AHIP Test Exam with 255questions and
answers 100%Correctly verified answers
latest update 2024/2025 RATED A+
Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan
and was disappointed with the service she received from her primary care physician
because she was told she would have to wait five weeks to get an appointment
when she was feeling ill. She called you to ask what she could do so she would not
have to put up with such poor access to care. What could you tell her? - CORRECT
ANSWERS She could file a grievance with her plan to complain about the lack
of timeliness in getting an appointment.
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? - CORRECT ANSWERS 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? - CORRECT ANSWERS
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? - CORRECT ANSWERS
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? - CORRECT ANSWERS
Medicare Supplemental Insurance would help cover his Part A and Part B
,AHIP Test Exam with 255questions and
answers 100%Correctly verified answers
latest update 2024/2025 RATED A+
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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS
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? - CORRECT ANSWERS 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? - CORRECT ANSWERS
He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
,AHIP Test Exam with 255questions and
answers 100%Correctly verified answers
latest update 2024/2025 RATED A+
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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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. - CORRECT ANSWERS 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? -
CORRECT ANSWERS 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? - CORRECT ANSWERS 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.
, AHIP Test Exam with 255questions and
answers 100%Correctly verified answers
latest update 2024/2025 RATED A+
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? -
CORRECT ANSWERS It is illegal for you to sell Mr. Capadona a Medigap plan
if he is enrolled in an MA plan, and besides, Medigap only works with Original
Medicare.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell
Mrs. Park that might be of assistance? - CORRECT ANSWERS 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.
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? - CORRECT
ANSWERS 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.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to
qualify for the Part D low-income subsidy. Where might he turn for help with his
prescription drug costs? - CORRECT ANSWERS Mr. Wu may still qualify for
help in paying Part D costs through his State Pharmaceutical Assistance Program.
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 in Medicaid, 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? - CORRECT ANSWERS 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 coverage back to the date of termination from Medicaid or coverage
beginning the month after the month of enrollment.
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
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ACADEMICNURSING001. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $19.99. You're not tied to anything after your purchase.