2023/2024 AHIP Module 1, 2, 3, 4, 5 (ACTUAL TEST ) Questions and
Answers GRADED A ALL COREECT
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 deductibles or coinsurance in Original Fee-for-Service
(FFS) Medicare as well as possibly someservices 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 ensureno gap in
coverage. What can you tell her? ✓She 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.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employedfull
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? ✓Most individuals who are citizens and age 65
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? ✓He may sign-up for Medicare at any time however
coverage usually begins on the fourth month afterdialysis 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 willbe entitled to Medicare and if
he enrolls how that will impact his employer- sponsored healthcare coverage. How would
you respond? ✓Juan 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 tocontinue to offer him coverage comparable to those under age 65 under
its employer-sponsored group health plan.
, 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 butreplace her
existing Medigap plan with one that provides drug coverage. What should you tell her? ✓
✓Mrs. 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?
✓✓Medicare 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 mightbe exposed to under
Medicare if he were to require hospitalization as a result of anillness. In general terms, what
could you tell him about his costs for inpatient hospital services
under Original Medicare? ✓✓Under 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 wouldbe 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 yearsand paying
Medicare taxes. What should you tell her? ✓✓To obtain Part B coverage, she 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 fromhis
employer's retiree coverage, but he wants to compare it to a Part D prescriptiondrug 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? ✓✓He
generally would pay a monthly premium, annual deductible, and per-prescription cost-
sharing.
Answers GRADED A ALL COREECT
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 deductibles or coinsurance in Original Fee-for-Service
(FFS) Medicare as well as possibly someservices 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 ensureno gap in
coverage. What can you tell her? ✓She 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.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employedfull
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? ✓Most individuals who are citizens and age 65
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? ✓He may sign-up for Medicare at any time however
coverage usually begins on the fourth month afterdialysis 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 willbe entitled to Medicare and if
he enrolls how that will impact his employer- sponsored healthcare coverage. How would
you respond? ✓Juan 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 tocontinue to offer him coverage comparable to those under age 65 under
its employer-sponsored group health plan.
, 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 butreplace her
existing Medigap plan with one that provides drug coverage. What should you tell her? ✓
✓Mrs. 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?
✓✓Medicare 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 mightbe exposed to under
Medicare if he were to require hospitalization as a result of anillness. In general terms, what
could you tell him about his costs for inpatient hospital services
under Original Medicare? ✓✓Under 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 wouldbe 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 yearsand paying
Medicare taxes. What should you tell her? ✓✓To obtain Part B coverage, she 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 fromhis
employer's retiree coverage, but he wants to compare it to a Part D prescriptiondrug 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? ✓✓He
generally would pay a monthly premium, annual deductible, and per-prescription cost-
sharing.
