Download AHIP 2019 STUDY GUIDE
AHIP PRACTICE QUIZ QUESTIONS
AHIP 2019 STUDY GUIDE
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AHIP 2019 STUDY GUIDE
AHIP PRACTICE QUIZ QUESTIONS
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? Choose one answer. a. Medicare is a program for people who have incomes and assets below specific limits, so you will have to find out her exact financial situation before telling her whether she can obtain Medicare coverage. b. 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. c. Medicare is a program for people of all ages with specific mental health disabilities. Since she is in excellent health, she would not qualify, but should instead look into her state’s Medicaid program if she wants further coverage. d. Eligibility for Medicare is based on whether or not a person has ever been employed by the federal government. If she or her husband were ever employed by the federal government, she can enroll in Medicare. Source: Medicare Program Basics
Question 2
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? Choose one answer.
a. Part C, which always covers dental and vision services, is covered under Original Medicare. b. Part D, which covers prescription drug services, is covered under Original Medicare. c. Part A, which covers long term custodial care services, is covered under Original Medicare. d. 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. Source: Different Ways to Get Medicare
Question 3
Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan may, at some time in the future, reduce his benefits below what is available in Original Medicare. What should you tell him about his concern? Choose one answer. a. Medicare health plans have the option of deciding, each year, what services they will cover. He is correct that the health plan could eliminate some benefits covered by Medicare and he should think carefully before enrolling in a Medicare health plan. b. Medicare health plans must cover all benefits available under Medicare Part A and Part B. Many also cover Part D prescription drugs. c. Medicare health plans offer a menu of benefits, from which he may choose, so if he ever wants to increase his coverage, he need only contact the plan and select other options. d. He should not be concerned because Medicare health plans must cover all IRS-approved health care expenses, which means that all of them provide substantially greater benefits than are available under Medicare Part A and Part B. Source: Different Ways to Get Medicare, continued
Question 4
a. Most individuals who are citizens and over age 65 and wish to be covered under Part A must enroll in a Medicare Health Plan. d. Medicare Health Plans do not necessarily have to cover all of the Original Medicare Part A and Part B services, but must include a maximum out-of-pocket limit. Source: Part C Medicare Health Plans
Question 6
Mr. Meoni’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.Meoni? Choose one answer. a. 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. b. Medicare Supplemental Insurance would cover his dental, vision and hearing services only. c. Medicare Supplemental Insurance would cover his long-term care services. d. Medicare Supplemental Insurance would cover all of his IRS approved health care expenditures not covered under Original Fee-for-Service (FFS) Medicare. Source: Medigap (Medicare Supplement Insurance) 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? Choose one answer.
b. All individuals who are citizens and over age 65 will be covered under Part A. c. Most individuals who are citizens and over age 65 and are covered under Part A must pay a monthly premium for that coverage. d. Most individuals who are citizens and over age 65 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.
Question 2
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? Choose one answer. a. He became eligible for Medicare when his disability eligibility determination was first made. b. Individuals who become eligible for such disability payments only have to wait 12 months before they can apply for coverage under Medicare. c. Individuals receiving such disability payments from the Social Security Administration continue to receive those payments, but only become eligible for Medicare upon reaching age 65. d. After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of age.
Question 3
Mr. Denton 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? Choose one answer. a. He may sign-up for Medicare at any time however coverage usually begins on the sixth month after dialysis treatments start.
b. The penalty will be a permanent 10% increase in his Part B premium for every 12 month period that passed during which he could have enrolled and did not. c. Mr. Diaz will not pay any penalty because he had continuous coverage under his employer’s plan. d. During the first year he is covered under Part B, his premiums will be 10% higher than they otherwise would be, after which point they will return to normal.
Question 6
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? Choose one answer. a. She may enroll at any time while she is covered under her employer plan, but she will have a special eight- month enrollment period that differs from the standard general enrollment period, during which she may enroll in Medicare Part B. b. She must wait at least 30 days after her employment terminates before she may enroll in Medicare Part B. c. She may only enroll in Part B during the general enrollment period whether she is retired or not. d. She may not enroll in Part B while covered under an employer group health plan and must wait until the standard general enrollment period after she retires.
