AHIP Final Exam questions and verified answers
(detailed & elaborated) ACTUAL EXAM 2025 TESTS!!
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?
Ans: Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance
Program.
Quiz 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?
Ans: After receiving such disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age.
Quiz 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?
Ans: 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.
Quiz 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?
,Ans: 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.
Quiz 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?
Ans: Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription drug
coverage policy to his present coverage.
Quiz 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?
Ans: He may sign-up for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.
Quiz 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?
Ans: Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan.
Quiz 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?
, Ans: 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.
Quiz Edward IP 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?
Ans: 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.
Quiz 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?
Ans: She may enroll at any time while she is covered under her employer plan, but she will have a
special eight-month enrollment period after the last month on her employer plan that differs from the
standard general enrollment period, during which she may enroll in Medicare Part B.
Quiz 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?
Ans: 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.
Quiz 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?
(detailed & elaborated) ACTUAL EXAM 2025 TESTS!!
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?
Ans: Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance
Program.
Quiz 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?
Ans: After receiving such disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age.
Quiz 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?
Ans: 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.
Quiz 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?
,Ans: 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.
Quiz 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?
Ans: Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription drug
coverage policy to his present coverage.
Quiz 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?
Ans: He may sign-up for Medicare at any time however coverage usually begins on the fourth month
after dialysis treatments start.
Quiz 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?
Ans: Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan.
Quiz 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?
, Ans: 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.
Quiz Edward IP 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?
Ans: 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.
Quiz 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?
Ans: She may enroll at any time while she is covered under her employer plan, but she will have a
special eight-month enrollment period after the last month on her employer plan that differs from the
standard general enrollment period, during which she may enroll in Medicare Part B.
Quiz 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?
Ans: 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.
Quiz 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?
