AHIP FWA 2026 EXAM SCRIPT
COMPREHENSIVE QUESTIONS WITH FULL
SOLUTIONS GRADED A+
⩥ 1. Mrs. Foster is covered by Original Medicare. She sustained a hip
fracture and is being successfully treated for that condition. However,
she and her physicians feel that after her lengthy hospital stay, she will
need a month or two of nursing and rehabilitative care. What should you
tell them about Original Medicare's coverage of care in a skilled nursing
facility? Answer: b. Medicare will cover Mrs. Foster's skilled nursing
services provided during the first 20 days of her stay, after which she
would have a copay until she has been in the facility for 100 days.
⩥ 1. 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?
Answer: a. 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.
⩥ 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? Answer: a. After receiving
,such disability payments for 24 months, he will be automatically
enrolled in Medicare, regardless of age.
⩥ 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? Answer: 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.
⩥ Mr. Singh would like drug coverage but does not want to be enrolled
in a Medicare Advantage plan. What should you tell him? Answer: 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.
⩥ 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
Medicare? Answer: 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.
,⩥ Mrs. Thomas 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? 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 after the last month on her employer plan that differs from the
standard general enrollment period, during which she may enroll in
Medicare Part B.
⩥ 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? Answer: 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.
⩥ Edward 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
⩥ 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 for the last three years, will soon turn age 65 and hopes to
enroll in Original Medicare. She comes to you for advice. What should
you tell her? Answer: You should tell Madeline that she will be able to
enroll in Medicare Part A without paying monthly premiums due to her
husband's long work record and participation in the Medicare system.
You should also tell Madeline that she will pay Part B premiums at more
than the standard lowest rate but less than the highest rate due her
substantial income.
⩥ 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.
⩥ 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
COMPREHENSIVE QUESTIONS WITH FULL
SOLUTIONS GRADED A+
⩥ 1. Mrs. Foster is covered by Original Medicare. She sustained a hip
fracture and is being successfully treated for that condition. However,
she and her physicians feel that after her lengthy hospital stay, she will
need a month or two of nursing and rehabilitative care. What should you
tell them about Original Medicare's coverage of care in a skilled nursing
facility? Answer: b. Medicare will cover Mrs. Foster's skilled nursing
services provided during the first 20 days of her stay, after which she
would have a copay until she has been in the facility for 100 days.
⩥ 1. 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?
Answer: a. 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.
⩥ 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? Answer: a. After receiving
,such disability payments for 24 months, he will be automatically
enrolled in Medicare, regardless of age.
⩥ 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? Answer: 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.
⩥ Mr. Singh would like drug coverage but does not want to be enrolled
in a Medicare Advantage plan. What should you tell him? Answer: 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.
⩥ 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
Medicare? Answer: 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.
,⩥ Mrs. Thomas 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? 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 after the last month on her employer plan that differs from the
standard general enrollment period, during which she may enroll in
Medicare Part B.
⩥ 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? Answer: 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.
⩥ Edward 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
⩥ 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 for the last three years, will soon turn age 65 and hopes to
enroll in Original Medicare. She comes to you for advice. What should
you tell her? Answer: You should tell Madeline that she will be able to
enroll in Medicare Part A without paying monthly premiums due to her
husband's long work record and participation in the Medicare system.
You should also tell Madeline that she will pay Part B premiums at more
than the standard lowest rate but less than the highest rate due her
substantial income.
⩥ 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.
⩥ 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
