AHIP - 2026 - Modules 1-5 Exam comprehensive questions fully solved &
updated (Latest Update 2026) UPDATE!!
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.
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.
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? - (answer)Anthony
is eligible for a special enrollment period (SEP) because he missed an enrollment period due to the
impact of the Federally declared disaster. This SEP will allow Anthony to enroll in Part B up to six months
after the end of the emergency declaration. Anthony may enroll in premium-free Part A at any time and
his Part A coverage will be retroactive for up to 6 months.
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. 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)
,AHIP - 2026 - Modules 1-5 Exam comprehensive questions fully solved &
updated (Latest Update 2026) UPDATE!!
Ms. Lewis has aggressive cancer and would like to know if Medicare will cover hospice services in case
she needs them. What should you tell her? - (answer)Medicare covers hospice services, and they will be
available for her.
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.
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 and would become a secondary payor.
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 obtain Part B coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher incomes.
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.
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.
, AHIP - 2026 - Modules 1-5 Exam comprehensive questions fully solved &
updated (Latest Update 2026) UPDATE!!
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.
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.
Edward 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.
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.
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.
updated (Latest Update 2026) UPDATE!!
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.
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.
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? - (answer)Anthony
is eligible for a special enrollment period (SEP) because he missed an enrollment period due to the
impact of the Federally declared disaster. This SEP will allow Anthony to enroll in Part B up to six months
after the end of the emergency declaration. Anthony may enroll in premium-free Part A at any time and
his Part A coverage will be retroactive for up to 6 months.
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. 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)
,AHIP - 2026 - Modules 1-5 Exam comprehensive questions fully solved &
updated (Latest Update 2026) UPDATE!!
Ms. Lewis has aggressive cancer and would like to know if Medicare will cover hospice services in case
she needs them. What should you tell her? - (answer)Medicare covers hospice services, and they will be
available for her.
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.
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 and would become a secondary payor.
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 obtain Part B coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher incomes.
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.
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.
, AHIP - 2026 - Modules 1-5 Exam comprehensive questions fully solved &
updated (Latest Update 2026) UPDATE!!
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.
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.
Edward 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.
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.
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.
