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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? 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. Correct Correct: Medicare Supplement Insurance (Medigap) helps to cover Part A and Part B cost- sharing in Original Medicare as well as possibly offering some services such as medical care when a beneficiary travels outside the United States. b. Medicare Supplemental Insurance would cover his dental, vision and hearing services only. Incorrect c. Medicare Supplemental Insurance would cover all of his IRS approved health care expenditures not covered under Original Fee-for-Service (FFS) Medicare. Incorrect d. Medicare Supplemental Insurance would cover his long-term care services. Incorrect Source: Module 1, Slide - Medigap (Medicare Supplement Insurance) Correct Marks for this submission: 1/1. Question Marks: 1
AHIP PRACTICE EXAM Questions and Answers
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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 hospital and home health services and the cost sharing has changed this year. Incorrect b. 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. Correct Correct: Part D provides prescription drug coverage. Premiums, plan formularies, and cost- sharing, among other factors, may change from one plan year to another. c. Part D covers physician and non-physician practitioner services and the deductible has not changed this year, but the physician charges may go up. Incorrect d. Part D covers long-term care services and she shouldn’t worry because there has been no change in coverage. Incorrect Source: Module 1, Slide - Original Medicare and Part D Prescription Drug Coverage Correct Marks for this submission: 1/1. Question Marks: 1 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
AHIP PRACTICE EXAM Questions and Answers
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d. You are sorry to disappoint Anita but Medigap plans are no longer available to those who turn age 65 after January 1, 2020. Anita should instead consider a Medicare Advantage plan. Incorrect Source: Module 1, Slide - Further Information on Medigap (Medicare Supplement Insurance), Slide - Changes in Medigap for Individuals Who Become Eligible for Medicare After December 31, 2019, Slide - Medigap Plans and Medigap Plans, continued Correct Marks for this submission: 1/1. Question Marks: 1 What impact, if any, will recent regulatory changes have upon Medigap plans? Choose one answer. a. The Part B deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020. Correct Correct: Starting January 1, 2020, Medigap plans sold to individuals who are newly eligible to Medicare will not be allowed to cover the Part B deductible. If an individual already had one of the plans before January 1, 2020, they will be able to keep their plan. If an individual was eligible for Medicare before January 1, 2020, but not yet enrolled, his or she may be able to purchase one of these plans. b. The Part A deductible will no longer be covered for individuals newly eligible for Medicare starting January 1, 2020. Incorrect c. The Part A deductible is no longer covered under Medigap plans for all enrollees starting January 1, 2020. Incorrect
AHIP PRACTICE EXAM Questions and Answers
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d. The Part B deductible will be covered for some newly eligible individuals depending on their financial status. Incorrect Source: Module 1, Slide - Changes in Medigap for Individuals Eligible for Medicare after December 31, 2019 Correct Marks for this submission: 1/1. Question Marks: 1 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? Choose one answer. a. Tell prospect Jerry Smith that he should drop his Medigap coverage and put those premium dollars toward the purchase of a standalone Part D prescription drug plan because he can
AHIP PRACTICE EXAM Questions and Answers
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for most preventive services. These services include immunizations such as annual flu shots. b. Benefits covered by Medicare Parts A and B include routine dental care, hearing aids, and routine eye care. Incorrect c. Medicare Part B generally provides prescription drug coverage. Incorrect d. Medicare Part A generally covers medically necessary physician and other health care professional services. Incorrect Source: Module 1, Slide Medicare Part B Benefits, Preventive Services and Screenings, Slide - Not Covered by Medicare Part A & B Correct Marks for this submission: 1/1. Question Marks: 1 Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan. What should you tell him?
