2024 AHIP EXAM WITH 100% VERIFIED QUESTIONS AND ANSWERS
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease
... [Show More] (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 monthafter
dialysis treatments start.
special eight-month enrollment period after the last month on her employer plan that differs
Mr. Diaz continued working with his company and was insured under his employer's group planuntil 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?
Mr. Diaz will not pay any penalty because he had continuous coverage under his employer'splan.
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 workedpart-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?
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 Medicaresystem. 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.
Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare
coverage due to end-stage renal disease (ESRD). A close relative donated their kidneyand Edward
successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his
Medicare coverage will continue, what should you say?
Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in
which the individual receives a kidney transplant unless they are eligible for Medicareon another basis
such as age or disability. Edward may, however, remain enrolled in Part B but solely for coverage of
immunosuppressive drugs if he has no other health care coverage that would cover the drugs.
Mrs. Peňa is 66 years old, has coverage under an employer plan, and will retire next year. She heard she
must enroll in Part B at the beginning of the year to ensure no gap in coverage. Whatcan you tell her?
She may enroll at any time while she is covered under her employer plan, but she will have a
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a Medigap plan topick 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, andbesides, Medigap
only works with Original Medicare.
Ms. Henderson believes that she will qualify for Medicare Coverage when she turns 65, withoutpaying any
premiums, because she has been working for 40 years and paying Medicare taxes. What should you tell
her?
from the standard general enrollment period, during which she may enroll in Medicare Part B.
To obtain Part B coverage, she must pay a standard monthly premium, though it is higher forindividuals
with higher incomes.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for thePart D lowincome subsidy. Where might he turn for help with his prescription drug costs?
Mr. Wu may still qualify for help in paying Part D costs through his State PharmaceuticalAssistance
Program.
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 whetherhe can obtain
coverage under Medicare. What should you tell him?
After receiving such disability payments for 24 months, he will be automatically enrolled inMedicare,
regardless of age.
Mildred Savage enrolled in All care Medicare Advantage plan several years ago. Mildred recently learned
that she is suffering from inoperable cancer and has just a few months to live.She would like to spend
these final months in hospice care. Mildred's family asks you whether hospice benefits will be paid for
under the All care Medicare Advantage plan. What should yousay?
Mildred may remain enrolled in all care and make a hospice election. Hospice benefits will be paid for by
Original Medicare under Part A and all care will continue to pay for any non-hospiceservices.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under OriginalFee-forService (FFS) Medicare. What could you tell him?
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 underOriginal
Medicare.
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 whichhe has had for
several years. However, the plan does not provide drug benefits. How would youadvise Agent John Miller
to proceed?
Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription drugcoverage
policy to his present coverage.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Parkthat might
be of assistance?
She should contact her state Medicaid agency to see if she qualifies for one of several programsthat can
help with Medicare costs for which she is responsible.
Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE). This coverage has
recently been terminated due to the end of the PHE. While Shirley was enrolled inMedicaid, she missed an
opportunity to enroll in Medicare and now wants Part B. Which of the following statements best describes
Shirley's ability to now enroll in Medicare Part B?
Shirley is eligible for a Special Enrollment Period (SEP) for up to six months after the termination of her
Medicaid coverage. Under this SEP, Shirley can choose retroactive coverageback to the date of
termination from Medicaid or coverage beginning the month after the month of enrollment.
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and willhave
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.
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it providesno 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 herMedigap policy
and enroll in a Part D prescription drug plan.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, andpaid 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 payingmonthly premiums.
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 coverageprovided to
Medicare beneficiaries?
Beneficiaries under Original Medicare have no cost-sharing for most preventive services whichinclude
immunizations such as annual flu shots.
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 hiswife's needs. What
could you tell Mr. Moy?
Medicare Supplemental Insurance would help cover his Part A and Part B deductibles or coinsurance in
Original Fee-for-Service (FFS) Medicare as well as possibly some services thatMedicare does not cover.
Anthony Boniface turned 65 in 2023. He was not receiving Social Security or Railroad Retirement
Benefits on his 65th birthday. He was interested in obtaining Medicare coverage and is eligible for
premium-free Part A. Before he could enroll in Medicare, his entire area was impacted by a hurricane
causing massive flooding and severe wind damage. The Federal government declared this to be a natural
disaster which has recently ended. During this period Anthony's initial enrollment period expired. Anthony
asks you how he can now obtain Medicarecoverage. What should you say?
Anthony is eligible for a special enrollment period (SEP) because he missed an enrollment period due to
the impact of the Federally declared disaster. This SEP will allow Anthony to enroll in Part B up to six
months after the end of the emergency declaration. Anthony may enroll in premium-free Part A at any
time and his Part A coverage will be retroactive [Show Less]