AHIP Final Exam Test Questions and Answers 2026/2027 – Verified Answers for Medicare Advantage, Part D, Medigap & Compliance

AHIP FINAL EXAM TEST
QUESTIONS AND ANSWERS
(2026/2027) (VERIFIED
ANSWERS

,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?correct answersHe 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 answersJuan 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.

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 answersMedicare
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.

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?correct answersShe 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.

Mrs. 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 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 answersMost 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.

,Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well,
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but it provides no drug coverage. She would like to keep the coverage she has
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c6 but replace her existing Medigap plan with one that provides drug coverage. What
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c6 should you tell her?correct answersMrs. Gonzalez cannot purchase a Medigap plan
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c6 that covers drugs, but she could keep her Medigap policy and enroll in a Part D
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c6 prescription drug plan. c6 c6




Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
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from arthritis through massage therapy. She is concerned about whether or not
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Medicare will cover these items and services. What should you tell her?correct
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answersMedicare does not cover massage therapy, or, in general, glasses or
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dentures.
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Mr. Patel is in good health and is preparing a budget in anticipation of his
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retirement when he turns 66. He wants to understand the health care costs he
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might be exposed to under Medicare if he were to require hospitalization as a
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result of an illness. In general terms, what could you tell him about his costs for
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inpatient hospital services
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under Original Medicare?correct answersUnder Original Medicare, there is a single
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deductible amount due for the first 60 days of any inpatient hospital stay, after
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which it converts into a per-day coinsurance amount through day 90. After day 90,
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he would pay a daily amount up to 60 days over his lifetime, after which he
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would be responsible for all costs.
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Ms. Henderson believes that she will qualify for Medicare Coverage when she
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turns 65, without paying any premiums, because she has been working for 40
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years and paying Medicare taxes. What should you tell her?correct answersTo
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obtain Part B coverage, she must pay a standard monthly premium, though it is
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higher for individuals with higher incomes.
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Mr. Alonso receives some help paying for his two generic prescription drugs from
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his employer's retiree coverage, but he wants to compare it to a Part D
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prescription drug plan. He asks you what costs he would generally expect to
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encounter when enrolling into a standard MedicarePart D prescription drug plan.
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What should you tell him?correct answersHe generally would pay a monthly
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premium, annual deductible, and per- prescription cost-sharing.
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age 65 or older and those under age 65 with certain disabilities, end-stage renal
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent
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disease, and Lou Gehrig's disease so she will be eligible for Medicare.
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health and will have considerable income when she retires. She is concerned that
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her income will make it impossible for her to qualify for Medicare. What could you
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tell her to address her concern?correct answersMedicare is a program for people
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, Mr. Xi will soon turn age 65 and has come to you for advice as to what services
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are provided under Original Medicare. What should you tell Mr. Xi that
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describes the health coverage provided to Medicare beneficiaries?correct
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answersBeneficiaries under Original Medicare have no cost-sharing for most
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preventive services which include immunizations such as annual flu shots.
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