AHIP FINAL EXAM TEST QUESTIONS AND ANSWERS (2024/2025) (VERIFIED ANSWERS)

2023 AHIP FINAL EXAM TEST k k k k




(With Verified Answers 100% k k k k




Correct) UPDATED APRIL 2 k k k




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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ksponsored 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
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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. k k k




Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what co
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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
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Original Fee-for- k


Service (FFS) Medicare as well as possibly someservices that Medicare does not co
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,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-
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month enrollment period after the last month on her employer plan that differs from t
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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
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orking, though some may be covered as a result of paying monthly premiums.
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Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well,but
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kit provides no drug coverage. She would like to keep the coverage she has butreplac
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e her existing Medigap plan with one that provides drug coverage. What should you
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tell her? ✓✓Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but s
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he could keep her Medigap policy and enroll in a Part D prescription drug plan.
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Mrs. West wears glasses and dentures and has enjoyed considerable pain relieffr
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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?
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✓✓Medicare does not cover massage therapy, or, in general, glasses or dentures. k k k k k k k k k k k




Mr. Patel is in good health and is preparing a budget in anticipation of his retirement
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when he turns 66. He wants to understand the health care costs he mightbe exposed to
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under Medicare if he were to require hospitalization as a result of anillness. In genera
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l terms, what could you tell him about his costs for inpatient hospital services
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under Original Medicare? ✓✓Under Original Medicare, there is a single deductibl
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e amount due for the first 60 days of any inpatient hospital stay, after
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which it converts into a per- k k k k k


day coinsurance amount through day 90. After day 90,he would pay a daily amount u
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p to 60 days over his lifetime, after which he wouldbe responsible for all costs.
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Ms. Henderson believes that she will qualify for Medicare Coverage when she turns
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65, without paying any premiums, because she has been working for 40 yearsand pay
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ing Medicare taxes. What should you tell her? ✓✓To obtain Part B coverage, she mu
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st pay a standard monthly premium, though it is higher for individuals with higher in
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comes.

Mr. Alonso receives some help paying for his two generic prescription drugs fromhi
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s employer's retiree coverage, but he wants to compare it to a Part D prescriptiondrug
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plan. He asks you what costs he would generally expect to encounter when enrollin
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g into a standard MedicarePart D prescription drug plan. What should youtell him?
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✓✓He generally would pay a monthly premium, annual deductible, and per-
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prescription cost-sharing. k