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Exam (elaborations)

AHIP ALL MODULES EXAM PRACTICE QUESTIONS AND ANSWERS

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  • 2025 AHIP
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  • 2025 AHIP

AHIP ALL MODULES EXAM PRACTICE QUESTIONS AND ANSWERS 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-To obtain Part B covera...

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  • October 31, 2024
  • 26
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • 2025 AHIP
  • 2025 AHIP
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Emillect
©EMILLECT2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




AHIP ALL MODULES EXAM PRACTICE

QUESTIONS AND ANSWERS


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✔✔-To obtain Part B coverage, she must pay a standard monthly premium, though it

is higher for individuals with higher incomes.


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? - ANSWER✔✔-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.


Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap,

Incorporated. Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare

coverage. Juan is a naturalized citizen and has contributed to the Medicare system for over 20 years.

Juan asks you if he will be entitled to Medicare and if he enrolls how that will impact his employer-


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, ©EMILLECT2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




sponsored healthcare coverage. How would you respond? - ANSWER✔✔-Juan is likely to be eligible for

Medicare once he turns age 65 and if he enrolls Medicare would become the primary payor of his

healthcare claims and Smallcap does not have to continue to offer him coverage comparable to those

under age 65 under its employer-sponsored group health plan.


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 Supplement (Medigap) plan which he has had for

several years. However, the plan does not provide drug benefits. How would you advise Agent John

Miller to proceed? - ANSWER✔✔-Tell prospect Jerry Smith that he should consider adding a standalone

Part D prescription drug coverage policy to his present coverage.


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 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.


Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a Medigap plan to pick up

costs not covered by that plan. What should you tell him? - ANSWER✔✔-It is illegal for you to sell Mr.

Capadona a Medigap plan if he is enrolled in an MA plan, and besides, Medigap only works with Original

Medicare.




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, ©EMILLECT2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




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? - ANSWER✔✔-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.


Mr. Buck has several family members who died from different cancers. He wants to know if Medicare

covers cancer screening. What should you tell him? - ANSWER✔✔-Medicare covers the periodic

performance of a range of screening tests that are meant to provide early detection of disease. Mr. Buck

will need to check specific tests before obtaining them to see if they will be covered.


Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has recently reviewed her Medicare

Summary Notice (MSN) and disagrees with a determination that partially denied one of her claims for

services. What advice would you give her? - ANSWER✔✔-Mrs. Duarte should file an appeal of this initial

determination within 120 days of the date she received the MSN in the mail.


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? - ANSWER✔✔-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.




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