8/29/23,b1:43bPM 2022bAHIPbTestbReviewbQuestionsbandbanswersb(100%bVerifiedbQuestionsb
…
2022 AHIP Test Review Question
b b b b
s and answers
b b
2022bAhipbReviewbUNITb1bMedicarebBasicsb
Questionb1
Mr.bBuckbhasbseveralbfamilybmembersbwhobdiedbfrombdifferentbcancers.bHebwantsbtobknowbifbMed
icareb coversbcancerbscreening.bWhatbshouldbyoubtellbhim?
a. MedicarebcoversballbscreeningbtestsbthatbhavebbeenbapprovedbbybthebFDAbonbabfrequencybdetermin
edbbyb thebtreatingbphysician.
b. Medicarebcoversbtreatmentsbforbexistingbdisease,binjury,bandbmalformedblimbsborbbodybparts.bAsbsu
ch,bitb doesbnotbcoverbanybscreeningbtestsbandbthesebmustbbebpaidbforbbybthebbeneficiarybout-of-
pocket.
c. Medicarebcoversbsomebscreeningbtestsbthatbmustbbebperformedbwithinbthebfirstbyearbafterbenrollme
nt.b Beyondbthatbpointbexpensesbforbscreeningbtestsbarebthebresponsibilitybofbthebbeneficiary.
d. Medicarebcoversbthebperiodicbperformancebofbabrangebofbscreeningbtestsbthatbarebmeantbtobprovide
bearlyb detectionbofbdisease.bMr.bBuckbwillbneedbtobcheckbspecificbtestsbbeforebobtainingbthembtobs
eebifbtheybwillb bebcovered.
Source:b Moduleb 1,b Slideb -b Medicareb Partb Bb Benefitsb -b Preventiveb Servicesb andb Screenings
Questionb2
Mr.bSchmidtbwouldblikebtobplanbforbretirementbandbhasbaskedbyoubwhatbisbcoveredbunderbOriginal
bFee-b for-bServiceb(FFSftbMedicare?bWhatbcouldbyoubtellbhim?
a. PartbC,bwhichbalwaysbcoversbdentalbandbvisionbservices,bisbcoveredbunderbOriginalbMedicare.
b. Partb A,bwhichb coversbhospital,bskilledbnursingbfacility,b hospice,bandbhomebhealthb servicesb
andb PartbB,
whichb coversb professionalb servicesb suchb asb thoseb providedb byb ab doctorb areb coveredb under
b Original
Medicb b .
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are
c. PartbA,bwhichbcoversblong-termbcustodialbcarebservices,bisbcoveredbunderbOriginalbMedicare.
d. PartbD,bwhichbcoversbprescriptionbdrugbservices,bisbcoveredbunderbOriginalbMedicare.
Source:b Moduleb 1,b Slideb -b Overviewb ofb Medicareb Benefitsb andb Coverageb -
b Partsb A,b B,b C,b andb Slideb -b
OverviewbofbDifferentbWaysbtobGetbMedicare
Questionb3
JuanbPerez,bwhobisbturningbageb65bnextbmonth,bintendsbtobworkbforbseveralbmorebyearsbatbSm
allcap,b Incorporated.bSmallcapbhasbabworkforcebofb15bemployeesbandboffersbemployer-
sponsoredb healthcarebcoverage.bJuanbisbabnaturalizedbcitizenbandbhasbcontributedbtobthebMe
dicarebsystembforb overb20byears.bJuanbasksbyoubifbhebwillbbebentitledbtobMedicarebandbifbheb
enrollsbhowbthatbwillb impactbhisbemployer-
bsponsoredbhealthcarebcoverage.bHowbwouldbyoubrespond?
a. JuanbisblikelybtobbebineligiblebforbMedicarebsincebhebwasbbornboutsidebthebUnitedbStatesbandbha
sbonlyb contributedbtobthebMedicarebsystembforb20byears.
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b. JuanbisblikelybtobbebeligiblebforbMedicareboncebhebturnsbageb65bandbifbhebenrollsbMedicareb
wouldb becomebthebprimarybpayorbofbhisbhealthcarebclaimsbbutbSmallcapbmustbcontinuebtoboff
erbhimb coveragebunderbitsbemployer-
sponsoredbgroupbhealthbplanbandbwouldbbecomebabsecondarybpayor.
c. JuanbisblikelybtobbebeligiblebforbMedicareboncebhebturnsbageb65bandbifbhebenrollsbhisbemployer-
b sponsoredbcoveragebwouldbcontinuebtobbebthebprimarybpayorbwhilebMedicarebwouldbbebconsid
eredbab secondarybpayorbofbhisbhealthcarebclaims.
