2023 AHIP FINAL EXAM TEST h h h h
(With Verified Answers 100% h h h h
Correct) UPDATED APRIL 2 h h h
023
Mr. Davis is 52 years old and has recently been diagnosed with end-
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stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can
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obtain coverage under Medicare. What should you tell him? ✓He may sign-
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up for Medicare at any time however coverage usually begins on the fourth month a
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fterdialysis treatments start.
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Juan Perez, who is turning age 65 next month, intends to work for several more yea
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rs at Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers
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employer-
sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to t
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he Medicare system for over 20 years. Juan asks you if he willbe entitled to Medicar
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e and if he enrolls how that will impact his employer-
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hsponsored healthcare coverage. How would you respond? ✓Juan is likely to be eli
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gible for Medicare once he turns age 65 and if he enrolls Medicare would become t
h h h h h h h h h h h h h h h
he primary payor of his healthcare claims and Smallcap does not have tocontinue to
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offer him coverage comparable to those under age 65 under its employer-
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sponsored group health plan. h h h
Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what co
h h h h h h h h h h h h h h
verage Medicare Supplemental Insurance provides since his health care needs are d
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ifferent from his wife's needs. What could you tell Mr. Moy? ✓Medicare Suppleme
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ntal Insurance would help cover his Part A and Part B deductibles or coinsurance in
h h h h h h h h h h h h h h h
Original Fee-for- h
Service (FFS) Medicare as well as possibly someservices that Medicare does not co
h h h h h h h h h h h h h
,ver.
,Mrs. Peňa is 66 years old, has coverage under an employer plan, and will retire next y
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ear. She heard she must enroll in Part B at the beginning of the year to ensureno gap in
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coverage. What can you tell her? ✓She may enroll at any time while she is covered u
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nder her employer plan, but she will have a special eight-
h h h h h h h h h h
month enrollment period after the last month on her employer plan that differs from t
h h h h h h h h h h h h h h
he standard general enrollment period, during which she may enroll in Medicare Part
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B.
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Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employedful
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l time, and paid taxes during that entire period. She is concerned that she will not qu
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alify for coverage under part A because she was not born in the United States. What
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should you tell her? ✓Most individuals who are citizens and age 65
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, or over are covered under Part A by virtue of having paid Medicare taxes whilew
h h h h h h h h h h h h h h h
orking, though some may be covered as a result of paying monthly premiums.
h h h h h h h h h h h h
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well,but
h h h h h h h h h h h h h h
hit provides no drug coverage. She would like to keep the coverage she has butreplac
h h h h h h h h h h h h h h h
e her existing Medigap plan with one that provides drug coverage. What should you
h h h h h h h h h h h h h h
tell her? ✓✓Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but s
h h h h h h h h h h h h h
he could keep her Medigap policy and enroll in a Part D prescription drug plan.
h h h h h h h h h h h h h h
Mrs. West wears glasses and dentures and has enjoyed considerable pain relieffr
h h h h h h h h h h h h
om arthritis through massage therapy. She is concerned about whether or notMe
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dicare will cover these items and services. What should you tell her?
h h h h h h h h h h h
✓✓Medicare does not cover massage therapy, or, in general, glasses or dentures. h h h h h h h h h h h
Mr. Patel is in good health and is preparing a budget in anticipation of his retirement
h h h h h h h h h h h h h h h h
when he turns 66. He wants to understand the health care costs he mightbe exposed to
h h h h h h h h h h h h h h h h h
under Medicare if he were to require hospitalization as a result of anillness. In genera
h h h h h h h h h h h h h h h
l terms, what could you tell him about his costs for inpatient hospital services
h h h h h h h h h h h h h
under Original Medicare? ✓✓Under Original Medicare, there is a single deductibl
h h h h h h h h h h
e amount due for the first 60 days of any inpatient hospital stay, after
h h h h h h h h h h h h h
which it converts into a per- h h h h h
day coinsurance amount through day 90. After day 90,he would pay a daily amount u
h h h h h h h h h h h h h h h
p to 60 days over his lifetime, after which he wouldbe responsible for all costs.
h h h h h h h h h h h h h h h
Ms. Henderson believes that she will qualify for Medicare Coverage when she turns
h h h h h h h h h h h h h
65, without paying any premiums, because she has been working for 40 yearsand pay
h h h h h h h h h h h h h h
ing Medicare taxes. What should you tell her? ✓✓To obtain Part B coverage, she mu
h h h h h h h h h h h h h h
st pay a standard monthly premium, though it is higher for individuals with higher in
h h h h h h h h h h h h h h
comes.
Mr. Alonso receives some help paying for his two generic prescription drugs fromhi
h h h h h h h h h h h h h
s employer's retiree coverage, but he wants to compare it to a Part D prescriptiondrug
h h h h h h h h h h h h h h h
plan. He asks you what costs he would generally expect to encounter when enrollin
h h h h h h h h h h h h h h
g into a standard MedicarePart D prescription drug plan. What should youtell him?
h h h h h h h h h h h h h h
✓✓He generally would pay a monthly premium, annual deductible, and per-
h h h h h h h h h h
prescription cost-sharing. h
(With Verified Answers 100% h h h h
Correct) UPDATED APRIL 2 h h h
023
Mr. Davis is 52 years old and has recently been diagnosed with end-
h h h h h h h h h h h h
stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can
h h h h h h h h h h h h h h h
obtain coverage under Medicare. What should you tell him? ✓He may sign-
h h h h h h h h h h h
up for Medicare at any time however coverage usually begins on the fourth month a
h h h h h h h h h h h h h h
fterdialysis treatments start.
