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AHIP FINAL EXAM 160 QUESTIONS AND DETAILED ANSWERS 2024 LATEST GRADED A+
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- AHIP
- Institution
- Bloomsburg University Of Pennsylvania
AHIP FINAL EXAM 160 QUESTIONS AND DETAILED ANSWERS 2024 LATEST GRADED A+
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AHIP FINAL EXAM 160 QUESTIONS AND DETAILED ANSWERS 2024LATEST GRADED A+
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last year. He is
currently enrolled in Original Medicare (Parts A and B) and a Part D prescription drug plan and did not
enroll in a Medicare Advantage (MA) plan during the last annual open enrollment period (AEP) which
has just closed. Mr. Wendt has heard that there are certain MA plans that might provide him with more
specialized coverage for his diabetes and wants to know if he must wait until the next annual open
enrollment period (AEP) before enrolling in such a plan. What should you tell him? - answer-d. If there is
a special needs plan (SNP) in Mr. Wendt's area that specializes in caring for individuals with diabetes, he
may enroll in the SNP at any time under a special enrollment period (SEP). Correct
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-d. Tell prospect Jerry Smith that he should consider adding a standalone
Part D prescription drug coverage policy to his present coverage.
Anita Magri will turn age 65 in August 2020. 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 Part F plan 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-a. You are sorry to disappoint Anita but a Medigap Part 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.
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
employersponsored healthcare coverage. How would you respond? - answer-d. 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.
Madeline Martinez was widowed several years ago. Her husband worked for many years and
contributed into the Medicare system. He also left a substantial estate which provides Madeline with an
annual income of approximately $130,000. Madeline, who has only worked part-time for the last three
years, will soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for advice. What
should you tell her? - answer-b. You should tell Madeline that she will be able to enroll in Medicare Part
,A without paying monthly premiums due to her husband's long work record and participation in the
Medicare system. You should also tell Madeline that she will pay Part B premiums at more than the
standard lowest rate but less than the highest rate due her substantial income.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social Security
Administration and has been receiving disability payments. He is wondering whether he can obtain
coverage under Medicare. What should you tell him? - answer-b. After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare, regardless of age.
Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will
soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell
him? - answer-b. He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
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-d. Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's
plan.
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? - answer-b. 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.
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-a. 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.
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-
forService (FFS) Medicare? What could you tell him? - answer-b. 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.
, Mrs. Geisler's neighbor told her she should look at her Part D options during the annual Medicare
enrollment period because features of Part D might have changed. Mrs. Geisler can't remember what
Part D is so she called you to ask what her neighbor was talking about. What could you tell her? -
answer-c. Part D covers prescription drugs and she should look at her premiums, formulary, and
costsharing among other factors to see if they have changed.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan.
What should you tell him? - answer-d. 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. 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-c. Medigap plans
help beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services.
Mrs. Quinn recently turned 66 and decided after many years of work to begin receiving Social Security
benefits. Shortly thereafter Mrs. Quinn received a letter informing her that she has been automatically
enrolled in Medicare Part B. She wants to understand what this means. What should you tell Mrs.
Quinn? - answer-d. Part B primarily covers physician services. She will be paying a monthly premium
and, with the exception of many preventive and screening tests, generally will have 20% coinsurance for
these services, in addition to an annual deductible.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - answer-b. Medicare will cover Mrs. Shield's
skilled nursing services provided during the first 20 days of her stay, after which she would have a copay
until she has been in the facility for 100 days.
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-c. Original Medicare covers ambulance services.
Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for the Part D low-
income subsidy. Where might he turn for help with his prescription drug costs? - answer-b. Mr. Wu may
still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided under
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