AHIP 2026 FINAL EXAM
AHIP 2026 FINAL EXAM STUDY GUIDE EXAM PREP NEWEST
2026/2027 ACTUAL EXAM COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
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 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.
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 Answer-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. 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.
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, AHIP 2026 FINAL EXAM
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 Answer-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 Answer-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.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him? - Correct 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.
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 Answer-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
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, AHIP 2026 FINAL EXAM
tell him? - Correct Answer-After receiving such disability payments for 24 months,
he will be automatically enrolled in Medicare, regardless of age.
Mr. Schmidt would like to plan for retirement and has asked you what is covered
under Original Fee-for-Service (FFS) Medicare. What could you tell him? - Correct
Answer-Part A, which covers hospital, skilled nursing facility, hospice, and home
health services and Part B, which covers professional services such as those
provided by a doctor are covered under Original Medicare.
Anthony Boniface turned 65 in 2024. He was not receiving Social Security or
Railroad Retirement Benefits on his 65th birthday. He was interested in obtaining
Medicare coverage and is eligible for premium-free Part A. Before he could enroll
in Medicare, his entire area was impacted by a hurricane causing massive flooding
and severe wind damage. The Federal government declared this to be a natural
disaster which has recently ended. During this period Anthony's initial enrollment
period expired. Anthony asks you how he can now obtain Medicare coverage.
What should you say? - Correct Answer-Anthony is eligible for a special enrollment
period (SEP) because he missed an enrollment period due to the impact of the
Federally declared disaster. This SEP will allow Anthony to enroll in Part B up to six
months after the end of the emergency declaration. Anthony may enroll in
premium-free Part A at any time and his Part A coverage will be retroactive for up
to 6 months.
Ms. Lewis has aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her? - Correct
Answer-Medicare covers hospice services, and they will be available for her.
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
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, AHIP 2026 FINAL EXAM
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? - Correct 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.
Ms. Galindo will turn 65 on June 10th. She has never previously qualified for
Medicare. She is entitled to Medicare Part A and intends to enroll in Part B. She
wants to know if she is eligible to enroll in a Medicare Advantage plan that
includes prescription drug coverage. What do you tell her? - Correct Answer-a.
Ms. Galindo can enroll in an MA-PD plan now since her initial election period (IEP)
for Part D prescription drug coverage and initial coverage election period (ICEP)
are occurring together beginning March 1st and ending September 30th.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage
(MA) and Part D plans that Agent Smith sells at the regular Tuesday brunch the
neighbors have for senior citizens. What should Agent Tom Smith tell Mr. Moreno
about the kinds of food that can be provided to potential enrollees who attend
the sales presentation? - Correct Answer-A meal cannot be provided, but light
snacks would be permitted.
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 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.
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AHIP 2026 FINAL EXAM STUDY GUIDE EXAM PREP NEWEST
2026/2027 ACTUAL EXAM COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
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 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.
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 Answer-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. 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.
1|Page
, AHIP 2026 FINAL EXAM
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 Answer-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 Answer-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.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him? - Correct 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.
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 Answer-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
2|Page
, AHIP 2026 FINAL EXAM
tell him? - Correct Answer-After receiving such disability payments for 24 months,
he will be automatically enrolled in Medicare, regardless of age.
Mr. Schmidt would like to plan for retirement and has asked you what is covered
under Original Fee-for-Service (FFS) Medicare. What could you tell him? - Correct
Answer-Part A, which covers hospital, skilled nursing facility, hospice, and home
health services and Part B, which covers professional services such as those
provided by a doctor are covered under Original Medicare.
Anthony Boniface turned 65 in 2024. He was not receiving Social Security or
Railroad Retirement Benefits on his 65th birthday. He was interested in obtaining
Medicare coverage and is eligible for premium-free Part A. Before he could enroll
in Medicare, his entire area was impacted by a hurricane causing massive flooding
and severe wind damage. The Federal government declared this to be a natural
disaster which has recently ended. During this period Anthony's initial enrollment
period expired. Anthony asks you how he can now obtain Medicare coverage.
What should you say? - Correct Answer-Anthony is eligible for a special enrollment
period (SEP) because he missed an enrollment period due to the impact of the
Federally declared disaster. This SEP will allow Anthony to enroll in Part B up to six
months after the end of the emergency declaration. Anthony may enroll in
premium-free Part A at any time and his Part A coverage will be retroactive for up
to 6 months.
Ms. Lewis has aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her? - Correct
Answer-Medicare covers hospice services, and they will be available for her.
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
3|Page
, AHIP 2026 FINAL EXAM
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? - Correct 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.
Ms. Galindo will turn 65 on June 10th. She has never previously qualified for
Medicare. She is entitled to Medicare Part A and intends to enroll in Part B. She
wants to know if she is eligible to enroll in a Medicare Advantage plan that
includes prescription drug coverage. What do you tell her? - Correct Answer-a.
Ms. Galindo can enroll in an MA-PD plan now since her initial election period (IEP)
for Part D prescription drug coverage and initial coverage election period (ICEP)
are occurring together beginning March 1st and ending September 30th.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage
(MA) and Part D plans that Agent Smith sells at the regular Tuesday brunch the
neighbors have for senior citizens. What should Agent Tom Smith tell Mr. Moreno
about the kinds of food that can be provided to potential enrollees who attend
the sales presentation? - Correct Answer-A meal cannot be provided, but light
snacks would be permitted.
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 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.
4|Page
