NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease
(ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under
Medicare. What should you tell him?correct answersHe may sign-up for Medicare at any
time however coverage usually begins on the fourth month after dialysis treatments start.
Juan Perez, who is turning age 65 next month, intends to work for several more years at
Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers
employer-sponsored healthcare coverage. Juan is a naturalized citizen and has 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?correct answersJuan is likely to be eligible for Medicare once he turns
age 65 and if he enrolls Medicare would become the primary payor of his healthcare claims
and Smallcap does not have to continue to offer him coverage comparable to those under
age 65 under its employer-sponsored group health plan.
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 answersMedicare Supplemental
Insurance would help cover his Part A and Part B deductibles or coinsurance in Original Fee-
for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover.
Mrs. Peňa 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. What can you tell her?correct answersShe may enroll at any time while she is
covered under her employer plan, but she will have a special eight-month enrollment
period after the last month on her employer plan that differs from the standard general
enrollment period, during which she may enroll in Medicare Part B.
NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
, NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
Mrs. 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 United States. What should you tell
her?correct answersMost individuals who are citizens and age 65 or over 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.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it
provides no drug coverage. She would like to keep the coverage she has but replace her
existing Medigap plan with one that provides drug coverage. What should you tell her?
correct answersMrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she
could keep her Medigap policy and enroll in a Part D prescription drug plan.
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through massage therapy. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her?correct answersMedicare does not
cover massage therapy, or, in general, glasses or dentures.
Mr. Patel is in good health and is preparing a budget in anticipation of his retirement when
he turns 66. He wants to understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization as a result of an illness. In general terms, what
could you tell him about his costs for inpatient hospital services
under Original Medicare?correct answersUnder Original Medicare, there is a single
deductible amount due for the first 60 days of any inpatient hospital stay, after which it
converts into a per-day coinsurance amount through day 90. After day 90, he would pay a
daily amount up to 60 days over his lifetime, after which he would be responsible for all
costs.
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?correct answersTo obtain Part B coverage, she
NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
, NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
must pay a standard monthly premium, though it is higher for individuals with higher
incomes.
Mr. Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug plan.
He asks you what costs he would generally expect to encounter when enrolling into a
standard MedicarePart D prescription drug plan. What should you tell him?correct
answersHe generally would pay a monthly premium, annual deductible, and per-
prescription cost-sharing.
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 answersMedicare is a program for people age 65 or older and those under age 65
with certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be
eligible for Medicare.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided
under Original Medicare. What should you tell Mr. Xi that best describes the health coverage
provided to Medicare beneficiaries?correct answersBeneficiaries under Original Medicare
have no cost-sharing for most preventive services which include immunizations such as
annual flu shots.
NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
, NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed her
Medicare Summary Notice (MSN) and disagrees with a determination that partially denied
one of her claims for services. What advice would you give her?correct answersMrs. Duarte
should file an appeal of this initial determination within 120 days of the date she received
the MSN in the mail.
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a Medigap plan
to pick up costs not covered by that plan.
What should you tell him?correct answersIt is illegal for you to sell Mr. Capadona a
Medigap plan if he is enrolled in an MA plan, and besides, Medigap only works with
Original Medicare.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs.
Park that might be of assistance?correct answersShe 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.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be
hospitalized. What should you tell Mr. Rainey (or his representative) about the length of an
inpatient psychiatric hospital stay that Medicare will cover?correct answersMedicare will
cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
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 answersPart A,
which covers hospital, skilled nursing facility, hospice, and home health services and Part B,
NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease
(ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under
Medicare. What should you tell him?correct answersHe may sign-up for Medicare at any
time however coverage usually begins on the fourth month after dialysis treatments start.
Juan Perez, who is turning age 65 next month, intends to work for several more years at
Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers
employer-sponsored healthcare coverage. Juan is a naturalized citizen and has 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?correct answersJuan is likely to be eligible for Medicare once he turns
age 65 and if he enrolls Medicare would become the primary payor of his healthcare claims
and Smallcap does not have to continue to offer him coverage comparable to those under
age 65 under its employer-sponsored group health plan.
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 answersMedicare Supplemental
Insurance would help cover his Part A and Part B deductibles or coinsurance in Original Fee-
for-Service (FFS) Medicare as well as possibly some services that Medicare does not cover.
Mrs. Peňa 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. What can you tell her?correct answersShe may enroll at any time while she is
covered under her employer plan, but she will have a special eight-month enrollment
period after the last month on her employer plan that differs from the standard general
enrollment period, during which she may enroll in Medicare Part B.
NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
, NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
Mrs. 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 United States. What should you tell
her?correct answersMost individuals who are citizens and age 65 or over 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.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it
provides no drug coverage. She would like to keep the coverage she has but replace her
existing Medigap plan with one that provides drug coverage. What should you tell her?
correct answersMrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she
could keep her Medigap policy and enroll in a Part D prescription drug plan.
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through massage therapy. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her?correct answersMedicare does not
cover massage therapy, or, in general, glasses or dentures.
Mr. Patel is in good health and is preparing a budget in anticipation of his retirement when
he turns 66. He wants to understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization as a result of an illness. In general terms, what
could you tell him about his costs for inpatient hospital services
under Original Medicare?correct answersUnder Original Medicare, there is a single
deductible amount due for the first 60 days of any inpatient hospital stay, after which it
converts into a per-day coinsurance amount through day 90. After day 90, he would pay a
daily amount up to 60 days over his lifetime, after which he would be responsible for all
costs.
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?correct answersTo obtain Part B coverage, she
NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
, NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
must pay a standard monthly premium, though it is higher for individuals with higher
incomes.
Mr. Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug plan.
He asks you what costs he would generally expect to encounter when enrolling into a
standard MedicarePart D prescription drug plan. What should you tell him?correct
answersHe generally would pay a monthly premium, annual deductible, and per-
prescription cost-sharing.
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 answersMedicare is a program for people age 65 or older and those under age 65
with certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be
eligible for Medicare.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided
under Original Medicare. What should you tell Mr. Xi that best describes the health coverage
provided to Medicare beneficiaries?correct answersBeneficiaries under Original Medicare
have no cost-sharing for most preventive services which include immunizations such as
annual flu shots.
NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
, NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed her
Medicare Summary Notice (MSN) and disagrees with a determination that partially denied
one of her claims for services. What advice would you give her?correct answersMrs. Duarte
should file an appeal of this initial determination within 120 days of the date she received
the MSN in the mail.
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a Medigap plan
to pick up costs not covered by that plan.
What should you tell him?correct answersIt is illegal for you to sell Mr. Capadona a
Medigap plan if he is enrolled in an MA plan, and besides, Medigap only works with
Original Medicare.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs.
Park that might be of assistance?correct answersShe 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.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be
hospitalized. What should you tell Mr. Rainey (or his representative) about the length of an
inpatient psychiatric hospital stay that Medicare will cover?correct answersMedicare will
cover a total of 190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
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 answersPart A,
which covers hospital, skilled nursing facility, hospice, and home health services and Part B,
NEW AHIP FINAL EXAM TEST WITH COMPLETE
SOLUTIONS QUESTIONS AND ANSWERS ALL VERIFIED