Incorrect:bMedicarebisbthebprimarybpayorbforbindividualsbwhobhavebgroupbhealthbcoveragebdueb
tob theirbcontinuedbemploymentbwithbabsmallbemployer.bAbsmallbgroupbhealthbplanbisboneboffer
edbbybab companybwithbfewerbthanb20bemployees.
d. JuanbisblikelybtobbebeligiblebforbMedicareboncebhebturnsbageb65bandbifbhebenrollsbMedicarebwo
uldb becomebthebprimarybpayorbofbhisbhealthcarebclaimsbandbSmallcapbdoesbnotbhavebtobcontinu
ebtobofferb himbcoveragebcomparablebtobthosebunderbageb65bunderbitsbemployer-
sponsoredbgroupbhealthbplan.
Source:bModuleb1,bSlideb-bEligibilitybforbPartbAbandbPartbBbBenefitsbandbSlideb-
bMedicarebforbIndividualsb Whob Areb Stillb Workingb -b Smallb GHPsb andb Slideb -
b Medicareb Coordinationb withb Employerb Groupb Health
PlansbQuestionb4
Mr.bBauerbisb49byearsbold,bbutbeighteenbmonthsbagobhebwasbdeclaredbdisabledbbybthebSocialbS
ecurityb Administrationbandbhasbbeenbreceivingbdisabilitybpayments.bHebisbwonderingbwhetherb
hebcanbobtainb coveragebunderbMedicare.bWhatbshouldbyoubtellbhim?
a. Afterb receivingb suchb disabilityb paymentsb forb 24b months,b heb willb beb automaticallyb enroll
edb inb Medicare,
regardlessb ofb a
ge.
b. Individualsb whob becomeb eligibleb forb suchb disabilityb paymentsb onlyb haveb tob waitb 12b monthsb before
theybcanbapplybforbcoveragebunderbMedicare.
c. Individualsb receivingb suchb disabilityb paymentsb fromb theb Socialb Securityb Administrationb continu
eb tob receivebthosebpaymentsbbutbonlybbecomebeligiblebforbMedicarebuponbreachingbageb65.
d. HebbecamebeligiblebforbMedicarebwhenbhisbdisabilitybeligibilitybdeterminationbwasbfirstb
made.b Source:bModuleb1,bSlideb-bMedicarebEnrollmentbPartbAb&bB
Questionb5
Ms.bMoorebplansbtobretirebwhenbshebturnsb65binbabfewbmonths.bShebisbinbexcellentbhealthbandbwi
llbhaveb considerablebincomebwhenbshebretires.bShebisbconcernedbthatbherbincomebwillbmakebitbimp
ossiblebforbherb tobqualifybforbMedicare.bWhatbcouldbyoubtellbherbtobaddressbherbconcern?
a. Medicarebisbabprogrambforbpeoplebwhobhavebincomesbandbassetsbbelowbspecificblimits,bsobyoubwi
llbhaveb tobfindboutbherbexactbfinancialbsituationbbeforebtellingbherbwhetherbshebcanbobtainbMedic
arebcoverage.
b. EligibilitybforbMedicarebisbbasedbonbwhetherborbnotbabpersonbhasbeverbbeenbemployedbbybtheb
federalb government.bIfbsheborbherbhusbandbwerebeverbemployedbbybthebfederalbgovernment,bsh
ebcanbenrollbinb Medicare.
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…
c. Medicarebisbabprogrambforbpeoplebofballbagesbwithbspecificbmentalbhealthbdisabilities.bSincebshe
bisbinb
excellentbhealth,bshebwouldbnotbqualify,bbutbshouldbinsteadblookbintobherbstate’sbMedicai
dbprogrambifb shebwantsbfurtherbcoverage.
d. Medicarebisbabprogrambforbpeoplebageb65borbolderbandbthosebunderbageb65bwithbcertainbdisab
ilities,b end-
stageb renalb disease,b andb Loub Gehrig’sb diseaseb sob sheb willb beb eligible
b forb Medicare.
