AHIP Final Exam Test Questions and Answers Latest (2023 / 2024) (Verified Answers)

AHIP 2023 Final Exam Test Questions and Answers

(Verified Answers)

1. 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 ANS He may signup for Medicare at any time however coverage usually begins on the fourth month

afterdialysis treatments start.

2. 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.

3. 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.

4. Mrs. PeHa is 66 years old, has coverage under an employer plan, and will retirnext 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, but she will have a special eightmonth enrollment period after the last month on her employer plan that differs fromthe standard general enrollment period, during which she may enroll in Medicare

Part B.

5. 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 qualify for coverage under part A because 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.

6. 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

coverage.What should you tell her ANS 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.

7. Mrs. West wears glasses and dentures and has enjoyed considerable pain

relief from arthritis through massage therapy. She is concerned about whetheror not Medicare will cover these items and services. What should you tell

her ANS Medicare does not cover massage therapy, or, in general, glasses or

dentures.

8. 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 hemight be exposed to under Medicare if he were to require hospitalization as aresult of an illness. In general terms, what could you tell him about his costsfor inpatient hospital services

under Original Medicare ANS Under Original Medicare, there is a single

deductible amount due for the first 60 days of any inpatient hospital stay, after

which it convertsinto 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 forall costs.

9. 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 ANS To

obtain Part B coverage, she must pay a standard monthly premium, though it is

higher forindividuals with higher incomes.