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AHIP Final Exam Question Bank(200 Questions & Answers) (Up-to-date, )
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AHIP Final Exam Question Bank(200 Questions & Answers) (Up-to-date, )
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,a. She may enroll at any time while she is covered under her employer plan, butshe 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. Correct: As long as Mrs. Peňa is covered
under her employer’s plan, she can enroll in Part B at any time. If she retires, she
will be able to enroll in Part B during a special enrollment period that lasts 8
months following the last month of her employer coverage.
b. She may not enroll in Part B while covered under an employer group health
plan and must wait until the standard general enrollment period after she
retires.
c. She may only enroll in Part B during the general enrollment period whether she
is retired or not
Feedback Source: Module 1, Slide - Enrollment in Parts A & B After the Initial
Enrollment Period
Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well,
but it provides no drug coverage. She would like to keep the coverage she has
but replace her existing Medigap plan with one that provides drug coverage.
What should you tell her?
a. Mrs. Gonzalez should purchase a K or L Medigap plan.
b. Mrs. Gonzalez can purchase a Medigap plan that covers drugs, but it likely
won’t offer coverage that is equivalent to that provided under Part D.
c. 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.
Correct: Individuals who are enrolled in Medigap plans may only obtain
Medicare drug coverage (Part D) through a stand-alone prescription drug
plan.
d. Medigap is a replacement for Original Medicare and she has been paying
for double coverage. She should simply drop her Medigap policy.
Feedback Source: Module 1, Slide - Beneficiaries with Medigap Plans with Drug
Coverage
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you
tell Mrs. Park that might be of assistance?
a. She should not sign up for a Medicare Advantage plan.
b. She should only seek help from private organizations to cover her Medicare costs.
c. She can apply to the Medicare agency for lower premiums and cost-sharing.
d. 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.
Correct: Mrs. Park can apply for programs through her State Medicaid office that
could assist with her Medicare costs, such as Medicare Savings Programs, Part D
low-income subsidies, and Medicaid.
Feedback Source: Module 1, Slide - Help for Individuals with Limited
Income/Resources
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?
,a. He generally would pay only a per-prescription co-payment. Medicare covers all
other costs.
b. He generally would pay only a monthly premium. Medicare covers all other costs.
c. He generally would pay only a monthly premium and deductible. Medicare
covers all other costs.
d. He generally would pay a monthly premium, annual deductible, and per-
prescription cost- sharing.
, Correct: Costs for Part D beneficiaries typically include a monthly premium,
annual deductible, and per-prescription cost-sharing.
Feedback Source: Module 1, Slide - Original Medicare and Part D Prescription Drug
Coverage.
Mr. Patel is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the health care costs he
might be exposed to under Medicare if he were to require hospitalization as a
result of an illness. In general terms, what could you tell him about his costs for
inpatient hospital services under Original Medicare?
a. Under Original Medicare, there is a single deductible amount due for the first 60
days of any inpatient hospital stay, after which it converts into a per-day
coinsurance amount through day 90. After day 90, he would pay a daily amount
up to 60 days over his lifetime, after which he would be responsible for all costs.
Correct: Beneficiaries are responsible for a single deductible amount for each
benefit period, followed by a per day coinsurance amount through day 90. For
day 91 and beyond, there is a charge for each “lifetime reserve day” up to 60
days over a beneficiary’s lifetime. After this, he would be responsible for all costs.
b. Under Original Medicare, the inpatient hospital co-payment is a percentage
of allowed charges. The percentage increases after 60 days and again after
90 days.
c. Under Original Medicare, if the inpatient hospital service is provided by a
participating Medicare provider, the co-payment is waived. Co-payments are
only charged when a beneficiary opts to receive care from a non-
participating provider.
d. Under Original Medicare, the inpatient hospital co-payment is a flat per-day
amount that remains the same throughout the first 60 days of a beneficiary’s
stay. After day 60 the amount gradually increases until day 90. After 90 days he
would pay the full amount of all costs. Feedback Source: Module 1, Slide -
Medicare Part A - Original Medicare Cost-Sharing for Inpatient Hospital Care
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?
a. All individuals who are citizens and age 65 or over will be covered under Part A.
b. Most individuals who are citizens and age 65 or over and are covered under Part
A must pay a monthly premium for that coverage.
c. Most individuals who are citizens and age 65 or over and wish to be covered
under Part A must enroll in a Medicare Advantage Plan.
d. 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.
Correct: Most individuals who are citizens and age 65 or older may qualify for
coverage either because they pay a monthly premium or because they paid
Medicare taxes while working for a specific duration.
Feedback Source: Module 1, Slide - Eligibility for Part A & B Benefits and Slide -
Medicare Premiums Part A
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
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