Question 7
Mrs. Kelly, age 65, is entitled to Part A, but has not yet enrolled in Part B. She is considering enrollment in a Medicare health plan (Part C). What should you advise her to do before she will be able to enroll into a Medicare health plan? Choose one answer. a. To enroll in a Medicare health plan, she need only be entitled to Part A, so she does not need to take any further steps.
b. In order to join a Medicare health plan, she must be enrolled in Parts A, B and D. c. Since she is age 65 she may enroll in any Medicare health plan, regardless of whether she is entitled to Part A or Part B coverage. d. In order to join a Medicare health plan, she also must enroll in Part B. Mrs. Park is an elderly retiree. She has a low, fixed income. What could you tell Mrs. Park that might be of assistance? Choose one answer.
Question 2
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? Choose one answer. a. Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program. b. Mr. Wu may still qualify for help in paying for Part D costs through the local Office of the Aging. c. Mr. Wu has no alternative but to liquidate his remaining assets and apply for coverage through his state’s Medicaid program. d. Mr. Wu may still qualify for help in paying for Part D costs through the Federal Pharmaceutical Assistance Program. a. She should not sign up for a Medigap or Medicare Advantage plan. b. She should contact her state Medicaid agency to see if she qualifies for one of several programs that can help with Medicare costs for which she is responsible. c. She can apply to the Medicare agency for lower premiums and cost-sharing. d. She should only seek help from private organizations to cover her Medicare costs.
d. Medicare will cover an unlimited number of days in a skilled-nursing facility, as long as a physician certifies that such care is needed.
Question 3
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? Choose one answer. a. Medicare will cover, at its allowable amount, as many stays as are needed throughout Mr. Rainey’s life, as long as no single stay exceeds 190 days. b. Medicare inpatient psychiatric coverage is limited to the same number of days covered for typical inpatient stays. c. Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey’s entire lifetime. d. Inpatient psychiatric services are not covered under Original Medicare.
Question 4
Mrs. Quinn has recently turned 66 and decided after many years of work to begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn and 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? Choose one answer. a. Part B will cover her dental and vision needs. b. She will need to pay no premiums for Part B as she qualifies for premium free coverage due to the number of quarters she has worked. c. She should disenroll if she does not want to pay the monthly premiums. There is no disadvantage to doing so.
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% co-payments for these services, in addition to an ann
Question 5
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? Choose one answer. a. Medicare covers treatments for existing disease, injury and malformed limbs or body parts. As such, it does not cover any screening tests and these must be paid for by the beneficiary out of pocket. b. Medicare covers some screening tests that must be performed within the first year after enrollment. Beyond that point expenses for screening tests are the responsibility of the beneficiary. c. Medicare covers 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. d. Medicare covers all screening tests that have been approved by the FDA on a frequency determined by the treating physician.
Question 6
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? Choose one answer. a. Original Medicare covers routine foot care. b. Original Medicare covers orthopedic shoes. c. Original Medicare covers ambulance services.
Mr. Alonso receives some help paying for his two generic prescription drugs from his employer’s retiree coverage, but he wants to compare it to a Part D prescription drug plan. He asks you what costs he would generally expect to encounter when enrolling into a standard Medicare Part D prescription drug plan. What should you tell him? Choose one answer. a. He generally would pay only a monthly premium. Medicare covers all other costs. b. He generally would pay only a monthly premium and deductible. Medicare covers all other costs. c. He generally would pay a monthly premium, annual deductible, and per-prescription cost sharing. d. He generally would pay only a per-prescription co-payment. Medicare covers all other costs.
Question 3
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? Choose one answer. a. Part D covers long-term care services and she shouldn’t worry because there has been no change in coverage. b. Part D covers physician and non-physician practitioner services and the deductible has not changed this year, but the physician charges may go up. c. Part D covers hospital and home health services and the cost sharing has changed this year. d. Part D covers prescription drugs and she should look at her premiums, formulary, and cost sharing among other factors to see if they have changed. 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?
Choose one answer. a. If Mrs. Paterson applies during the Medigap open enrollment period, she will have to undergo a medical review to determine if she has a pre-existing condition that would increase the premium for a Medigap policy. b. Medigap plans are not sold by private companies and are a government insurance product. c. Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services. d. All costs not covered by Medicare are covered by some Medigap plans.
