AHIP Modules 1-5 Exam Study
Guide – Practice Questions
with Verified Answers. GRADED
A+. Latest 2026/2027 Update
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.
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.
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
(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? - Answer✔✔-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? -
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? -
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.
, 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? - 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? -
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? - 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? - Answer✔✔-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? - Answer✔✔-To
Guide – Practice Questions
with Verified Answers. GRADED
A+. Latest 2026/2027 Update
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.
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.
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
(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? - Answer✔✔-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? -
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? -
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.
, 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? - 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? -
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? - 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? - Answer✔✔-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? - Answer✔✔-To
