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-ANSWERSIt 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-ANSWERSTell 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-ANSWERSMr. 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-ANSWERSUnder 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-ANSWERSMedicare 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-ANSWERSJuan 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-ANSWERSMedicare 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
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-ANSWERSIt 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-ANSWERSTell 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-ANSWERSMr. 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-ANSWERSUnder 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-ANSWERSMedicare 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-ANSWERSJuan 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-ANSWERSMedicare 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