Question 2
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? Choose one answer. a. 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. b. Mrs. Gonzalez should purchase a K or L Medigap plan. c. Medigap is a replacement for Original Medicare and she has been paying for double coverage. She should simply drop her Medigap policy. d. Mrs. Gonzalez can purchase a Medigap plan that covers drugs, but it likely won’t offer coverage that is equivalent to that provided under Part D.
Question 3
Mr. Kelly has substantial financial means. He enrolled in Original Medicare and purchased a Medigap policy many years ago that offered prescription drug coverage. The prescription drug coverage has not been comparable to that offered by Medicare Part D for several years and despite notification, Mr. Kelly took no action. Which of the following statements best describes what will occur if Mr. Kelly now decides to enroll in Medicare Part D?
b. The Part A deductible is no longer covered under Medigap plans for all enrollees staring January 1, 2020. c. The Part B deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020. d. The Part A deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020.
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? Choose one answer. a. Mr. Diaz will not pay any penalty because he had continuous coverage under his employer’s plan. b. The penalty will be a permanent 10% increase in his Part B premium for every 12 month period that passed during which he could have enrolled and did not. c. Mr. Diaz will pay a penalty, which will be a flat amount each year, paid during the first month of coverage. d. During the first year he is covered under Part B, his premiums will be 10% higher than they otherwise would be, after which point they will return to normal.
Question 2
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? Choose one answer.
a. MSA enrollees may only receive covered health care services from a limited panel of network providers because otherwise some providers may charge more than Original Medicare rates. b. All beneficiaries enrolled in an MSA pay a plan premium in addition to their Part B premium. c. For enrollees in an MSA, after the annual deductible is met, the MSA plan generally pays 75% of covered services. d. 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.
Question 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? Choose one answer. a. Individuals receiving such disability payments from the Social Security Administration continue to receive those payments, but only become eligible for Medicare upon reaching age 65. b. He became eligible for Medicare when his disability eligibility determination was first made. c. Individuals who become eligible for such disability payments only have to wait 12 months before they can apply for coverage under Medicare. d. After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of age.
Question 4
Mrs. Wolf wears glasses and dentures and has enjoyed considerable pain relief from arthritis through acupuncture. She is concerned about whether or not Medicare will cover these items and services. What should you tell her? Choose one answer.
b. Medicare Health Plans do not necessarily have to cover all of the Original Medicare Part A and Part B services, but must include a maximum out-of-pocket limit. c. Medicare Health Plans are not permitted to offer any benefits beyond those available under the Original Medicare program and must have the same maximum out-of-pocket limit on Part A and Part B services as FFS Medicare. d. All Medicare Health Plans offer cost-sharing that is lower than Original Medicare for all Part A and Part B covered services, but the maximum out-of-pocket limit is higher than in Original Medicare.
Question 7
Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan may, at some time in the future, reduce his benefits below what is available in Original Medicare. What should you tell him about his concern? Choose one answer. a. Medicare health plans have the option of deciding, each year, what services they will cover. He is correct that the health plan could eliminate some benefits covered by Medicare and he should think carefully before enrolling in a Medicare health plan. b. Medicare health plans must cover all benefits available under Medicare Part A and Part B. Many also cover Part D prescription drugs. c. He should not be concerned because Medicare health plans must cover all IRS-approved health care expenses, which means that all of them provide substantially greater benefits than are available under Medicare Part A and Part B. d. Medicare health plans offer a menu of benefits, from which he may choose, so if he ever wants to increase his coverage, he need only contact the plan and select other options.
Question 8
Mrs. Quinn has recently turned 66 and decided after many years of work to begin receiving Social Security benefits. Shortly thereafter Mrs. Quinn and 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? Choose one answer.
a. Part B will cover her dental and vision needs. b. She should disenroll if she does not want to pay the monthly premiums. There is no disadvantage to doing so. c. She will need to pay no premiums for Part B as she qualifies for premium free coverage due to the number of quarters she has worked. 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% co-payments for these services, in addition to an annual deductible.
Question 9
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? Choose one answer. a. 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. b. Part D, which covers prescription drug services, is covered under Original Medicare. c. Part A, which covers long term custodial care services, is covered under Original Medicare. d. Part C, which always covers dental and vision services, is covered under Original Medicare.
Question 10
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? Choose one answer. a. Mr. Wu may still qualify for help in paying for Part D costs through the local Office of the Aging.
