2024 AHIP Exam – Q’s And A’s
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 kidney and 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? ✔️Ans - 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 Medicare on 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.
Mildred Savage enrolled in Allcare 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 Allcare Medicare Advantage plan. What should you say?
✔️Ans - Mildred may remain enrolled in Allcare and make a hospice election.
Hospice benefits will be paid for by Original Medicare under Part A and
Allcare will continue to pay for any non-hospice services.
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?
✔️Ans - Mr. Diaz will not pay any penalty because he had continuous coverage
under his employer's plan.
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?
✔️Ans - 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 that Medicare does not cover.
,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? ✔️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.
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? ✔️Ans - After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age.
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? ✔️Ans -
Beneficiaries under Original Medicare have no cost-sharing for most
preventive services which include immunizations such as annual flu shots.
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. What can you tell her? ✔️Ans - She
may enroll at any time while she is covered under her employer plan, but she
will have a special eight-month enrollment period after the last month on her
employer plan that differs from the standard general enrollment period,
during which she may enroll in Medicare Part B.
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? ✔️Ans - He
may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
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? ✔️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.
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? ✔️Ans - To
obtain Part B coverage, she must pay a standard monthly premium, though it
is higher for individuals with higher incomes.
To obtain Part B coverage, she must pay a standard monthly premium, though
it is higher for individuals with higher incomes. ✔️Ans - 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.
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? ✔️Ans - Tell prospect Jerry Smith that he
should consider adding a standalone Part D prescription drug coverage policy
to his present coverage.
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? ✔️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.
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? ✔️Ans - It is illegal for you to sell Mr. Capadona a Medigap plan if he
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 kidney and 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? ✔️Ans - 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 Medicare on 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.
Mildred Savage enrolled in Allcare 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 Allcare Medicare Advantage plan. What should you say?
✔️Ans - Mildred may remain enrolled in Allcare and make a hospice election.
Hospice benefits will be paid for by Original Medicare under Part A and
Allcare will continue to pay for any non-hospice services.
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?
✔️Ans - Mr. Diaz will not pay any penalty because he had continuous coverage
under his employer's plan.
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?
✔️Ans - 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 that Medicare does not cover.
,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? ✔️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.
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? ✔️Ans - After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age.
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? ✔️Ans -
Beneficiaries under Original Medicare have no cost-sharing for most
preventive services which include immunizations such as annual flu shots.
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. What can you tell her? ✔️Ans - She
may enroll at any time while she is covered under her employer plan, but she
will have a special eight-month enrollment period after the last month on her
employer plan that differs from the standard general enrollment period,
during which she may enroll in Medicare Part B.
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? ✔️Ans - He
may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
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? ✔️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.
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? ✔️Ans - To
obtain Part B coverage, she must pay a standard monthly premium, though it
is higher for individuals with higher incomes.
To obtain Part B coverage, she must pay a standard monthly premium, though
it is higher for individuals with higher incomes. ✔️Ans - 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.
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? ✔️Ans - Tell prospect Jerry Smith that he
should consider adding a standalone Part D prescription drug coverage policy
to his present coverage.
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? ✔️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.
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? ✔️Ans - It is illegal for you to sell Mr. Capadona a Medigap plan if he
