AHIP 2022 Questions and Answers
Rated A
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?
a. Medicare Part B generally provides prescription drug coverage.
b. Beneficiaries under Original Medicare have no cost-sharing for most preventive services
which include immunizations such as annual flu shots.
c. Medicare Part A generally covers medically necessary physician and other health care
professional services.
d. Benefits covered by Medicare Parts A and B include routine dental care, hearing aids, and
routine eye care. ✔✔b. Beneficiaries under Original Medicare have no cost-sharing for most
preventive services which include immunizations such as annual flu shots.
(Beneficiaries enrolled in both Original Medicare (Parts A and B) have no cost-sharing for most
preventive services. These services include immunizations such as annual flu shots.)
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him?
,a. Mr. Singh must leave Original Medicare to receive drug coverage.
b. Part D prescription drug coverage can only be obtained by enrollment into a Medicare
Advantage plan that also covers Part A and Part B services.
c. Mr. Singh will have to enroll in Medicaid if he wishes to obtain prescription drug coverage
through some means other than a Medicare Advantage plan.
d. Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for
Part A and Part B services through Original Fee-for-Service Medicare. ✔✔d. Mr. Singh can
enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B
services through Original Fee-for-Service Medicare.
(Prescription drug coverage is available to those who enroll in a stand-alone Part D prescription
drug plan and continue coverage under Original Medicare Part A and Part B.)
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. What can you tell her about Medigap as an option to address this concern?
a. Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for
medically necessary services.
b. Medigap plans are not sold by private companies and are a government insurance product.
,c. All costs not covered by Medicare are covered by some Medigap plans.
d. If Mrs. Paterson applies during the Medigap open enrollment period, she will have to undergo
a medical review to determine if she has a pre-existing condition that would increase the
premium for a Medigap policy. ✔✔a. Medigap plans help beneficiaries cover coinsurance, co-
payments, and/or deductibles for medically necessary services.
(Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles when
Original Medicare determines that a benefit is medically necessary.)
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?
a. The penalty will be a permanent 10% increase in his Part B premium for every 12-month
period that passed during which he could have enrolled and did not.
b. Mr. Diaz will pay a penalty, which will be a flat amount each year, paid during the first month
of coverage.
c. During the first year, he is covered under Part B, his premiums will be 10% higher than they
otherwise would be, after which point they will return to normal.
, d. Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's
plan. ✔✔d. Mr. Diaz will not pay any penalty because he had continuous coverage under his
employer's plan.
(Individuals with coverage based on their own current employment are not subject to the late
enrollment penalty.)
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?
a. 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.
b. Eligibility for Medicare is based on whether or not a person has ever been employed by the
federal government. If she or her husband were ever employed by the federal government, she
can enroll in Medicare.
c. Medicare is a program for people who have incomes and assets below specific limits, so you
will have to find out her exact financial situation before telling her whether she can obtain
Medicare coverage.
Rated A
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?
a. Medicare Part B generally provides prescription drug coverage.
b. Beneficiaries under Original Medicare have no cost-sharing for most preventive services
which include immunizations such as annual flu shots.
c. Medicare Part A generally covers medically necessary physician and other health care
professional services.
d. Benefits covered by Medicare Parts A and B include routine dental care, hearing aids, and
routine eye care. ✔✔b. Beneficiaries under Original Medicare have no cost-sharing for most
preventive services which include immunizations such as annual flu shots.
(Beneficiaries enrolled in both Original Medicare (Parts A and B) have no cost-sharing for most
preventive services. These services include immunizations such as annual flu shots.)
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage
plan. What should you tell him?
,a. Mr. Singh must leave Original Medicare to receive drug coverage.
b. Part D prescription drug coverage can only be obtained by enrollment into a Medicare
Advantage plan that also covers Part A and Part B services.
c. Mr. Singh will have to enroll in Medicaid if he wishes to obtain prescription drug coverage
through some means other than a Medicare Advantage plan.
d. Mr. Singh can enroll in a stand-alone prescription drug plan and continue to be covered for
Part A and Part B services through Original Fee-for-Service Medicare. ✔✔d. Mr. Singh can
enroll in a stand-alone prescription drug plan and continue to be covered for Part A and Part B
services through Original Fee-for-Service Medicare.
(Prescription drug coverage is available to those who enroll in a stand-alone Part D prescription
drug plan and continue coverage under Original Medicare Part A and Part B.)
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original
Medicare. What can you tell her about Medigap as an option to address this concern?
a. Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for
medically necessary services.
b. Medigap plans are not sold by private companies and are a government insurance product.
,c. All costs not covered by Medicare are covered by some Medigap plans.
d. If Mrs. Paterson applies during the Medigap open enrollment period, she will have to undergo
a medical review to determine if she has a pre-existing condition that would increase the
premium for a Medigap policy. ✔✔a. Medigap plans help beneficiaries cover coinsurance, co-
payments, and/or deductibles for medically necessary services.
(Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles when
Original Medicare determines that a benefit is medically necessary.)
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?
a. The penalty will be a permanent 10% increase in his Part B premium for every 12-month
period that passed during which he could have enrolled and did not.
b. Mr. Diaz will pay a penalty, which will be a flat amount each year, paid during the first month
of coverage.
c. During the first year, he is covered under Part B, his premiums will be 10% higher than they
otherwise would be, after which point they will return to normal.
, d. Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's
plan. ✔✔d. Mr. Diaz will not pay any penalty because he had continuous coverage under his
employer's plan.
(Individuals with coverage based on their own current employment are not subject to the late
enrollment penalty.)
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?
a. 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.
b. Eligibility for Medicare is based on whether or not a person has ever been employed by the
federal government. If she or her husband were ever employed by the federal government, she
can enroll in Medicare.
c. Medicare is a program for people who have incomes and assets below specific limits, so you
will have to find out her exact financial situation before telling her whether she can obtain
Medicare coverage.
