AHIP - 2026 - MODULES 1-5 EXAM WITH
CORRECT QUESTIONS AND ANSWERS
2025
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? - CORRECT-ANSWERS>>>>>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? - CORRECT-ANSWERS>>>>>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? - CORRECT-ANSWERS>>>>>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? - CORRECT-
ANSWERS>>>>>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? -
CORRECT-ANSWERS>>>>>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? - CORRECT-ANSWERS>>>>>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? - CORRECT-
ANSWERS>>>>>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? - CORRECT-ANSWERS>>>>>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? - CORRECT-
ANSWERS>>>>>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? - CORRECT-
ANSWERS>>>>>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? - CORRECT-
ANSWERS>>>>>To obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher incomes.
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? - CORRECT-ANSWERS>>>>>After receiving such
CORRECT QUESTIONS AND ANSWERS
2025
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? - CORRECT-ANSWERS>>>>>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? - CORRECT-ANSWERS>>>>>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? - CORRECT-ANSWERS>>>>>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? - CORRECT-
ANSWERS>>>>>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? -
CORRECT-ANSWERS>>>>>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? - CORRECT-ANSWERS>>>>>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? - CORRECT-
ANSWERS>>>>>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? - CORRECT-ANSWERS>>>>>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? - CORRECT-
ANSWERS>>>>>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? - CORRECT-
ANSWERS>>>>>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? - CORRECT-
ANSWERS>>>>>To obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher incomes.
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? - CORRECT-ANSWERS>>>>>After receiving such
