AHIP FINAL EXAM 100+ QUESTIONS AND CORRECT ANSWERS
NEWEST 2024-2025//ALREADY GRADED A+
Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized.
What should you tell Mr. Rainey (or his representative) about the length of an inpatient psychiatric
hospital stay that Medicare will cover? - ANSWER-Medicare will cover a total of 190 days of inpatient
psychiatric care during Mr. Rainey's entire lifetime.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided under
Original Medicare. What should you tell Mr. Xi that best describes the health coverage provided to
Medicare beneficiaries? - ANSWER-Beneficiaries under Original Medicare have no cost-sharing for most
preventive services.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan.
What should you tell him? - ANSWER-Mr. Singh can enroll in a stand-alone prescription drug plan and
continue to be covered for Part A and Part B services through Original Fee-for-Service Medicare.
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? - ANSWER-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.
Mrs. Quinn recently turned 66 and decided after many years of work to retire and begin receiving Social
Security benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she had been
automatically enrolled in Medicare Part B. She wants to understand what this means. What should you
tell Mrs. Quinn? - ANSWER-Part B primarily covers physician services. She will be paying a monthly
premium and, except for many preventive and screening tests, generally will have 20% co-payments for
these services, in addition to an annual deductible.
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 because 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.
,What impact, if any, have recent regulatory changes had on Medigap plans? - ANSWER-The Part B
deductible is no longer covered for individuals newly eligible for Medicare starting January 1, 2020.
Mrs. Paterson is concerned about the deductibles and co-payments associated with Original Medicare.
What can you tell her about Medigap as an option to address this concern? - ANSWER-Medigap plans
do not cover Original Medicare benefits, but they coordinate with Original Medicare coverage.
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and would like to know
which of the following services Original Medicare will cover if the appropriate criteria are met. What
could you tell her? - ANSWER-Original Medicare covers ambulance services.
Ms. Brooks has aggressive cancer and would like to know if Medicare will cover hospice services in case
she needs them. What should you tell her? - ANSWER-Medicare covers hospice services, and they will
be available for her.
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.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original Medicare Part A and Part
B. She would also like to enroll in a Medicare Supplement (Medigap) plan. Anita's older neighbor Mel has
told her about the Medigap Plan F in which he is enrolled. It not only provides foreign travel emergency
benefits but also covers his Medicare Part B deductible. Anita comes to you for advice. What should you
tell her? - ANSWER-You are sorry to disappoint Anita, but a Medigap F plan is no longer available to
those who turn age 65 after January 1, 2020. Anita might instead consider other Medigap plans that
offer foreign travel benefits but do not cover the Part B deductible.
Hank's Fish Store, Inc. is a small company with just 15 employees located in Florida. Hank, the store
owner, has provided excellent health benefits to the store's workforce. William, one of the store's
longtime employees, will soon be reaching age 65 and eligible for Medicare. William is in good health. He
intends to remain an active full-time employee, working several years after becoming eligible for
Medicare. What type(s) of retiree health benefit will Hank's Fish Store be able to offer William? -
, ANSWER-Hank's can continue to offer William the same employee health benefit plan, or, if William
enrolls in Medicare Part B, it can enroll him in a Medicare Advantage plan that is offered to the public.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he has
coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he
have to do? - ANSWER-He will have to enroll in Part B.
Mrs. Velasquez cares for her frail elderly mother, Maria, who lives in North Carolina. She is worried that
without additional support, her mother will need to go into a nursing home. Mrs. Velasquez asks you if
there is any Medicare plan that might allow her mother to remain in the community rather than going
into a nursing home. How should you advise Mrs. Velasquez? - ANSWER-There are Programs of
AllInclusive Care for the Elderly (PACE) for frail elderly beneficiaries certified as needing a nursing home
level of care but are able to live safely in the community at the time of enrolment.
Which of the following statement(s) is/are correct about a Medicare Savings Account (MSA) Plans? I.
MSAs may have either a partial network, full network, or no network of providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal deductible of $500
indexed for inflation.
IV. Non-network providers must accept the same amount that Original Medicare would pay them as
payment in full. - ANSWER-I, II, and IV only
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to enroll in
a MA MSA plan that she heard about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive medications. Currently, she is enrolled in
Original Medicare and a standalone Part D plan. How would you advise Mrs. Chi? - ANSWER-Mrs. Chi
may enroll in a MA MSA plan and remain in her current standalone Part D prescription drug plan.
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own home. She is
attracted by the idea of maintaining control over a Medical Savings Account (MSA) but is not sure if the
plan associated with the account will fit her needs. What specific piece of information about a Medicare
MSA plan would it be important for her to know, prior to enrolling in such a plan? - ANSWER-All MSAs
cover Part A and Part B benefits, but not Part D prescription drug benefits, which could be obtained by
also enrolling in a separate prescription drug plan.