Source:bModuleb1,bSlideb-bEligibilitybforbPartbAbandbPartbBbBenefits
Questionb6
Mrs.bDuartebisbenrolledbinbOriginalbMedicarebPartsbAbandbB.bShebhasbrecentlybreviewedbherbMe
dicareb SummarybNoticeb(MSNftbandbdisagreesbwithbabdeterminationbthatbpartiallybdeniedboneb
ofbherbclaimsb forbservices.bWhatbadvicebwouldbyoubgivebher?
a. Mrs.b Duarteb shouldb fileb anb appealb ofb thisb initialb determinationb withinb 120b daysb ofb theb da
teb sheb received
theb MSNb inb the
b mail.
b. Mrs.bDuartebhasbnobrightbtobappealbthisbdeterminationbsincebherbclaimbhasbbeenbpartiallybpaid.
c. Mrs.b Duarteb shouldb fileb anb appealb ofb thisb initialb determinationb withinb 90b daysb ofb theb da
teb sheb receivedbthebMSNbinbthebmail.bIfbshebstillbdisagreesbwithbMedicarebAdministrativebContract
orfisb(MACfisftb furtherb decisionb sheb shouldb requestb ab reconsiderationb byb ab qualifiedb independ
entb partyb withinb 10b days.
Incorrect:bBeneficiariesbmustbfilebanbappealbrelatedbtobPartbAborbBbservicesbwithinb120bdaysbofbtheb
dateb theyb getb theb MSNb inb theb mail.b Ifb ab beneficiaryb disagreesb withb theb Medicareb Admin
istrativeb Contractor’sb decision,b he/sheb hasb 180b daysb afterb gettingb theb decisionb noticeb tob r
equestb ab reconsiderationbbybabQualifiedbIndependentbContractor.
d. Mrs.bDuartebshouldbrequestbabreconsiderationbofbthebdecisionbbybabqualifiedbindependentbpartyb
withinb 60bdaysbofbthebdatebshebreceivedbthebMSNbinbthebmail.
Source:bModuleb1,bSlideb-bAppealsbrelatedbtobPartbAbandbPartbBbCoveragebandbPaymentbDeterminations.
Questionb7
Mr.bMoyfisbwifebhasbabMedicarebAdvantagebplan,bbutbhebwantsbtobunderstandbwhatbcoveragebMe
dicareb SupplementalbInsurancebprovidesbsincebhisbhealthbcarebneedsbarebdifferentbfrombhisbwife’
sbneeds.b WhatbcouldbyoubtellbMr.bMoy?
a. MedicarebSupplementalbInsurancebwouldbcoverbhisbdental,bvisionbandbhearingbservicesbonly.
b. MedicarebSupplementalbInsurancebwouldbhelpbcoverbhisbPartbAbandbPartbBbdeductiblesborbcoinsur
anceb inbOriginalbFee-for-
Serviceb(FFSftbMedicarebasbwellbasbpossiblybsomebservicesbthatbMedicarebdoesbnotb cover.
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2022 AHIP Test Review Question
b b b b
s and answers
b b
2022bAhipbReviewbUNITb1bMedicarebBasicsb
Questionb1
Mr.bBuckbhasbseveralbfamilybmembersbwhobdiedbfrombdifferentbcancers.bHebwantsbtobknowbifbMed
icareb coversbcancerbscreening.bWhatbshouldbyoubtellbhim?
a. MedicarebcoversballbscreeningbtestsbthatbhavebbeenbapprovedbbybthebFDAbonbabfrequencybdetermin
edbbyb thebtreatingbphysician.
b. Medicarebcoversbtreatmentsbforbexistingbdisease,binjury,bandbmalformedblimbsborbbodybparts.bAsbsu
ch,bitb doesbnotbcoverbanybscreeningbtestsbandbthesebmustbbebpaidbforbbybthebbeneficiarybout-of-
pocket.
c. Medicarebcoversbsomebscreeningbtestsbthatbmustbbebperformedbwithinbthebfirstbyearbafterbenrollme
nt.b Beyondbthatbpointbexpensesbforbscreeningbtestsbarebthebresponsibilitybofbthebbeneficiary.
d. Medicarebcoversbthebperiodicbperformancebofbabrangebofbscreeningbtestsbthatbarebmeantbtobprovide
bearlyb detectionbofbdisease.bMr.bBuckbwillbneedbtobcheckbspecificbtestsbbeforebobtainingbthembtobs
eebifbtheybwillb bebcovered.
Source:b Moduleb 1,b Slideb -b Medicareb Partb Bb Benefitsb -b Preventiveb Servicesb andb Screenings
Questionb2
Mr.bSchmidtbwouldblikebtobplanbforbretirementbandbhasbaskedbyoubwhatbisbcoveredbunderbOriginal
bFee-b for-bServiceb(FFSftbMedicare?bWhatbcouldbyoubtellbhim?
a. PartbC,bwhichbalwaysbcoversbdentalbandbvisionbservices,bisbcoveredbunderbOriginalbMedicare.
b. Partb A,bwhichb coversbhospital,bskilledbnursingbfacility,b hospice,bandbhomebhealthb servicesb
andb PartbB,
whichb coversb professionalb servicesb suchb asb thoseb providedb byb ab doctorb areb coveredb under
b Original
Medicb b .