h h h
Juan Perez, who is turning age 65 next month, intends to work for several more yea
h h h h h h h h h h h h h h h
rs at Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers
h h h h h h h h h h h h
employer-
sponsored healthcare coverage. Juan is a naturalized citizen and has contributed to t
h h h h h h h h h h h h
he Medicare system for over 20 years. Juan asks you if he willbe entitled to Medicar
h h h h h h h h h h h h h h h h
e and if he enrolls how that will impact his employer-
h h h h h h h h h h
hsponsored healthcare coverage. How would you respond? ✓Juan is likely to be eli
h h h h h h h h h h h h
gible for Medicare once he turns age 65 and if he enrolls Medicare would become t
h h h h h h h h h h h h h h h
he primary payor of his healthcare claims and Smallcap does not have tocontinue to
h h h h h h h h h h h h h h h
offer him coverage comparable to those under age 65 under its employer-
h h h h h h h h h h h
sponsored group health plan. h h h
Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what co
h h h h h h h h h h h h h h
verage Medicare Supplemental Insurance provides since his health care needs are d
h h h h h h h h h h h
ifferent from his wife's needs. What could you tell Mr. Moy? ✓Medicare Suppleme
h h h h h h h h h h h h
ntal Insurance would help cover his Part A and Part B deductibles or coinsurance in
h h h h h h h h h h h h h h h
Original Fee-for- h
Service (FFS) Medicare as well as possibly someservices that Medicare does not co
h h h h h h h h h h h h h
,ver.
,Mrs. Peňa is 66 years old, has coverage under an employer plan, and will retire next y
h h h h h h h h h h h h h h h h
ear. She heard she must enroll in Part B at the beginning of the year to ensureno gap in
h h h h h h h h h h h h h h h h h h h
coverage. What can you tell her? ✓She may enroll at any time while she is covered u
h h h h h h h h h h h h h h h h h
nder her employer plan, but she will have a special eight-
h h h h h h h h h h
month enrollment period after the last month on her employer plan that differs from t
h h h h h h h h h h h h h h
he standard general enrollment period, during which she may enroll in Medicare Part
h h h h h h h h h h h h
B.
h
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employedful
h h h h h h h h h h h h h h h h
l time, and paid taxes during that entire period. She is concerned that she will not qu
h h h h h h h h h h h h h h h h
alify for coverage under part A because she was not born in the United States. What
h h h h h h h h h h h h h h h h
should you tell her? ✓Most individuals who are citizens and age 65
h h h h h h h h h h h
, or over are covered under Part A by virtue of having paid Medicare taxes whilew
h h h h h h h h h h h h h h h
orking, though some may be covered as a result of paying monthly premiums.
h h h h h h h h h h h h
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well,but
h h h h h h h h h h h h h h
hit provides no drug coverage. She would like to keep the coverage she has butreplac
h h h h h h h h h h h h h h h
e her existing Medigap plan with one that provides drug coverage. What should you
h h h h h h h h h h h h h h
tell her? ✓✓Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but s
h h h h h h h h h h h h h
he could keep her Medigap policy and enroll in a Part D prescription drug plan.
h h h h h h h h h h h h h h
Mrs. West wears glasses and dentures and has enjoyed considerable pain relieffr
h h h h h h h h h h h h
om arthritis through massage therapy. She is concerned about whether or notMe
h h h h h h h h h h h h
dicare will cover these items and services. What should you tell her?
h h h h h h h h h h h
✓✓Medicare does not cover massage therapy, or, in general, glasses or dentures. h h h h h h h h h h h
Mr. Patel is in good health and is preparing a budget in anticipation of his retirement
h h h h h h h h h h h h h h h h
when he turns 66. He wants to understand the health care costs he mightbe exposed to
h h h h h h h h h h h h h h h h h
under Medicare if he were to require hospitalization as a result of anillness. In genera
h h h h h h h h h h h h h h h
l terms, what could you tell him about his costs for inpatient hospital services
h h h h h h h h h h h h h
under Original Medicare? ✓✓Under Original Medicare, there is a single deductibl
h h h h h h h h h h
e amount due for the first 60 days of any inpatient hospital stay, after
h h h h h h h h h h h h h
which it converts into a per- h h h h h
day coinsurance amount through day 90. After day 90,he would pay a daily amount u
h h h h h h h h h h h h h h h
p to 60 days over his lifetime, after which he wouldbe responsible for all costs.
h h h h h h h h h h h h h h h
Ms. Henderson believes that she will qualify for Medicare Coverage when she turns
h h h h h h h h h h h h h
65, without paying any premiums, because she has been working for 40 yearsand pay
h h h h h h h h h h h h h h
ing Medicare taxes. What should you tell her? ✓✓To obtain Part B coverage, she mu
h h h h h h h h h h h h h h
st pay a standard monthly premium, though it is higher for individuals with higher in
h h h h h h h h h h h h h h
comes.
Mr. Alonso receives some help paying for his two generic prescription drugs fromhi
h h h h h h h h h h h h h
s employer's retiree coverage, but he wants to compare it to a Part D prescriptiondrug
h h h h h h h h h h h h h h h
plan. He asks you what costs he would generally expect to encounter when enrollin
h h h h h h h h h h h h h h
g into a standard MedicarePart D prescription drug plan. What should youtell him?
h h h h h h h h h h h h h h
✓✓He generally would pay a monthly premium, annual deductible, and per-
h h h h h h h h h h
prescription cost-sharing. h
