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AHIP 2025 MODULE 1 QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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AHIP 2025 MODULE 1 QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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AHIP 2025 MODULE 1 QUESTIONS ANDANSWERS WITH SOLUTIONS 2024
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? - ANSWER Beneficiaries under Original Medicare have no cost-sharing for most
preventive services
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security
benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been automatically
enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs.
Quinn? - ANSWER Part B primarily covers physician services. She will be paying a monthly premium and,
except for many preventive screening and tests, generally will have 20 percent co-payments for these
services in addition to an annual deductible
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? - ANSWER He may sign up for Medicare at any time however coverage usually begins on the fourth
month after dialysis treatment
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 Medicare Part D prescription drug
plan. What should you tell him? - ANSWER He generally would pay a monthly premium, annual
deductible, and per-prescription cost sharing.
Ms. Brooks has an aggressive cancer and would like to know if Medicare will cover hospice services in
case she needs them. What should you tell her? - ANSWER Medicare covers hospice services and they
will be available to her.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that might
be of assistance? - ANSWER She should contact her state Medicaid agency to see if she qualifies for one
of several programs that can help with Medicare costs for which she is responsible.
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? - ANSWER Mrs. Duarte should file an appeal of this initial
determination within 120 days of the date she received the MSN in the mail.
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