AHIP module 1 UPDATED Exam Questions
and CORRECT Answers
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 ANSWER - Medicare is a program for people 65 or older and those under the
age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be
eligible for Medicare.
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 ANSWER - 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. 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? - CORRECT ANSWER - Medicare
Advantage plans must cover all benefits available under Medicare Part A and Part B. Many also
cover Part D prescription drugs.
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? -
CORRECT ANSWER - The card she received is valid, the change has been made to
protect Medicare beneficiaries from identity theft, and she should now destroy her old card.
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? - CORRECT ANSWER - 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.
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 ANSWER - 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.
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 US. What should you tell her? - CORRECT ANSWER -
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.
Bauer is 49 years old, but eighteen months ago he was declared disabled by the SSA and has
been receiving disability payments. He is wondering whether he can obtain coverage under
Medicare. What should you tell him? - CORRECT ANSWER - After receiving such
disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of
age.
Mr. Denton is 52 years old and has recently been diagnosed with end-stage renal disease and will
soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you
tell him? - CORRECT ANSWER - He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments start.
Ms. Henderson believes that she will qualify for Medicare coverage when she turns 65, w/o
paying any premiums, because she has been working for 40 years and paying Medicare taxes.
What should you tell her? - CORRECT ANSWER - In order to obtain Part B coverage, she
must pay a standard monthly premium, though it is higher for individuals with higher incomes.
Mr. Diaz continued working with his company and was insured under his employer's group plan
until he reached 68 years old. 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. -
CORRECT ANSWER - Mr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
Mrs. Pena 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. -
CORRECT ANSWER - She may not enroll at any time while she is covered under her
and CORRECT Answers
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 ANSWER - Medicare is a program for people 65 or older and those under the
age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be
eligible for Medicare.
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 ANSWER - 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. 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? - CORRECT ANSWER - Medicare
Advantage plans must cover all benefits available under Medicare Part A and Part B. Many also
cover Part D prescription drugs.
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? -
CORRECT ANSWER - The card she received is valid, the change has been made to
protect Medicare beneficiaries from identity theft, and she should now destroy her old card.
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? - CORRECT ANSWER - 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.
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 ANSWER - 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.
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 US. What should you tell her? - CORRECT ANSWER -
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.
Bauer is 49 years old, but eighteen months ago he was declared disabled by the SSA and has
been receiving disability payments. He is wondering whether he can obtain coverage under
Medicare. What should you tell him? - CORRECT ANSWER - After receiving such
disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of
age.
Mr. Denton is 52 years old and has recently been diagnosed with end-stage renal disease and will
soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you
tell him? - CORRECT ANSWER - He may sign-up for Medicare at any time however
coverage usually begins on the fourth month after dialysis treatments start.
Ms. Henderson believes that she will qualify for Medicare coverage when she turns 65, w/o
paying any premiums, because she has been working for 40 years and paying Medicare taxes.
What should you tell her? - CORRECT ANSWER - In order to obtain Part B coverage, she
must pay a standard monthly premium, though it is higher for individuals with higher incomes.
Mr. Diaz continued working with his company and was insured under his employer's group plan
until he reached 68 years old. 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. -
CORRECT ANSWER - Mr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
Mrs. Pena 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. -
CORRECT ANSWER - She may not enroll at any time while she is covered under her
