Exam (elaborations)
AHIP 2024 FINAL EXAM QUESTIONS AND ANSWERS
AHIP 2024 FINAL EXAM QUESTIONS AND ANSWERS
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AHIP 2024 FINAL EXAM QUESTIONS
AND ANSWERS
Mrs.sParksissanselderlysretiree.sMrs.sParkshassaslowsfixedsincome.sWhatscouldsyoustellsMrs.
sParksthatsmightsbesofsassistance?s-
sans✔✔ShesshouldscontactshersstatesMedicaidsagencystosseesifsshesqualifiessforprograms
sthatscanshelpswithsMedicarescostssforswhichsshesissresponsible.
MadelinesMartinezswasswidowedsseveralsyearssago.sHershusbandsworkedsforsmanysyears
sandscontributedsintosthesMedicaressystem.sHesalsosleftsassubstantialsestateswhichsprovid
essMadelineswithsansannualsincomesofsapproximatelys$130,000.sMadeline,swhoshassonlys
workedspart-
timesforstheslaststhreesyears,swillssoonsturnsages65sandshopesstosenrollsinsOriginalsMedicar
e.sShescomesstosyousforsadvice.sWhatsshouldsyoustellsher?s-
sans✔✔YousshouldstellsMadelinesthatssheswillsbesablestosenrollsinsMedicaresPartsAswithout
spayingsmonthlyspremiumssduestoshershusband'sslongsworksrecordsandsparticipationsinsthe
sMedicaressystem.sYousshouldsalsostellsMadelinesthatssheswillspaysPartsBspremiumssatsmo
resthansthesstandardslowestsratesbutslesssthanstheshighestsratesduesherssubstantialsincome
.
Mr.sBauersiss49syearssold,sbutseighteensmonthssagosheswassdeclaredsdisabledsbysthesSoc
ialsSecuritysAdministrationsandshassbeensreceivingsdisabilityspayments.sHesisswonderings
whethershescansobtainscoveragesundersMedicare.sWhatsshouldsyoustellshims-
sans✔✔Aftersreceivingssuchsdisabilityspaymentssfors24smonths,sheswillsbesautomaticallyse
nrolledsinsMedicare,sregardlesssofsage.
Mr.sSchmidtswouldslikestosplansforsretirementsandshassaskedsyouswhatsisscoveredsundersO
riginalsFee-for-Services(FFS)sMedicare?sWhatscouldsyoustellshim?s-
sans✔✔PartsA,swhichscoversshospital,sskilledsnursingsfacility,shospicesandshomeshealthsse
rvicessandsPartsB,swhichscoverssprofessionalsservicesssuchsassthosesprovidedsbysasdoctor
sarescoveredsundersOriginalsMedicare.
Mrs.sPeňasiss66syearssold,shasscoveragesundersansemployersplan,sandswillsretiresnextsyea
r.sShesheardsshesmustsenrollsinsPartsBsatsthesbeginningsofsthesyearstosensuresnosgapsinsco
verage.sWhatscansyoustellsher?s-
sans✔✔Shesmaysenrollsatsanystimeswhilesshesisscoveredsundershersemployersplan,sbutssh
eswillshavesasspecialseightsmonthsenrollmentsperiodsthatsdifferssfromsthesstandardsgenerals
enrollmentsperiod,sduringswhichsshesmaysenrollsinsMedicaresPartsB.
AgentsJohnsMillersissmeetingswithsJerrysSmith,sasnewsprospect.sJerrysisscurrentlysenrolleds
insMedicaresPartssAsandsB.sJerryshassalsospurchasedsasMedicaresSupplements(Medigap)s
planswhichsheshasshadsforsseveralsyears.sHowever,sthesplansdoessnotsprovidesdrugsbenefi
ts.sHowswouldsyousadvisesAgentsJohnsMillerstosproceed?s-
, sans✔✔TellsprospectsJerrysSmithsthatshesshouldsconsidersaddingsasstandalonesPartsDspre
scriptionsdrugscoveragespolicystoshisspresentscoverage.
Mr.sDiazscontinuedsworkingswithshisscompanysandswassinsuredsundershissemployer'ssgrou
psplansuntilshesreachedsages68.sHeshassheardsthatstheresissaspremiumspenaltysforsthosesw
hosdidsnotssignsupsforsPartsBswhensfirstseligiblesandswantsstosknowshowsmuchsheswillshaves
tospay.sWhatsshouldsyoustellshim?s-
sans✔✔Thespenaltyswillsbesaspermanents10%sincreasesinshissPartsBspremiumsforseverys12
-monthsperiodsthatspassedsduringswhichshescouldshavesenrolledsandsdidsnot.
Ms.sMooresplansstosretireswhensshesturnss65sinsasfewsmonths.sShesissinsexcellentshealthsa
ndswillshavesconsiderablesincomeswhensshesretires.sShesissconcernedsthatshersincomeswil
lsmakesitsimpossiblesforsherstosqualifysforsMedicare.sWhatscouldsyoustellsherstosaddresssher
sconcern?s-
sans✔✔Medicaresissasprogramsforspeoplesages65sorsoldersandsthosesundersages65swithsce
rtainsdisabilities,send-
stagesrenalsdisease,sandsLousGehrig'ssdiseasessossheswillsbeseligiblesforsMedicare.
MildredsSavagesenrolledsinsAllcaresMedicaresAdvantagesplansseveralsyearssago.sMildreds
recentlyslearnedsthatsshesisssufferingsfromsinoperablescancersandshassjustsasfewsmonthsst
oslive.sSheswouldslikestosspendsthesesfinalsmonthssinshospicescare.sMildred'ssfamilysaskssy
ouswhethershospicesbenefitsswillsbespaidsforsundersthesAllcaresMedicaresAdvantagesplan.s
Whatsshouldsyoussay?s-
sans✔✔MildredsmaysremainsenrolledsinsAllcaresandsmakesashospiceselection.sHospicesbe
nefitsswillsbespaidsforsbysOriginalsMedicaresundersPartsAsandsAllcareswillscontinuestospaysf
orsanysnon-hospicesservices.
Mr.sGomezsnotessthatsasPrivatesFee-for-
Services(PFFS)splansavailablesinshissareashassansattractivespremium.sHeswantsstosknowsifs
hesmustsusesdoctorssinsasnetworksasshisscurrentsHMOsplansrequiresshimstosdo.sWhatsshou
ldsyoustellshim?s-
sans✔✔HesmaysreceiveshealthscaresservicessfromsanysdoctorsallowedstosbillsMedicare,sass
longsasshesshowssthesdoctorsthesplan'ssidentificationscardsandsthesdoctorsagreesstosaccept
sthesPFFSsplan'sspaymentstermssandsconditions,swhichscouldsincludesbalancesbilling.
Mr.sKellyswantsstosknowswhethershesisseligiblestossignsupsforsasPrivatesfee-for-
services(PFFS)splan.sWhatsquestionsswouldsyousneedstosaskstosdetermineshisseligibility?s-
sans✔✔YouswouldsneedstosasksMr.sKellysifshesissenrolledsinsPartsAsandsPartsBsandsifshesliv
essinsthesPFFSsplan'ssservicesarea.
Mrs.sWangswantsstosknowsgenerallyshowsthesbenefitssundersOriginalsMedicaresmightscom
parestosthesbenefitsspackagesofsasMedicaresAdvantagesPlansbeforesshesstartsslookingsatss
pecificsplans.sWhatscouldsyoustellsher?s-
sans✔✔MedicaresAdvantagesPlanssmaysoffersextrasbenefitssthatsOriginalsMedicaresdoess