AHIP CERTIFICATION - PART #1 EXAM
GUIDE QUESTIONS AND ANSWERS
d - Answer-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. 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.
b. Medicare is a program for people of all ages with specific mental health disabilities.
Since she is in excellent health, she would not qualify, but should instead look into her
state's Medicaid program if she wants further coverage.
c. 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.
d. 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.
b - Answer-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 D, which covers prescription drug 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 C, which always covers dental and vision services, is covered under Original
Medicare.
d. Part A, which covers long term custodial care services, is covered under Original
Medicare.
c - Answer-Mr. Hernandez is concerned that if he signs up for a Medicare Advantage
plan, the health plan may, at some time in the future, reduce his benefits below what is
available in Original Medicare. What should you tell him about his concern?
a. He should not be concerned because Medicare health plans must cover all IRS-
approved health care expenses, which means that all of them provide substantially
greater benefits than are available under Medicare Part A and Part B.
b. Medicare health plans offer a menu of benefits, from which he may choose, so if he
ever wants to increase his coverage, he need only contact the plan and select other
options.
, c. Medicare health plans must cover all benefits available under Medicare Part A and
Part B. Many also cover Part D prescription drugs.
d. Medicare health plans have the option of deciding, each year, what services they will
cover. He is correct that the health plan could eliminate some benefits covered by
Medicare and he should think carefully before enrolling in a Medicare health plan.
b - Answer-Mrs. Roberts has just received a new Medicare identity card in the mail. She
is concerned that it is a forgery since it does not have her Social Security number on it.
What should you tell her?
a. The card is indeed a forgery since newly issued Medicare cards will have both a
beneficiary's Social Security number and date of birth imprinted on them.
b. The card she received I valid, the change has been made to protect Medicare
beneficiaries from identity theft, and she should now destroy her old card.
c. The card is indeed a forgery since all identity cards are being phased-out in favor of
a new electronic identity system developed by the Social Security Administration.
d. The card she received is valid but she should keep her old card for at least two years
and present it whenever she receives health care.
a - Answer-Mrs. Willard wants to know generally how the benefits under Original
Medicare might compare to the benefit package of a Medicare Health Plan before she
starts looking at specific plans. What could you tell her?
a. Medicare Health Plans may offer extra benefits that Original Medicare does not offer
such as vision, hearing, and dental services and must include a maximum out-of-pocket
limit on Part A and Part B services.
b. Medicare Health Plans do not necessarily have to cover all of the Original Medicare
Part A and Part B services, but must include a maximum out-of-pocket limit.
c. Medicare Health Plans are not permitted to offer any benefits beyond those available
under the Original Medicare program and must have the same maximum out-of-pocket
limit on Part A and Part B services as FFS Medicare.
d. All Medicare Health Plans offer cost-sharing that is lower than Original Medicare for
all Part A and Part B covered services, but the maximum out-of-pocket limit is higher
than in Original Medicare.
d - Answer-Mr. Meoni'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.Meoni?
a. Medicare Supplemental Insurance would cover all of his IRS approved health care
expenditures not covered under Original Fee-for-Service (FFS) Medicare.
b. Medicare Supplemental Insurance would cover his dental, vision and hearing
services only.
c. Medicare Supplemental Insurance would cover his long-term care services.
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