AHIP EXAM WITH CORRECT
QUESTIONS AND ANSWERS 2025
Mr. Wendt suffers from diabetes which has gotten progressively worse during
the last year. He is currently enrolled in Original Medicare (Parts A and B)
and a Part D prescription drug plan and did not enroll in a Medicare
Advantage (MA) plan during the last annual open enrollment period (AEP)
which has just closed. Mr. Wendt has heard that there are certain MA plans
that might provide him with more specialized coverage for his diabetes and
wants to know if he must wait until the next annual open enrollment period
(AEP) before enrolling in such a plan. What should you tell him? - CORRECT-
ANSWERSd. If there is a special needs plan (SNP) in Mr. Wendt's area that
specializes in caring for individuals with diabetes, he may enroll in the SNP at
any time under a special enrollment period (SEP). Correct
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-ANSWERSd. Tell prospect Jerry
Smith that he should consider adding a standalone Part D prescription drug
coverage policy to his present coverage.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original
Medicare Part A and Part B. She would also like to enroll in a Medicare
,Supplement (Medigap) plan. Anita's older neighbor Mel has told her about
the Medigap Part F plan in which he is enrolled. It not only provides foreign
travel emergency benefits but also covers his Medicare Part B deductible.
Anita comes to you for advice. What should you tell her? - CORRECT-
ANSWERSa. You are sorry to disappoint Anita but a Medigap Part F plan is no
longer available to those who turn age 65 after January 1,2020. Anita might
instead consider other Medigap plans that offer foreign travel benefits but do
not cover the Part B deductible.
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-ANSWERSd. 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.
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? -
CORRECT-ANSWERSb. 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. 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-ANSWERSb. After receiving such
disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age.
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-
ANSWERSb. He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
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?
, - CORRECT-ANSWERSd. Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's 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-ANSWERSb. Medicare Supplemental Insurance would help cover
his Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare
as well as possibly some services that Medicare does not cover.
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-
ANSWERSa. Most 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.
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? - CORRECT-ANSWERSb. 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.
Mrs. Geisler's neighbor told her she should look at her Part D options during
the annual Medicare enrollment period because features of Part D might
QUESTIONS AND ANSWERS 2025
Mr. Wendt suffers from diabetes which has gotten progressively worse during
the last year. He is currently enrolled in Original Medicare (Parts A and B)
and a Part D prescription drug plan and did not enroll in a Medicare
Advantage (MA) plan during the last annual open enrollment period (AEP)
which has just closed. Mr. Wendt has heard that there are certain MA plans
that might provide him with more specialized coverage for his diabetes and
wants to know if he must wait until the next annual open enrollment period
(AEP) before enrolling in such a plan. What should you tell him? - CORRECT-
ANSWERSd. If there is a special needs plan (SNP) in Mr. Wendt's area that
specializes in caring for individuals with diabetes, he may enroll in the SNP at
any time under a special enrollment period (SEP). Correct
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-ANSWERSd. Tell prospect Jerry
Smith that he should consider adding a standalone Part D prescription drug
coverage policy to his present coverage.
Anita Magri will turn age 65 in August 2020. Anita intends to enroll in Original
Medicare Part A and Part B. She would also like to enroll in a Medicare
,Supplement (Medigap) plan. Anita's older neighbor Mel has told her about
the Medigap Part F plan in which he is enrolled. It not only provides foreign
travel emergency benefits but also covers his Medicare Part B deductible.
Anita comes to you for advice. What should you tell her? - CORRECT-
ANSWERSa. You are sorry to disappoint Anita but a Medigap Part F plan is no
longer available to those who turn age 65 after January 1,2020. Anita might
instead consider other Medigap plans that offer foreign travel benefits but do
not cover the Part B deductible.
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-ANSWERSd. 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.
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? -
CORRECT-ANSWERSb. 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. 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-ANSWERSb. After receiving such
disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age.
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-
ANSWERSb. He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
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?
, - CORRECT-ANSWERSd. Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's 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-ANSWERSb. Medicare Supplemental Insurance would help cover
his Part A and Part B cost sharing in Original Fee-for-Service (FFS) Medicare
as well as possibly some services that Medicare does not cover.
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-
ANSWERSa. Most 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.
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? - CORRECT-ANSWERSb. 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.
Mrs. Geisler's neighbor told her she should look at her Part D options during
the annual Medicare enrollment period because features of Part D might
