AHIP - 2026 - Modules 1-5 Exam
Questions and Answers (Latest 2026)
Mr. Capadona would like to purchase a Medicare Advantage
(MA) plan and a Medigap plan to pick up costs not covered by
that plan. What should you tell him? - Correct Answers ✅It
is illegal for you to sell Mr. Capadona a Medigap plan if he is
enrolled in an MA plan, and besides, Medigap only works with
Original Medicare.
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? - Correct Answers ✅Tell prospect Jerry
Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage.
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? - Correct Answers ✅Mr. Wu may still qualify for
help in paying Part D costs through his State Pharmaceutical
Assistance Program (SPAP).
Mr. Vasquez 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 he might be exposed to
under Medicare if he were to require hospitalization because
of an illness. In general terms, what could you tell him about
his costs for inpatient hospital services under Original
,AHIP - 2026 - Modules 1-5 Exam
Questions and Answers (Latest 2026)
Medicare? - Correct Answers ✅Under Original Medicare,
there is a single deductible amount due for the first 60 days
of any inpatient hospital stay, after which it converts into 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 for all costs.
Mr. Moy will soon turn age 65. He is slightly younger than his
wife. 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? - Correct
Answers ✅Medicare Supplemental Insurance would help
cover his Part A deductible and Part B coinsurance or
copayments in Original Fee-for-Service (FFS) Medicare as well
as possibly some services that Medicare does not cover.
Juan Perez, who is turning age 65 next month, intends to
work for several more years at Smallcap, Incorporated.
Smallcap has a workforce of 15 employees and offers
employer-sponsored healthcare coverage. Juan is a
naturalized citizen 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 impact his
employer- sponsored healthcare coverage. How would you
respond? - Correct Answers ✅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-
,AHIP - 2026 - Modules 1-5 Exam
Questions and Answers (Latest 2026)
sponsored group health plan. 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.
Ms. Kumar 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? - Correct Answers
✅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.
Mrs. Ellis recently turned 66 and decided after many years of
work to retire and begin receiving Social Security benefits.
Shortly thereafter Mrs. Ellis received a letter informing her
that she had been automatically enrolled in Medicare Part B.
She wants to understand what this means. What should you
tell Mrs. Ellis? - Correct Answers ✅Part B primarily covers
physician services. She will be paying a monthly premium
and, except for many preventive and screening tests,
generally will have 20% co-payments for these services, in
addition to an annual deductible.
, AHIP - 2026 - Modules 1-5 Exam
Questions and Answers (Latest 2026)
Mr. Singh would like drug coverage but does not want to be
enrolled in a Medicare Advantage plan. What should you tell
him? - Correct Answers ✅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.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed
income. What could you tell Mrs. Cook that might be of
assistance? - Correct Answers ✅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.
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? - Correct
Answers ✅To obtain Part B coverage, she must pay a
standard monthly premium, though it is higher for individuals
with higher incomes.
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? - Correct Answers ✅After receiving
such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
Questions and Answers (Latest 2026)
Mr. Capadona would like to purchase a Medicare Advantage
(MA) plan and a Medigap plan to pick up costs not covered by
that plan. What should you tell him? - Correct Answers ✅It
is illegal for you to sell Mr. Capadona a Medigap plan if he is
enrolled in an MA plan, and besides, Medigap only works with
Original Medicare.
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? - Correct Answers ✅Tell prospect Jerry
Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage.
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? - Correct Answers ✅Mr. Wu may still qualify for
help in paying Part D costs through his State Pharmaceutical
Assistance Program (SPAP).
Mr. Vasquez 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 he might be exposed to
under Medicare if he were to require hospitalization because
of an illness. In general terms, what could you tell him about
his costs for inpatient hospital services under Original
,AHIP - 2026 - Modules 1-5 Exam
Questions and Answers (Latest 2026)
Medicare? - Correct Answers ✅Under Original Medicare,
there is a single deductible amount due for the first 60 days
of any inpatient hospital stay, after which it converts into 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 for all costs.
Mr. Moy will soon turn age 65. He is slightly younger than his
wife. 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? - Correct
Answers ✅Medicare Supplemental Insurance would help
cover his Part A deductible and Part B coinsurance or
copayments in Original Fee-for-Service (FFS) Medicare as well
as possibly some services that Medicare does not cover.
Juan Perez, who is turning age 65 next month, intends to
work for several more years at Smallcap, Incorporated.
Smallcap has a workforce of 15 employees and offers
employer-sponsored healthcare coverage. Juan is a
naturalized citizen 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 impact his
employer- sponsored healthcare coverage. How would you
respond? - Correct Answers ✅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-
,AHIP - 2026 - Modules 1-5 Exam
Questions and Answers (Latest 2026)
sponsored group health plan. 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.
Ms. Kumar 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? - Correct Answers
✅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.
Mrs. Ellis recently turned 66 and decided after many years of
work to retire and begin receiving Social Security benefits.
Shortly thereafter Mrs. Ellis received a letter informing her
that she had been automatically enrolled in Medicare Part B.
She wants to understand what this means. What should you
tell Mrs. Ellis? - Correct Answers ✅Part B primarily covers
physician services. She will be paying a monthly premium
and, except for many preventive and screening tests,
generally will have 20% co-payments for these services, in
addition to an annual deductible.
, AHIP - 2026 - Modules 1-5 Exam
Questions and Answers (Latest 2026)
Mr. Singh would like drug coverage but does not want to be
enrolled in a Medicare Advantage plan. What should you tell
him? - Correct Answers ✅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.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed
income. What could you tell Mrs. Cook that might be of
assistance? - Correct Answers ✅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.
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? - Correct
Answers ✅To obtain Part B coverage, she must pay a
standard monthly premium, though it is higher for individuals
with higher incomes.
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? - Correct Answers ✅After receiving
such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
