AHIP EXAM QUESTIONS AND ANSWERS.
LATEST 2025/2026 A+ UPDATE (REAL EXAM
UPDATE)
Davis is 52 years old and has recently been diagnosed with end-stage
renal disease (ESRD) and will soon begin dialysis. He is wondering if he
can obtain coverage under Medicare. What should you tell him? - CORRECT
ANS>>He may sign-up for Medicare at any time however coverage usually
begins on the fourth month after dialysis treatments start.
Juan Perez, who is turning age 65 next month, intends to work for several
more years at Smallcap, Incorporated. Smallcap has a workforce of15
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
- CORRECT ANS>>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.
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
- CORRECT ANS>>Medicare Supplemental Insurance would help cover
his Part A and Part B deductibles or coinsurance in Original Fee-for-Service
(FFS) Medicare as well as possibly some services that Medicare does not
cover.
Peňa 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? - CORRECT
ANS>>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.
Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is
AHIP
,concerned that she will not qualify for coverage under part A because she
was not born in the United States. What should you tell her? - CORRECT
ANS>>Most individuals who are citizens and age 65 or over are covered
under Part A by virtue of having paid Medicare taxes while working,
though some may be covered as a result of paying monthly premiums.
Gonzalez is enrolled in Original Medicare and has a Medigap policy as well,
but it provides no drug coverage. She would like to keep the coverage she
has but replace her existing Medigap plan with one that provides drug
coverage. What should you tell her? - CORRECT ANS>>Mrs. Gonzalez
cannot purchase a Medigap plan that covers drugs, but she could keep her
Medigap policy and enroll in a Part D prescription drug plan.
West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through massage therapy. She is concerned about whether
or not Medicare will cover these items and services. What should you tell
her? - CORRECT ANS>>Medicare does not cover massage therapy, or, in
general, glasses or dentures.
Patel 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 as a result of an illness. In general terms, what could you
tell him about his costs for inpatient hospital services under Original
Medicare? - CORRECT ANS>>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.
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
ANS>>To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
Alonso receives some help paying for his two generic prescription drugs
from his employer's retiree coverage, but he wants to compare it to a Part
D prescription drug plan. He asks you what costs he would generally
expect to encounter when enrolling into a standard Medicare Part D
prescription drug plan. What should you tell him? - CORRECT ANS>>He
generally would pay a monthly premium, annual deductible, and per-
prescription cost-sharing.
AHIP
, Moore 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
ANS>>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.
Xi will soon turn age 65 and has come to you for advice as to what services
are provided under
Original Medicare. What should you tell Mr. Xi that best describes the
health coverage provided to Medicare beneficiaries? - CORRECT
ANS>>Beneficiaries under Original Medicare have no cost-sharing for
most preventive services which include immunizations such as annual flu
shots.
Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a
determination that partially denied one of her claims for services. What
advice would you give her? - CORRECT ANS>>Mrs. Duarte should file an
appeal of this initial determination within 120 days of the date she
received the MSN in the mail.
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 ANS>>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.
Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance? - CORRECT ANS>>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.
Rainey is experiencing paranoid delusions and his physician feels that he
should be hospitalized. What should you tell Mr. Rainey (or his
representative) about the length of an inpatient psychiatric hospital stay
that Medicare will cover? - CORRECT ANS>>Medicare will cover a total of
190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
Schmidt would like to plan for retirement and has asked you what is
covered under Original Fee-forService (FFS) Medicare? What could you tell
him? - CORRECT ANS>>Part A, which covers hospital, skilled nursing
facility, hospice, and home health services and Part B, which covers
AHIP
LATEST 2025/2026 A+ UPDATE (REAL EXAM
UPDATE)
Davis is 52 years old and has recently been diagnosed with end-stage
renal disease (ESRD) and will soon begin dialysis. He is wondering if he
can obtain coverage under Medicare. What should you tell him? - CORRECT
ANS>>He may sign-up for Medicare at any time however coverage usually
begins on the fourth month after dialysis treatments start.
Juan Perez, who is turning age 65 next month, intends to work for several
more years at Smallcap, Incorporated. Smallcap has a workforce of15
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
- CORRECT ANS>>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.
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
- CORRECT ANS>>Medicare Supplemental Insurance would help cover
his Part A and Part B deductibles or coinsurance in Original Fee-for-Service
(FFS) Medicare as well as possibly some services that Medicare does not
cover.
Peňa 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? - CORRECT
ANS>>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.
Chen will be 65 soon, has been a citizen for twelve years, has been
employed full time, and paid taxes during that entire period. She is
AHIP
,concerned that she will not qualify for coverage under part A because she
was not born in the United States. What should you tell her? - CORRECT
ANS>>Most individuals who are citizens and age 65 or over are covered
under Part A by virtue of having paid Medicare taxes while working,
though some may be covered as a result of paying monthly premiums.
Gonzalez is enrolled in Original Medicare and has a Medigap policy as well,
but it provides no drug coverage. She would like to keep the coverage she
has but replace her existing Medigap plan with one that provides drug
coverage. What should you tell her? - CORRECT ANS>>Mrs. Gonzalez
cannot purchase a Medigap plan that covers drugs, but she could keep her
Medigap policy and enroll in a Part D prescription drug plan.
West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through massage therapy. She is concerned about whether
or not Medicare will cover these items and services. What should you tell
her? - CORRECT ANS>>Medicare does not cover massage therapy, or, in
general, glasses or dentures.
Patel 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 as a result of an illness. In general terms, what could you
tell him about his costs for inpatient hospital services under Original
Medicare? - CORRECT ANS>>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.
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
ANS>>To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
Alonso receives some help paying for his two generic prescription drugs
from his employer's retiree coverage, but he wants to compare it to a Part
D prescription drug plan. He asks you what costs he would generally
expect to encounter when enrolling into a standard Medicare Part D
prescription drug plan. What should you tell him? - CORRECT ANS>>He
generally would pay a monthly premium, annual deductible, and per-
prescription cost-sharing.
AHIP
, Moore 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
ANS>>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.
Xi will soon turn age 65 and has come to you for advice as to what services
are provided under
Original Medicare. What should you tell Mr. Xi that best describes the
health coverage provided to Medicare beneficiaries? - CORRECT
ANS>>Beneficiaries under Original Medicare have no cost-sharing for
most preventive services which include immunizations such as annual flu
shots.
Duarte is enrolled in Original Medicare Parts A and B. She has recently
reviewed her Medicare Summary Notice (MSN) and disagrees with a
determination that partially denied one of her claims for services. What
advice would you give her? - CORRECT ANS>>Mrs. Duarte should file an
appeal of this initial determination within 120 days of the date she
received the MSN in the mail.
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 ANS>>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.
Park is an elderly retiree. Mrs. Park has a low fixed income. What could
you tell Mrs. Park that might be of assistance? - CORRECT ANS>>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.
Rainey is experiencing paranoid delusions and his physician feels that he
should be hospitalized. What should you tell Mr. Rainey (or his
representative) about the length of an inpatient psychiatric hospital stay
that Medicare will cover? - CORRECT ANS>>Medicare will cover a total of
190 days of inpatient psychiatric care during Mr. Rainey's entire lifetime.
Schmidt would like to plan for retirement and has asked you what is
covered under Original Fee-forService (FFS) Medicare? What could you tell
him? - CORRECT ANS>>Part A, which covers hospital, skilled nursing
facility, hospice, and home health services and Part B, which covers
AHIP
