AHIP Examination. Contains Questions and
Answers||2025||
Q. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs.
Park that might be of assistance?
✓ She should contact her state Medicaid agency to see if she qualifies for programs that can
help with Medicare costs for which she is responsible.
Q. Madeline Martinez was widowed several years ago. Her husband worked for many years and
contributed to 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 65 and hopes to enroll in Original Medicare. She comes to you
for advice. What should you tell her?
✓ You should tell Madeline that she can 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 to her substantial income.
Q. 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?
✓ After receiving such disability payments for 24 months, he will be automatically enrolled
in Medicare, regardless of age.
Q. 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?
✓ 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.
Q. 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?
✓ She may enroll at any time while she is covered under her employer plan, but she will
have a special eight-month enrollment period that differs from the standard general
enrollment period, during which she may enroll in Medicare Part B.
, Q. 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?
✓ Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription
drug coverage policy to his present coverage.
Q. 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?
✓ The penalty will be a permanent 10% increase in his Part B premium for every 12-month
period that passed during which he could have enrolled and did not.
Q. Ms. 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?
✓ 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.
Q. Mildred Savage enrolled in the 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?
✓ 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.
Q. Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an
attractive premium. He wants to know if he must use doctors in a network as his current HMO
plan requires him to do. What should you tell him?
✓ He may receive health care services from any doctor allowed to bill Medicare, as long as
he shows the doctor the plan's identification card and the doctor agrees to accept the
PFFS plan's payment terms and conditions, which could include balance billing.
Q. Mr. Kelly wants to know whether he is eligible to sign up for a private fee-for-service (PFFS)
plan. What questions would you need to ask to determine his eligibility?
Answers||2025||
Q. Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs.
Park that might be of assistance?
✓ She should contact her state Medicaid agency to see if she qualifies for programs that can
help with Medicare costs for which she is responsible.
Q. Madeline Martinez was widowed several years ago. Her husband worked for many years and
contributed to 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 65 and hopes to enroll in Original Medicare. She comes to you
for advice. What should you tell her?
✓ You should tell Madeline that she can 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 to her substantial income.
Q. 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?
✓ After receiving such disability payments for 24 months, he will be automatically enrolled
in Medicare, regardless of age.
Q. 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?
✓ 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.
Q. 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?
✓ She may enroll at any time while she is covered under her employer plan, but she will
have a special eight-month enrollment period that differs from the standard general
enrollment period, during which she may enroll in Medicare Part B.
, Q. 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?
✓ Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription
drug coverage policy to his present coverage.
Q. 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?
✓ The penalty will be a permanent 10% increase in his Part B premium for every 12-month
period that passed during which he could have enrolled and did not.
Q. Ms. 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?
✓ 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.
Q. Mildred Savage enrolled in the 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?
✓ 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.
Q. Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an
attractive premium. He wants to know if he must use doctors in a network as his current HMO
plan requires him to do. What should you tell him?
✓ He may receive health care services from any doctor allowed to bill Medicare, as long as
he shows the doctor the plan's identification card and the doctor agrees to accept the
PFFS plan's payment terms and conditions, which could include balance billing.
Q. Mr. Kelly wants to know whether he is eligible to sign up for a private fee-for-service (PFFS)
plan. What questions would you need to ask to determine his eligibility?
