2024 AHIP Exam
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?
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?
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?
Mr. Diaz will not pay any penalty because he had continuous coverage under his
employer's plan.
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