AHIP MODULE 1 VERSIONS 1-5
COMPLETE STUDY SET WITH
WELL RATED VERIFIED ANSWERS
AHIP module 1 Version 1
What impact, if any, will the Medicare Access and CHIP Reauthorization Act of 2015
(MACRA) have upon Medigap plans? Correct Answer- d. The Part B deductible will
no longer be covered for individuals newly eligible for Medicare starting January 1,
2020. Correct
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 Answer- d.
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. Correct
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? Correct Answer- a.
Medicare health plans must cover all benefits available under Medicare Part A and Part
B. Many also cover Part D prescription drugs. Correct
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? Correct Answer- a. 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. Correct
, AHIP MODULE 1 VERSIONS 1-5
COMPLETE STUDY SET WITH
WELL RATED VERIFIED ANSWERS
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her
own home. She is attracted by the idea of maintaining control over a Medical Savings
Account (MSA), but is not sure if the plan associated with the account will fit her
needs. What specific piece of information about a Medicare MSA plan would it be
important for her to know, prior to enrolling in such a plan? Correct Answer- a. All
MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits, which
could be obtained by also enrolling in a separate prescription drug plan. Correct
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?
Choose one answer.
a. 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.
b. Most individuals who are citizens and over age 65 and wish to be covered under
Part A must enroll in a Medicare Health Plan.
c. Most individuals who are citizens and over age 65 and are covered under Part A
must pay a monthly premium for that coverage.
d. All individuals who are citizens and over age 65 will be covered under Part A.
Correct Answer- a. 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.
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?
, AHIP MODULE 1 VERSIONS 1-5
COMPLETE STUDY SET WITH
WELL RATED VERIFIED ANSWERS
Correct Answer- d. 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 (ESRD) and will soon begin dialysis. He is wondering if he can obtain
coverage under Medicare. What should you tell him? Correct Answer- a. He may sign-
up for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start. Correct
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 Answer- a. In order to
obtain Part B coverage, she must pay a standard
, AHIP MODULE 1 VERSIONS 1-5
COMPLETE STUDY SET WITH
WELL RATED VERIFIED ANSWERS
monthly premium, though it is higher for individuals with higher incomes. Correct
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? Correct Answer- b. Mr.
Diaz will not pay any penalty because he had continuous coverage under his
employer's plan. Correct
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 Answer- d. She may 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. Correct
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is
considering enrollment in a Medicare health plan (Part C). What should you advise her
to do before she will be able to enroll into a Medicare health plan? Correct Answer-
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is
considering enrollment in a Medicare health plan (Part C). What should you advise her
to do before she will be able to enroll into a Medicare health plan?
Mrs. Park is an elderly retiree. She has a low, fixed income. What could you tell Mrs.
Park that might be of assistance? Correct Answer- d. She 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.
Correct
COMPLETE STUDY SET WITH
WELL RATED VERIFIED ANSWERS
AHIP module 1 Version 1
What impact, if any, will the Medicare Access and CHIP Reauthorization Act of 2015
(MACRA) have upon Medigap plans? Correct Answer- d. The Part B deductible will
no longer be covered for individuals newly eligible for Medicare starting January 1,
2020. Correct
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 Answer- d.
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. Correct
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? Correct Answer- a.
Medicare health plans must cover all benefits available under Medicare Part A and Part
B. Many also cover Part D prescription drugs. Correct
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? Correct Answer- a. 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. Correct
, AHIP MODULE 1 VERSIONS 1-5
COMPLETE STUDY SET WITH
WELL RATED VERIFIED ANSWERS
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her
own home. She is attracted by the idea of maintaining control over a Medical Savings
Account (MSA), but is not sure if the plan associated with the account will fit her
needs. What specific piece of information about a Medicare MSA plan would it be
important for her to know, prior to enrolling in such a plan? Correct Answer- a. All
MSAs cover Part A and Part B benefits, but not Part D prescription drug benefits, which
could be obtained by also enrolling in a separate prescription drug plan. Correct
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?
Choose one answer.
a. 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.
b. Most individuals who are citizens and over age 65 and wish to be covered under
Part A must enroll in a Medicare Health Plan.
c. Most individuals who are citizens and over age 65 and are covered under Part A
must pay a monthly premium for that coverage.
d. All individuals who are citizens and over age 65 will be covered under Part A.
Correct Answer- a. 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.
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?
, AHIP MODULE 1 VERSIONS 1-5
COMPLETE STUDY SET WITH
WELL RATED VERIFIED ANSWERS
Correct Answer- d. 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 (ESRD) and will soon begin dialysis. He is wondering if he can obtain
coverage under Medicare. What should you tell him? Correct Answer- a. He may sign-
up for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start. Correct
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 Answer- a. In order to
obtain Part B coverage, she must pay a standard
, AHIP MODULE 1 VERSIONS 1-5
COMPLETE STUDY SET WITH
WELL RATED VERIFIED ANSWERS
monthly premium, though it is higher for individuals with higher incomes. Correct
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? Correct Answer- b. Mr.
Diaz will not pay any penalty because he had continuous coverage under his
employer's plan. Correct
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 Answer- d. She may 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. Correct
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is
considering enrollment in a Medicare health plan (Part C). What should you advise her
to do before she will be able to enroll into a Medicare health plan? Correct Answer-
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is
considering enrollment in a Medicare health plan (Part C). What should you advise her
to do before she will be able to enroll into a Medicare health plan?
Mrs. Park is an elderly retiree. She has a low, fixed income. What could you tell Mrs.
Park that might be of assistance? Correct Answer- d. She 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.
Correct
