2025/2026 AHIP | 169 QUESTIONS | WITH CORRECT SOLUTIONS GRADED A+
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 his Medicare coverage will
continue, what should you say? Answer- Individuals eligible for Medicare based on
ESRD generally lose eligibility 36 months after the month in which the individual
receives a kidney transplant unless they are eligible for Medicare on another basis
such as age or disability. Edward may, however, remain enrolled in Part B but solely
for coverage of immunosuppressive drugs if he has no other health care coverage
that would cover the drugs.
Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago.
Mildred recently learned that she is suffering from inoperable cancer and has 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 paid for under the Allcare
Medicare Advantage plan. What should you say? Answer- Mildred may 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 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 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- 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- 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 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- 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.