AHIP Questions and Answers Latest
2023 Graded A+
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social
Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What
should you tell Mrs. Quinn? ✔✔Part B primarily covers physician services. She will be paying a
monthly premium and, with the exception of many preventive and screening tests, generally will
have 20% coinsurance for these services, in addition to an annual deductible.
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like
to know which of the following services Original Medicare will cover if the appropriate criteria
are met? What could you tell her? ✔✔Original Medicare covers ambulance services.
Mr. Diaz continued working with his company and was insured under his employer's group plan
until he reached age 68. 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. What should
you tell him? ✔✔Mr. Diaz will not pay any penalty because he had continuous coverage under
his employer's plan.
,Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare Part A
and Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's
older neighbor Mel has told her about the Medigap Part F plan in which he is enrolled. It not
only provides foreign travel emergency benefits but also covers his Medicare Part B deductible.
Anita comes to you for advice. What should you tell her? ✔✔You are sorry to disappoint Anita
but a Medigap Part F plan is no longer available to those who turn age 65 after January 1,2020.
Anita might instead consider other Medigap plans that offer foreign travel benefits but do not
cover the Part B deductible.
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.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social
Security Administration 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. 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.
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 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.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being
successfully treated for that condition. However, she and her physicians feel that after her
lengthy hospital stay she will need a month or two of nursing and rehabilitative care. What
should you tell them about Original Medicare's coverage of care in a skilled nursing facility?
✔✔Medicare will cover Mrs. Shield's skilled nursing services provided during the first 20 days
of her stay, after which she would have a copay until she has been in the facility for 100 days.
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? ✔✔Beneficiaries under Original Medicare have no cost-
sharing for most preventive services which include immunizations such as annual flu shots.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual
Medicare enrollment period because features of Part D might have changed. Mrs. Geisler can't
remember what Part D is so she called you to ask what her neighbor was talking about. What
could you tell her? ✔✔Part D covers prescription drugs and she should look at her premiums,
formulary, and cost-sharing among other factors to see if they have changed.
What impact, if any, will recent regulatory changes have upon Medigap plans? ✔✔The Part B
deductible will no longer be covered for individuals newly eligible for Medicare starting January
1, 2020.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for the
Part D low-income subsidy. Where might he turn for help with his prescription drug costs?
✔✔Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical
Assistance Program.
Madeline Martinez was widowed several years ago. Her husband worked for many years and
contributed into the Medicare system. He also left a substantial estate which provides Madeline
with an annual income of approximately $130,000. Madeline, who has only worked part-time for
2023 Graded A+
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social
Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What
should you tell Mrs. Quinn? ✔✔Part B primarily covers physician services. She will be paying a
monthly premium and, with the exception of many preventive and screening tests, generally will
have 20% coinsurance for these services, in addition to an annual deductible.
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like
to know which of the following services Original Medicare will cover if the appropriate criteria
are met? What could you tell her? ✔✔Original Medicare covers ambulance services.
Mr. Diaz continued working with his company and was insured under his employer's group plan
until he reached age 68. 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. What should
you tell him? ✔✔Mr. Diaz will not pay any penalty because he had continuous coverage under
his employer's plan.
,Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare Part A
and Part B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's
older neighbor Mel has told her about the Medigap Part F plan in which he is enrolled. It not
only provides foreign travel emergency benefits but also covers his Medicare Part B deductible.
Anita comes to you for advice. What should you tell her? ✔✔You are sorry to disappoint Anita
but a Medigap Part F plan is no longer available to those who turn age 65 after January 1,2020.
Anita might instead consider other Medigap plans that offer foreign travel benefits but do not
cover the Part B deductible.
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.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social
Security Administration 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. 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.
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 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.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being
successfully treated for that condition. However, she and her physicians feel that after her
lengthy hospital stay she will need a month or two of nursing and rehabilitative care. What
should you tell them about Original Medicare's coverage of care in a skilled nursing facility?
✔✔Medicare will cover Mrs. Shield's skilled nursing services provided during the first 20 days
of her stay, after which she would have a copay until she has been in the facility for 100 days.
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? ✔✔Beneficiaries under Original Medicare have no cost-
sharing for most preventive services which include immunizations such as annual flu shots.
Mrs. Geisler's neighbor told her she should look at her Part D options during the annual
Medicare enrollment period because features of Part D might have changed. Mrs. Geisler can't
remember what Part D is so she called you to ask what her neighbor was talking about. What
could you tell her? ✔✔Part D covers prescription drugs and she should look at her premiums,
formulary, and cost-sharing among other factors to see if they have changed.
What impact, if any, will recent regulatory changes have upon Medigap plans? ✔✔The Part B
deductible will no longer be covered for individuals newly eligible for Medicare starting January
1, 2020.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for the
Part D low-income subsidy. Where might he turn for help with his prescription drug costs?
✔✔Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical
Assistance Program.
Madeline Martinez was widowed several years ago. Her husband worked for many years and
contributed into the Medicare system. He also left a substantial estate which provides Madeline
with an annual income of approximately $130,000. Madeline, who has only worked part-time for
