AHIP Final & Module 1–5 Test Bank |
Complete Questions and Answers
Graded A+ Guaranteed Pass (2026)
‣ 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? -✓✓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? -✓✓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
Medicare? -✓✓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? -✓✓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? -✓✓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.
,‣ 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? -
✓✓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? -✓✓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? -✓✓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? -✓✓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? -✓✓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? -✓✓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? -✓✓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? -✓✓Anthony is eligible for a
Complete Questions and Answers
Graded A+ Guaranteed Pass (2026)
‣ 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? -✓✓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? -✓✓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
Medicare? -✓✓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? -✓✓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? -✓✓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.
,‣ 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? -
✓✓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? -✓✓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? -✓✓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? -✓✓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? -✓✓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? -✓✓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? -✓✓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? -✓✓Anthony is eligible for a
