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2022 AHIP UNIT 1 Medicare Basics
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2022 AHIP UNIT 1 Medicare Basics
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2022 AHIP UNIT 1Medicare Basics
Question 1
Mr. Buck has several family members who died from different cancers. He wants to know if Medicare
covers cancer screening. What should you tell him?
a. Medicare covers all screening tests that have been approved by the FDA on a frequency determined
by the treating physician.
b. Medicare covers treatments for existing disease, injury, and malformed limbs or body parts. As such, it
does not cover any screening tests and these must be paid for by the beneficiary out-of-pocket.
c. Medicare covers some screening tests that must be performed within the first year after enrollment.
Beyond that point expenses for screening tests are the responsibility of the beneficiary.
d. Medicare covers the periodic performance of a range of screening tests that are meant to provide
early detection of disease. Mr. Buck will need to check specific tests before obtaining them to see if they
will be covered.
Source: Module 1, Slide - Medicare Part B Benefits - Preventive Services and Screenings
Question 2
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?
a.Part C, which always covers dental and vision services, is covered under Original Medicare.
b.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.
c.Part A, which covers long-term custodial care services, is covered under Original Medicare.
d.Part D, which covers prescription drug services, is covered under Original Medicare.
Source: Module 1, Slide - Overview of Medicare Benefits and Coverage - Parts A, B, C, and Slide -
Overview of Different Ways to Get Medicare
Question 3
Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap,
Incorporated. Smallcap has a workforce of 15 employees and offers employer-sponsored 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?
a.Juan is likely to be ineligible for Medicare since he was born outside the United States and has only
contributed to the Medicare system for 20 years.
, b. 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 but Smallcap must continue to offer him coverage
under its employer-sponsored group health plan and would become a secondary payor.
c.Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls his employer-sponsored
coverage would continue to be the primary payor while Medicare would be considered a secondary
payor of his healthcare claims.
Incorrect: Medicare is the primary payor for individuals who have group health coverage due to their
continued employment with a small employer. A small group health plan is one offered by a company
with fewer than 20 employees.
d. 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.
Source: Module 1, Slide - Eligibility for Part A and Part B Benefits and Slide - Medicare for Individuals
Who Are Still Working - Small GHPs and Slide - Medicare Coordination with Employer Group Health Plans
Question 4
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?
a.After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age.
b.Individuals who become eligible for such disability payments only have to wait 12 months before they
can apply for coverage under Medicare.
c.Individuals receiving such disability payments from the Social Security Administration continue to
receive those payments but only become eligible for Medicare upon reaching age 65.
d.He became eligible for Medicare when his disability eligibility determination was first made.
Source: Module 1, Slide - Medicare Enrollment Part A & B
Question 5
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?
a.Medicare is a program for people who have incomes and assets below specific limits, so you will have
to find out her exact financial situation before telling her whether she can obtain Medicare coverage.
b.Eligibility for Medicare is based on whether or not a person has ever been employed by the federal
government. If she or her husband were ever employed by the federal government, she can enroll in
Medicare.
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