AHIP STUDY GUIDE 2018 – FOR STUDY PURPOSES ONLY
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1
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
imposs...
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?
Choose one answer.
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. Medicare is a program for people age 65 or older and those
under age 65 with certain disabilities, end stage renal disease or
Lou Gehrig’s disease, so she will be eligible for Medicare.
c. 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.
d. 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.
Source: Medicare Program Basics
Question2
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?
Choose one answer.
a. Part D, which covers prescription drug services, is covered under
Original Medicare.
b. Part A, which covers long term custodial care services, is covered
under Original Medicare.
c. Part C, which always covers dental and vision services, is
covered under Original Medicare.
, d. 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.
Source: Different Ways to Get Medicare
Question3
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?
Choose one answer.
a. 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. 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.
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 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.
Source: Different Ways to Get Medicare, continued
Question4
Mrs. Raskin is a widow who will attain aged 65 and enroll in Medicare in just a few weeks. She
concerned about having prescription drug coverage. Which of the following statements provides
the best advice?
Choose one answer.
a. Prescription drug coverage can be obtained by purchasing a Medicare
Supplement (Medigap) Plan F policy.
b. Comprehensive prescription drug coverage is now included under Part
B of Medicare.
, c. Prescription drug coverage can be obtained by enrolling in a Medicare
Advantage plan that includes Part D coverage.
d. Comprehensive prescription drug coverage is offered by all Medicare
Advantage Plans (Part C).
Source: Overview of Different Ways to Get Medicare
Question5
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?
Choose one answer.
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 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.
c. 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. 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.
Source: Part C Medicare Health Plans
Question6
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?
Choose one answer.
a. Medicare Supplemental Insurance would cover his long-term care
services.
b. Medicare Supplemental Insurance would cover his dental, vision
and hearing services only.
, c. Medicare Supplemental Insurance would cover all of his IRS
approved health care expenditures not covered under Original Fee-
for-Service (FFS) Medicare.
d. Medicare Supplemental Insurance would help cover his Part A and
Part B cost sharing in Original Fee-for-Service (FFS) Medicare as
well as possibly some services that Medicare does not cover.
Source: Medigap (Medicare Supplement Insurance)
1
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?
Choose one answer.
a. All individuals who are citizens and over age 65 will be covered
under Part A.
b. Most individuals who are citizens and over age 65 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.
c. Most individuals who are citizens and over age 65 and are
covered under Part A must pay a monthly premium for that
coverage.
d. Most individuals who are citizens and over age 65 and wish to be
covered under Part A must enroll in a Medicare Health Plan.
Source: Medicare Entitlement – Part A; Medicare Program Basics (provides reference to
citizenship).
b. nAfter nreceiving nsuch ndisability npayments nfor n24 nmonths,
nhe nwill nbenautomatically nenrolled nin nMedicare, nregardless nof
nage. n
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