AHIP Exam Study Guide Solutions
Medicare Advantage - ANSWER--Cover all Part A and Part B benefits;
-Provide plan cost-sharing actuarially equivalent to cost sharing under Medicare Parts A and B, but may
be different for specific services; and
-Include an annual maximum out-of-pocket (MOOP) limi...
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? - 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 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? -
ANSWER✔✔-Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's
plan.
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? -
ANSWER✔✔-She may enroll at any time while she is covered under her employer plan, but she will have
a special eight-month enrollment period that differs from the standard general enrollment period, during
which she may enroll in Medicare Part B.
Mrs. Kelly is entitled to Part A, but is not yet enrolled in Part B. She is considering enrollment in a
Medicare health plan. What should you advise her to do before she will be able to enroll into a Medicare
health plan? - ANSWER✔✔-In order to join a Medicare health plan, she must be enrolled in Parts A, B
and D
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