AHIP CERTIFICATION EXAM MODULE 1 2022/2023(COMPLETE
QUESTIONS AND ANSWERS)
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have
considerable income when she retires. She is concerned that her income will make it impossible for her
to qualify for Medicare. What could you tell her to address her concern?
(correct answer)Medicare is a program for people 65 or older and those under the age 65 with certain
disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for Medicare.
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?
(correct answer)Part A, which covers hospital, skilled nursing facility, hospice, and home health services
and Part B, which covers professional services such as those provided by a doctor are covered under
Original Medicare.
Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan may, at
some time in the future, reduce his benefits below what is available in Original Medicare. What should
you tell him about his concern?
(correct answer)Medicare Advantage plans must cover all benefits available under Medicare Part A and
Part B. Many also cover Part D prescription drugs.
Mrs. Roberts has just received a new Medicare identity card in the mail. She is concerned that it is a
forgery since it does not have her Social Security number on it. What should you tell her?
(correct answer)The card she received is valid, the change has been made to protect Medicare
beneficiaries from identity theft, and she should now destroy her old card.
Mrs. Willard wants to know generally how the benefits under Original Medicare might compare to the
benefit package of a Medicare Health Plan before she starts looking at specific plans. What could you
tell her?
(correct answer)Medicare Health Plans may offer extra benefits that Original Medicare does not offer
such as vision, hearing, and dental services and must include a maximum out-of-pocket limit on Part A
and Part B services.
, Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what coverage Medicare
Supplemental Insurance provides since his health care needs are different from his wife's needs. What
could you tell Mr.Moy?
(correct answer)Medicare Supplemental Insurance would help cover his Part A and Part B cost sharing in
Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover.
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 US. What should you tell her?
(correct answer)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.
Bauer is 49 years old, but eighteen months ago he was declared disabled by the SSA and has been
receiving disability payments. He is wondering whether he can obtain coverage under Medicare. What
should you tell him?
(correct answer)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 and will soon
begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him?
(correct answer)He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
QUESTIONS AND ANSWERS)
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have
considerable income when she retires. She is concerned that her income will make it impossible for her
to qualify for Medicare. What could you tell her to address her concern?
(correct answer)Medicare is a program for people 65 or older and those under the age 65 with certain
disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for Medicare.
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?
(correct answer)Part A, which covers hospital, skilled nursing facility, hospice, and home health services
and Part B, which covers professional services such as those provided by a doctor are covered under
Original Medicare.
Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan may, at
some time in the future, reduce his benefits below what is available in Original Medicare. What should
you tell him about his concern?
(correct answer)Medicare Advantage plans must cover all benefits available under Medicare Part A and
Part B. Many also cover Part D prescription drugs.
Mrs. Roberts has just received a new Medicare identity card in the mail. She is concerned that it is a
forgery since it does not have her Social Security number on it. What should you tell her?
(correct answer)The card she received is valid, the change has been made to protect Medicare
beneficiaries from identity theft, and she should now destroy her old card.
Mrs. Willard wants to know generally how the benefits under Original Medicare might compare to the
benefit package of a Medicare Health Plan before she starts looking at specific plans. What could you
tell her?
(correct answer)Medicare Health Plans may offer extra benefits that Original Medicare does not offer
such as vision, hearing, and dental services and must include a maximum out-of-pocket limit on Part A
and Part B services.
, Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what coverage Medicare
Supplemental Insurance provides since his health care needs are different from his wife's needs. What
could you tell Mr.Moy?
(correct answer)Medicare Supplemental Insurance would help cover his Part A and Part B cost sharing in
Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover.
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 US. What should you tell her?
(correct answer)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.
Bauer is 49 years old, but eighteen months ago he was declared disabled by the SSA and has been
receiving disability payments. He is wondering whether he can obtain coverage under Medicare. What
should you tell him?
(correct answer)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 and will soon
begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him?
(correct answer)He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
