AHIP 2021/2022 Exam bank (answered) explained.

AHIP 2022 EXAM

1. Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving

Social Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her

that she has been automatically enrolled in Medicare Part B. She wants to understand

what this means. What should you tell Mrs. Quinn?

(correct ANS)- Part B primarily covers physician services. She will be paying a monthly

premium and, with the exception of many preventive and screening tests, generally will

have 20% coinsurance for these services, in addition to an annual deductible.

2. Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and

would like to know which of the following services Original Medicare will cover if the

appropriate criteria are met? What could you tell her?

(correct ANS)- Original Medicare covers ambulance services.

3. 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 ANS)- Mr. Diaz will not pay any penalty because he had continuous coverage

under his employer's plan.

4. Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original Medicare

Part A and Part B. She would also like to enroll in a Medicare Supplement (Medigap)

plan. Anita's older neighbor Mel has told her about the Medigap Part F plan in which he

is enrolled. It not only provides foreign travel emergency benefits but also covers his

Medicare Part B deductible. Anita comes to you for advice. What should you tell her?

(correct ANS)- You are sorry to disappoint Anita but a Medigap Part F plan is no longer

available to those who turn age 65 after January 1,2020. Anita might instead consider

other Medigap plans that offer foreign travel benefits but do not cover the Part B

deductible.

5. Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what

coverage Medicare Supplemental Insurance provides since his health care needs are

different from his wife's needs. What could you tell Mr. Moy?

(correct ANS)- Medicare Supplemental Insurance would help cover his Part A and Part

B cost sharing in Original Fee-for-Service (FFS) Medicare as well as possibly some

services that Medicare does not cover.

6. 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?

(correct ANS)- After receiving such disability payments for 24 months, he will be

automatically enrolled in Medicare, regardless of age.

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7. 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 ANS)- 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.

8. 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?

(correct ANS)- 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.

9. Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being

successfully treated for that condition. However, she and her physicians feel that after her

lengthy hospital stay she will need a month or two of nursing and rehabilitative care.

What should you tell them about Original Medicare's coverage of care in a skilled

nursing facility?

(correct ANS)- Medicare will cover Mrs. Shield's skilled nursing services provided

during the first 20 days of her stay, after which she would have a copay until she has been

in the facility for 100 days.

10. 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?

(correct ANS)- Beneficiaries under Original Medicare have no cost-sharing for most

preventive services which include immunizations such as annual flu shots.

11. Mrs. Geisler's neighbor told her she should look at her Part D options during the annual

Medicare enrollment period because features of Part D might have changed. Mrs. Geisler

can't remember what Part D is so she called you to ask what her neighbor was talking

about. What could you tell her?

(correct ANS)- Part D covers prescription drugs and she should look at her premiums,

formulary, and cost-sharing among other factors to see if they have changed.

12. What impact, if any, will recent regulatory changes have upon Medigap plans?

(correct ANS)- The Part B deductible will no longer be covered for individuals newly

eligible for Medicare starting January 1, 2020.

13. Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify

for the Part D low-income subsidy. Where might he turn for help with his prescription

drug costs?

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(correct ANS)- Mr. Wu may still qualify for help in paying Part D costs through his State

Pharmaceutical Assistance Program.

14. Madeline Martinez was widowed several years ago. Her husband worked for many years

and contributed into the Medicare system. He also left a substantial estate which provides

Madeline with an annual income of approximately $130,000. Madeline, who has only

worked part-time for the last three years, will soon turn age 65 and hopes to enroll in

Original Medicare. She comes to you for advice. What should you tell her?

(correct ANS)- You should tell Madeline that she will be able to enroll in Medicare Part

A without paying monthly premiums due to her husband's long work record and

participation in the Medicare system. You should also tell Madeline that she will pay Part

B premiums at more than the standard lowest rate but less than the highest rate due her

substantial income.

15. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled

in Medicare Parts A and B. Jerry has also purchased a Medicare Supplement (Medigap)

plan which he has had for several years. However, the plan does not provide drug

benefits. How would you advise Agent John Miller to proceed?

(correct ANS)- Tell prospect Jerry Smith that he should consider adding a standalone

Part D prescription drug coverage policy to his present coverage.

16. 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?

(correct ANS)- Medigap plans help beneficiaries cover coinsurance, co-payments, and/or

deductibles for medically necessary services

17. Mr. Davis 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 ANS)- He may sign-up for Medicare at any time however coverage usually

begins on the fourth month after dialysis treatments start.

18. 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?

(correct ANS)- Most individuals who are citizens and age 65 or over 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.

19. Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare

Advantage plan. What should you tell him?

(correct ANS)- 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.

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