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…
are
c. PartbA,bwhichbcoversblong-termbcustodialbcarebservices,bisbcoveredbunderbOriginalbMedicare.
d. PartbD,bwhichbcoversbprescriptionbdrugbservices,bisbcoveredbunderbOriginalbMedicare.
Source:b Moduleb 1,b Slideb -b Overviewb ofb Medicareb Benefitsb andb Coverageb -
b Partsb A,b B,b C,b andb Slideb -b
OverviewbofbDifferentbWaysbtobGetbMedicare
Questionb3
JuanbPerez,bwhobisbturningbageb65bnextbmonth,bintendsbtobworkbforbseveralbmorebyearsbatbSm
allcap,b Incorporated.bSmallcapbhasbabworkforcebofb15bemployeesbandboffersbemployer-
sponsoredb healthcarebcoverage.bJuanbisbabnaturalizedbcitizenbandbhasbcontributedbtobthebMe
dicarebsystembforb overb20byears.bJuanbasksbyoubifbhebwillbbebentitledbtobMedicarebandbifbheb
enrollsbhowbthatbwillb impactbhisbemployer-
bsponsoredbhealthcarebcoverage.bHowbwouldbyoubrespond?
a. JuanbisblikelybtobbebineligiblebforbMedicarebsincebhebwasbbornboutsidebthebUnitedbStatesbandbha
sbonlyb contributedbtobthebMedicarebsystembforb20byears.
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b. JuanbisblikelybtobbebeligiblebforbMedicareboncebhebturnsbageb65bandbifbhebenrollsbMedicareb
wouldb becomebthebprimarybpayorbofbhisbhealthcarebclaimsbbutbSmallcapbmustbcontinuebtoboff
erbhimb coveragebunderbitsbemployer-
sponsoredbgroupbhealthbplanbandbwouldbbecomebabsecondarybpayor.
c. JuanbisblikelybtobbebeligiblebforbMedicareboncebhebturnsbageb65bandbifbhebenrollsbhisbemployer-
b sponsoredbcoveragebwouldbcontinuebtobbebthebprimarybpayorbwhilebMedicarebwouldbbebconsid
eredbab secondarybpayorbofbhisbhealthcarebclaims.
Incorrect:bMedicarebisbthebprimarybpayorbforbindividualsbwhobhavebgroupbhealthbcoveragebdueb
tob theirbcontinuedbemploymentbwithbabsmallbemployer.bAbsmallbgroupbhealthbplanbisboneboffer
edbbybab companybwithbfewerbthanb20bemployees.
d. JuanbisblikelybtobbebeligiblebforbMedicareboncebhebturnsbageb65bandbifbhebenrollsbMedicarebwo
uldb becomebthebprimarybpayorbofbhisbhealthcarebclaimsbandbSmallcapbdoesbnotbhavebtobcontinu
ebtobofferb himbcoveragebcomparablebtobthosebunderbageb65bunderbitsbemployer-
sponsoredbgroupbhealthbplan.
Source:bModuleb1,bSlideb-bEligibilitybforbPartbAbandbPartbBbBenefitsbandbSlideb-
bMedicarebforbIndividualsb Whob Areb Stillb Workingb -b Smallb GHPsb andb Slideb -
b Medicareb Coordinationb withb Employerb Groupb Health
PlansbQuestionb4
Mr.bBauerbisb49byearsbold,bbutbeighteenbmonthsbagobhebwasbdeclaredbdisabledbbybthebSocialbS
ecurityb Administrationbandbhasbbeenbreceivingbdisabilitybpayments.bHebisbwonderingbwhetherb
hebcanbobtainb coveragebunderbMedicare.bWhatbshouldbyoubtellbhim?
a. Afterb receivingb suchb disabilityb paymentsb forb 24b months,b heb willb beb automaticallyb enroll
edb inb Medicare,
regardlessb ofb a
ge.
b. Individualsb whob becomeb eligibleb forb suchb disabilityb paymentsb onlyb haveb tob waitb 12b monthsb before
theybcanbapplybforbcoveragebunderbMedicare.
c. Individualsb receivingb suchb disabilityb paymentsb fromb theb Socialb Securityb Administrationb continu
eb tob receivebthosebpaymentsbbutbonlybbecomebeligiblebforbMedicarebuponbreachingbageb65.
