AHIP Module 1 Exam Questions and
Answers 2022/2023 (100%)
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?
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?
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?
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?
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?
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?
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?
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?
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?
He may sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
Ms. Henderson believes that she will qualify for Medicare coverage when she
turns 65, w/o paying any premiums, because she has been working for 40 years
and paying Medicare taxes. What should you tell her?
In order to obtain Part B coverage, she must pay a standard monthly premium, though it
is higher for individuals with higher incomes.
Mr. Diaz continued working with his company and was insured under his
employer's group plan until he reached 68 years old. 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.
Mr. Diaz will not pay any penalty because he had continuous coverage under his
employer's plan.
Mrs. Pena 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.
She may not 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.
Answers 2022/2023 (100%)
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?
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?
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?
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?
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?
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?
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?
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?
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?
He may sign-up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatments start.
Ms. Henderson believes that she will qualify for Medicare coverage when she
turns 65, w/o paying any premiums, because she has been working for 40 years
and paying Medicare taxes. What should you tell her?
In order to obtain Part B coverage, she must pay a standard monthly premium, though it
is higher for individuals with higher incomes.
Mr. Diaz continued working with his company and was insured under his
employer's group plan until he reached 68 years old. 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.
Mr. Diaz will not pay any penalty because he had continuous coverage under his
employer's plan.
Mrs. Pena 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.
She may not 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.