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Choose one answer. a. Mr. Singh will have to enroll in Medicaid if he wishes to obtain prescription drug coverage through some means other than a Medicare Advantage plan. Incorrect b. Mr. Singh must leave Original Medicare to receive drug coverage. Incorrect c. 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. Correct Correct: Prescription drug coverage is available to those who enroll in a stand-alone Part D prescription drug plan and continue coverage under Original Medicare Part A and Part B. d. Part D prescription drug coverage can only be obtained by enrollment into a Medicare Advantage plan that also covers Part A and Part B services. Incorrect Source: Module 1, Slide - Original Medicare and Part D Prescription Drug Coverage Correct Marks for this submission: 1/1. Question Marks: 1 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. a. Most individuals who are citizens and age 65 or over and are covered under Part A must pay a monthly premium for that coverage. Incorrect b. 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
AHIP PRACTICE EXAM Questions and Answers
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enrolls how that will impact his employer-sponsored healthcare coverage. How would you respond? Choose one answer. a. 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 but Smallcap must continue to offer him coverage under its employer-sponsored group health plan and would become a secondary payor. Incorrect b. Juan is likely to be ineligible for Medicare since he was born outside the United States and has only contributed to the Medicare system for 20 years. Incorrect c. Juan is likely to be eligible for Medicare once he turns age 65 and if he enrolls his employer- sponsored coverage would continue to be the primary payor while Medicare would be considered a secondary payor of his healthcare claims. Incorrect 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. Correct Correct: Medicare is the primary payor for individuals who have group health coverage as a result of their or their spouse’s employment with a company that is not a large group health plan (GHP) (basically, one with fewer than 20 employees). Furthermore, small GHPs do not have to continue to offer their age 65 and over employees and their spouses the same benefits under the GHP as individuals under age 65. Source: Module 1, Slide - Eligibility for Part A and Part B, Slide - Medicare for Individuals Who Are Still Working – Small GHPs
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Correct Marks for this submission: 1/1. Question Marks: 1 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. After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of age. Correct Correct: Individuals with disabilities who are under age 65 are automatically enrolled in Medicare Parts A and B the month after they have received Social Security or Railroad Retirement disability benefits for 24 months. b. He became eligible for Medicare when his disability eligibility determination was first made. Incorrect
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a physician certifies that such care is needed. Incorrect c. Once she has expended her liquid assets, Medicare will cover 80% of Mrs. Shields long- term care costs. Incorrect d. Mrs. Shields will have to apply for Medicaid to have her skilled nursing services covered because Medicare does not provide such a benefit. Incorrect Source: Module 1, Slide - Medicare Part A – Original Medicare Cost Sharing for Skilled Nursing and Rehabilitative Care Correct Marks for this submission: 1/1. Question Marks: 1 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? Choose one answer. a. Part B will cover her dental and vision needs. Incorrect
AHIP PRACTICE EXAM Questions and Answers
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b. 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. Correct Correct: Medicare Part B primarily covers physician services. Enrollees pay a monthly premium based on their income level and have 20 percent coinsurance cost-sharing with the exception of preventive benefits. 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. Incorrect d. She should disenroll if she does not want to pay the monthly premiums. There is no disadvantage in doing so. Incorrect Source: Module 1, Slide – Medicare Premiums for Part B, Slide Medicare Part B Benefits, Slide
- Medicare Part B – Original Medicare Cost Sharing, Slide - Preventive Services and Screenings Correct Marks for this submission: 1/1. Question Marks: 1 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. 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. Incorrect
AHIP PRACTICE EXAM Questions and Answers
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Choose one answer. a. Mr. Wu may still qualify for help in paying for Part D costs through the local Office of the Aging. Incorrect b. Mr. Wu may still qualify for help in paying for Part D costs through the Federal Pharmaceutical Assistance Program. Incorrect c. Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program. Correct Correct: A State Pharmaceutical Assistance Program may be able to provide assistance with prescription drug costs for those who are of limited means but do not qualify for the Part D low- income subsidy. d. Mr. Wu has no alternative but to liquidate his remaining assets and apply for coverage through his state’s Medicaid program. Incorrect Source: Module 1, Slide Help for Individuals with Limited Income/Resources - Apply to State Medicaid Office Correct Marks for this submission: 1/1. Question Marks: 1 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. Medigap plans are not sold by private companies and are a government insurance product. Incorrect
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b. 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. Incorrect c. Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles for medically necessary services. Correct Correct: Medigap plans help beneficiaries cover coinsurance, co-payments, and/or deductibles when Original Medicare determines that a benefit is medically necessary. d. All costs not covered by Medicare are covered by some Medigap plans. Incorrect Source: Module 1, Slide - Medigap (Medicare Supplement Insurance), Slide – Medigap Coverage Correct Marks for this submission: 1/1. Question Marks: 1 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
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Source: Module 1, Slide - Eligibility for Premium -free Part A, Slide - Medicare Premiums for Part B and the IRMAA Correct Marks for this submission: 1/1. Question Marks: 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? 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. Incorrect b. He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. Correct Correct: Individuals with ESRD may sign up for Medicare at any time. Coverage typically begins on the fourth month after dialysis treatments start, but it could be earlier if certain conditions are met.
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c. He may not sign-up for Medicare until he reaches age 62, the date he first becomes eligible for Social Security benefits. Incorrect d. He may sign-up for Medicare at any time and coverage usually begins immediately. Incorrect Mrs. Davenport enrolled in the ABC Medicare Advantage (MA) plan several years ago. In mid- February of 2021, her doctor confirms a diagnosis of end-stage renal disease (ESRD). What options will Mrs. Davenport have regarding her MA plan during the next open enrollment season? Choose one answer. a. She must remain enrolled in her ABC MA plan unless the plan terminates. Incorrect b. She must immediately drop her ABC MA plan and enroll in a Special Needs Plan (SNP) for individuals suffering from ESRD if one is available in her area. Incorrect Incorrect: Because Mrs. Davenport had enrolled in the ABC MA plan before she developed ESRD, she may remain enrolled in the plan. She also has the option to (1) enroll in another MA plan in her service area, or (2) enroll in a Special Needs Plan (SPN) for persons suffering from ESRN if one is available in her area. c. She must immediately drop her ABC MA plan and enroll in Original Medicare. Incorrect d. She may remain in her ABC MA plan, enroll in another MA plan in her service area, or enroll in a Special Needs Plan (SNP) for individuals suffering from ESRD if one is available in her area. Correct Source: Module 2, Slide – Individuals with ESRD Beginning in 2021, Slide - Medicare Advantage Eligibility: SNPs Incorrect
AHIP PRACTICE EXAM Questions and Answers
