrolled in Allcare and make
Medicare Advantage plan several a hospice election. Hospice benefits will be paid
years ago. Mildred recently learned for by Original Medicare under Part A and Allcare
that she is suffering from will continue to pay for any non-hospice services.
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?
Madeline Martinez was widowed You should tell Madeline that she will be able to
several years ago. Her husband enroll in Medicare Part A without paying monthly
worked for many years and premiums due to her husband's long work record
contributed into the Medicare and participation in the Medicare system. You
system. He also left a substantial should also tell Madeline that she will pay Part B
estate which provides Madeline premiums at more than the standard lowest rate
with an annual income of but less than the highest rate due her substantial
approximately $130,000. Madeline, income.
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?
Mr. Singh would like drug coverage Mr. Singh can enroll in a stand-alone prescription
but does not want to be enrolled in drug plan and continue to be covered for Part A
a Medicare Advantage plan. What and Part B services through Original Fee-for-
should you tell him? Service Medicare.
