2022 AHIP EXAM QUESTIONS WITH VERIFIED ANSWERS RATED A+
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time,
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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? - 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.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it
provides no drug coverage. She would like to keep the coverage she has but replace her
existing Medigap plan with one that provides drug coverage. What should you tell her? - Mrs.
Gonzalez cannot purchase a Medigap plan that covers drugs, but she could keep her Medigap
policy and enroll in a Part D prescription drug plan.
Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from
arthritis through massage therapy. She is concerned about whether or not Medicare will
cover these items and services. What should you tell her? - Medicare does not cover
massage therapy, or, in general, glasses or dentures.
Mr. Patel is in good health and is preparing a budget in anticipation of his retirement when
he turns 66. He wants to understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization as a result of an illness. In general terms,
what could you tell him about his costs for inpatient hospital services
under Original Medicare? - Under Original Medicare, there is a single deductible amount due
for the first 60 days of any inpatient hospital stay, after which it converts into a per-day
coinsurance amount through day 90. After day 90, he would pay a daily amount up to 60
days over his lifetime, after which he would be responsible for all costs.
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? - To obtain Part B coverage, she must pay a
standard monthly premium, though it is higher for individuals with higher incomes.
Mr. Alonso receives some help paying for his two generic prescription drugs from his
employer's retiree coverage, but he wants to compare it to a Part D prescription drug plan.
He asks you what costs he would generally expect to encounter when enrolling into a
standard MedicarePart D prescription drug plan. What should you tell him? - He generally
would pay a monthly premium, annual deductible, and per-prescription cost-sharing.
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? - 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.
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? - Beneficiaries under Original Medicare have no costsharing for most preventive services which include immunizations such as annual flu shots.
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed her
Medicare Summary Notice (MSN) and disagrees with a determination that partially denied
one of her claims for services. What advice would you give her? - Mrs. Duarte should file an
appeal of this initial determination within 120 days of the date she received the MSN in the
mail.
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a Medigap plan to
pick up costs not covered by that plan.
What should you tell him? - It is illegal for you to sell Mr. Capadona a Medigap plan if he is
enrolled in an MA plan, and besides, Medigap only works with Original Medicare.
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? - He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments start.
Juan Perez, who is turning age 65 next month, intends to work for several more years at
Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers employersponsored healthcare coverage. Juan is a naturalized citizen and has contributed to the
Medicare system for over 20 years. Juan asks you if he will be entitled to Medicare and if he
enrolls how that will impact his employer-sponsored healthcare coverage. How would you
respond? -Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls
Medicare would become the primary payor of his healthcare claims and Smallcap does not
have to continue to offer him coverage comparable to those under age 65 under its
employer-sponsored group health plan. [Show Less]