AHIP 2024 Final Exam's (5 Sets of Exams) with Updated Latest Questions and Answers (Verified by Expert)

AHIP 2024 Final Exam’s (5 Sets of Exams) with Updated Latest Questions and Answers (Verified by Expert)

AHIP 2024 Final Exam Questions and Answers Updated (Verified Answers)

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AHIP 2024 Final Exam
Questions and Answers (Verified Answers)
1.Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance
ANS She should contact her state Medicaid agency to see if she
qualifies for programs that can help with Medicare costs for which she isresponsible.

Madeline Martinez was widowed several years ago. Her husband workedfor many years and contributed into the Medicare system. He also left asubstan- tial estate which provides Madeline with an annual income ofapproximately
$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 toyou for advice. What should you tell her
ANS 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 workrecord and participation in the Medicare system. You should also tell
Madeline that she will pay Part B premiums at more than the standard

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lowest rate but less than the highest rate due her substantial income.
3.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:
ANS After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
4.Mr. Schmidt would like to plan for retirement and has asked you what is
covered under Original Fee-for-Service (FFS) Medicare? What could you tell
him
ANS 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.
5.Mrs. PeHa 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
ANS She may enroll at any time while she is covered under her employeplan, but she will have a special eight month enrollment period that
differs from the standard general enrollment period, during which she

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may enroll in Medicare Part B.
6.Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry iscur- rently enrolled in Medicare Parts A and B. Jerry has also purchased aMedicare Supplement (Medigap) plan which he has had for several years.However, the plan does not provide drug benefits. How would you adviseAgent John Miller to proceed
ANS Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present
coverage.

Mr. Diaz continued working with his company and was insured under hisemployer’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
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AHIP 2024 Final Exam Test Updated Questions and Answers (Verified Answers)

Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare coverage due to end-stage renal disease (ESRD).
A close relative donated their kidney and Edward successfully underwent
transplant surgery 12 months ago. Edward is now age 50 and asks you if hisMedicare coverage will continue, what should you say
ANS Individuals eligible forMedicare based on ESRD generally lose eligibility 36
months after the month in which the individual receives a kidney transplant unless they are
eligible for Medicareon another basis such as age or disability. Edward may, however,
remain enrolled inPart B but solely for coverage of immunosuppressive drugs if he has no
other healthcare coverage that would coverthe drugs.
Mildred Savage enrolled in Allcare Medicare Advantage plan several yearsago. Mildred recently learned that she is suffering from inoperable cancer andhas just a few months to live. She would like to spend these final months in
hospice care. Mildred’s family asks you whether hospice benefits will be paidfor under the Allcare Medicare Advantage plan.What should you say
ANS Mildredmay remain enrolled in Allcare and make a hospice election. Hospice
benefits will be paid for by Original Medicare under Part A and Allcare will continue
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2024 AHIP Final Exam Updated Test Questions and Answers
(Verified Answers)

to pay for any non-hospice services.

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 penaltyfor those who did not sign up for Part B when first eligible andwants to know how much he will have to pay. What should you tell him
ANS Mr. Diaz will not pay any penalty because he had continuous coverageunder 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
ANS Medicare Supplemental Insurance would help cover his Part A and Part B
deductibles or coinsurance 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 concernedthat she will not qualifyfor coverage under part Abecause she was not born inthe United States. What should you tell her
ANS Most individuals who are citizens and age 65 or over are covered under ParA by
virtue of having paid Medicare taxes while working, though some may be covered as a
result of paying monthly premiums.
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Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social Security Administration and has been receiving disability3 / 25

2024 AHIP Final Exam Updated Questions and Answers (Verified Answers)

AHIP 2024 Final Exam Test Questions and Answers
(Verified Answers)

Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolledin 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
ANS He will have toenroll in Part B.
Mr. Lopez has heard that he can sign up for a product called “Medicare
Advantage” but is not sure about what type of plan designs are available
through this program. What should you tell him about the types of health
plans that are available through the Medicare Advantage program
ANS Theyare Medicare health plans such as HMOs, PPOs, PFFS, and MSAs.
Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree group health plan that includes drug coverage with
nominal copays. He heard about a neighbor’s MA-PD plan that you representand because he takes numerous prescription drugs, he is considering signing
up for it. What should you tell him
ANS When possible, it is always the best option tohave both the employer’s plan
and the MA-PD, so he would have no out- of-pocketexpenses.
Dr.Elizabeth Brennan does not contract with the ABC PFFS plan but acceptsthe plan’s terms and conditions for payment. Mary Rodgers sees Dr. Brennanfor treatment. How much may Dr. Brennan charge
ANS Dr. Brennan can charge Mary Rogers no more than the cost sharing
specified in the PFFS plan’s terms andcondition of payment which may include
balance billing up to 15%of the Medicare rate
Mrs. Willard wants to know generally how the benefits under Original
Medicare might compare to the benefits package of a Medicare Advantage
Plan before she starts looking at specific plans. What could you tell her
ANS

Medicare Advantage Plans may offer extra benefits that Original Medicare does
notoffer such as vision, hearing, and dental services and must include a maximum
out-of-pocket limit on Part A and Part B services.

Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. Sheis considering enrollment in a Medicare Advantage plan (Part C).What shouldyou advise her to do before she will be able to enroll in a Medicare Advantageplan
ANS To join a Medicare Advantage plan, she also must enroll in Part B.
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AHIP 2024 Final Exam Test Questions and Answers (Verified Answers)

AHIP 2024 Final Exam Questions and Answers
(Verified Answers)

Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area
that does not include drug coverage.She wants to enroll in the plan and enrollin a stand-alone prescription drug plan. What should you tell her
ANS She couldenroll in a PFFS plan and a stand-alone Medicare prescription
drug plan.
Mrs. Roswell is a new Medicare beneficiary who has just retired from retailwork. She is interested in selecting a Medicare Part D prescription drug plan.She takes a number of medications and is concerned that she has not been
able to identify a plan that covers all of her medications. She does not want
to make an abrupt change to new drugs that would be covered and asks whatshe should do. What should you tell her
ANS Every Part D drug plan is required tocover a single one-month fill of her
existing medications sometime during a 90-daytransition period.
Mr. Robinson was quite ill recently and forgot to pay his monthly premium
for his MA-PD plan. He is worried that he will lose his coverage now when
he needs it the most. He is certain his plan will disenroll him because that is
what happened to a friend of his in a similar type of plan. What can you tell
Mr. Robinson about his situation
ANS Plan sponsors have the option to do nothingwhen a plan member does not
pay their premiums or disenroll the member after agrace period and notice.
Mrs. Allen has a rare condition for which two different brand name drugs
are the only available treatment. She is concerned that since no generic
prescription drug is available and these drugs are very high cost, she will notbe able to find a Medicare Part D prescription drug plan that covers either
one of them. What should you tell her
ANS Medicare prescription drug plans are required to cover drugs in each
therapeutic category. She should be able to enroll in a Medicare prescription drug
plan that covers the medications she needs.
One of your clients, Lauren Nichols, has heard about a Medicare concept
from one of her neighbors called TrOOP. She asks you to explain it. What
do you say
ANS TrOOP stands for true out-of-pocket expenses that count toward the
Medicare Part D catastrophic limit and include not only expenses paid by a
beneficiary but also in some instances drug manufacturer discounts.
Mrs. Fiore is a retired federal worker with coverage under a Federal Employee Health Benefits (FEHB) plan that includes creditable drug coverage. She is Powered by https://learnexams.com/search/study?query=

2024 AHIP Final Exam Test Updated Questions and Answers (Verified Answers)

AHIP 2024 Final Exam Test Questions and Answers
(Verified Answers)

Juan Perez, who is turning age 65 next month, intends to work for several
more years at Smallcap, Incorporated. Smallcap has a workforce of15 employees and offers employer-sponsored healthcare coverage. Juan is a naturalizedcitizen 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 impacthis employer-sponsored healthcare coverage. How would you respond
ANS Juanis likely to be eligible for Medicare once he turns age 65 and if he
enrolls Medicarewould become the primary payor of his healthcare claims and
Smallcap does not have to continue to offer him coverage comparable to those
under age 65under itsemployer-sponsored group health plan.
Mr. Moy’s wife has a Medicare Advantage plan, but he wants to under-

stand what coverage Medicare Supplemental Insurance provides since his
health care needs are different from his wife’s needs. What could you tell Mr.
Moy
ANS Medicare Supplemental Insurance would help cover his Part A and PartB
deductibles or coinsurance in Original Fee-for-Service (FFS) Medicare as well as
possibly some services that Medicare does not cover.

Mrs. PeHa is 66 years old, has coverage under an employer plan, and willretirnext year. She heard she must enroll in Part B at the beginning of the year toensure no gap in coverage. What can you tell her
ANS 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.
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 concernedthat she will not qualifyfor coverage under part Abecause she was not born inthe United States. What should you tell her
ANS 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. Gonzalez is enrolled in Original Medicare and has a Medigap policy aswell, 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
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