d. HebbecamebeligiblebforbMedicarebwhenbhisbdisabilitybeligibilitybdeterminationbwasbfirstb
made.b Source:bModuleb1,bSlideb-bMedicarebEnrollmentbPartbAb&bB
Questionb5
Ms.bMoorebplansbtobretirebwhenbshebturnsb65binbabfewbmonths.bShebisbinbexcellentbhealthbandbwi
llbhaveb considerablebincomebwhenbshebretires.bShebisbconcernedbthatbherbincomebwillbmakebitbimp
ossiblebforbherb tobqualifybforbMedicare.bWhatbcouldbyoubtellbherbtobaddressbherbconcern?
a. Medicarebisbabprogrambforbpeoplebwhobhavebincomesbandbassetsbbelowbspecificblimits,bsobyoubwi
llbhaveb tobfindboutbherbexactbfinancialbsituationbbeforebtellingbherbwhetherbshebcanbobtainbMedic
arebcoverage.
b. EligibilitybforbMedicarebisbbasedbonbwhetherborbnotbabpersonbhasbeverbbeenbemployedbbybtheb
federalb government.bIfbsheborbherbhusbandbwerebeverbemployedbbybthebfederalbgovernment,bsh
ebcanbenrollbinb Medicare.
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…
c. Medicarebisbabprogrambforbpeoplebofballbagesbwithbspecificbmentalbhealthbdisabilities.bSincebshe
bisbinb
excellentbhealth,bshebwouldbnotbqualify,bbutbshouldbinsteadblookbintobherbstate’sbMedicai
dbprogrambifb shebwantsbfurtherbcoverage.
d. Medicarebisbabprogrambforbpeoplebageb65borbolderbandbthosebunderbageb65bwithbcertainbdisab
ilities,b end-
stageb renalb disease,b andb Loub Gehrig’sb diseaseb sob sheb willb beb eligible
b forb Medicare.
Source:bModuleb1,bSlideb-bEligibilitybforbPartbAbandbPartbBbBenefits
Questionb6
Mrs.bDuartebisbenrolledbinbOriginalbMedicarebPartsbAbandbB.bShebhasbrecentlybreviewedbherbMe
dicareb SummarybNoticeb(MSNftbandbdisagreesbwithbabdeterminationbthatbpartiallybdeniedboneb
ofbherbclaimsb forbservices.bWhatbadvicebwouldbyoubgivebher?
a. Mrs.b Duarteb shouldb fileb anb appealb ofb thisb initialb determinationb withinb 120b daysb ofb theb da
teb sheb received
theb MSNb inb the
b mail.
b. Mrs.bDuartebhasbnobrightbtobappealbthisbdeterminationbsincebherbclaimbhasbbeenbpartiallybpaid.
c. Mrs.b Duarteb shouldb fileb anb appealb ofb thisb initialb determinationb withinb 90b daysb ofb theb da
teb sheb receivedbthebMSNbinbthebmail.bIfbshebstillbdisagreesbwithbMedicarebAdministrativebContract
orfisb(MACfisftb furtherb decisionb sheb shouldb requestb ab reconsiderationb byb ab qualifiedb independ
entb partyb withinb 10b days.
Incorrect:bBeneficiariesbmustbfilebanbappealbrelatedbtobPartbAborbBbservicesbwithinb120bdaysbofbtheb
dateb theyb getb theb MSNb inb theb mail.b Ifb ab beneficiaryb disagreesb withb theb Medicareb Admin
istrativeb Contractor’sb decision,b he/sheb hasb 180b daysb afterb gettingb theb decisionb noticeb tob r
equestb ab reconsiderationbbybabQualifiedbIndependentbContractor.
d. Mrs.bDuartebshouldbrequestbabreconsiderationbofbthebdecisionbbybabqualifiedbindependentbpartyb
withinb 60bdaysbofbthebdatebshebreceivedbthebMSNbinbthebmail.
Source:bModuleb1,bSlideb-bAppealsbrelatedbtobPartbAbandbPartbBbCoveragebandbPaymentbDeterminations.
Questionb7
Mr.bMoyfisbwifebhasbabMedicarebAdvantagebplan,bbutbhebwantsbtobunderstandbwhatbcoveragebMe
dicareb SupplementalbInsurancebprovidesbsincebhisbhealthbcarebneedsbarebdifferentbfrombhisbwife’
sbneeds.b WhatbcouldbyoubtellbMr.bMoy?
a. MedicarebSupplementalbInsurancebwouldbcoverbhisbdental,bvisionbandbhearingbservicesbonly.
b. MedicarebSupplementalbInsurancebwouldbhelpbcoverbhisbPartbAbandbPartbBbdeductiblesborbcoinsur
anceb inbOriginalbFee-for-
Serviceb(FFSftbMedicarebasbwellbasbpossiblybsomebservicesbthatbMedicarebdoesbnotb cover.
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