AHIP Final Exam with Question And
Answers 100% Verified (Guarantee A+)
2025/2026
1. 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? - ANSWER>>Mr. Wu may still qualify for help in paying Part D costs
through his State Pharmaceutical Assistance Program.
2. 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>>After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
3. 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.
4. 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? -
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.
5. 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?
- ANSWER>>Tell prospect Jerry Smith that he should consider adding a standalone
Part D prescription drug coverage policy to his present coverage.
6. Mr. 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? - ANSWER>>He may sign-
up for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.
7. Mr. Diaz continued working with his company and was insured under his employer's
group plan until he reached age 68. He has heard that there is a premium penalty for
those who did not sign up for Part B when first eligible and wants to know how much
he will have to pay. What should you tell him? - ANSWER>>Mr. Diaz will not pay
any penalty because he had continuous coverage under his employer's plan.
8. 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.
9. Edward IP 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.
10. Mrs. 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? - ANSWER>>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.
11. 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.
Answers 100% Verified (Guarantee A+)
2025/2026
1. 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? - ANSWER>>Mr. Wu may still qualify for help in paying Part D costs
through his State Pharmaceutical Assistance Program.
2. 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>>After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
3. 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.
4. 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? -
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.
5. 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?
- ANSWER>>Tell prospect Jerry Smith that he should consider adding a standalone
Part D prescription drug coverage policy to his present coverage.
6. Mr. 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? - ANSWER>>He may sign-
up for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.
7. Mr. Diaz continued working with his company and was insured under his employer's
group plan until he reached age 68. He has heard that there is a premium penalty for
those who did not sign up for Part B when first eligible and wants to know how much
he will have to pay. What should you tell him? - ANSWER>>Mr. Diaz will not pay
any penalty because he had continuous coverage under his employer's plan.
8. 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.
9. Edward IP 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.
10. Mrs. 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? - ANSWER>>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.
11. 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.
