AHIP EXAM 2026 Questions and
Answers
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 answer-d. 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
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,proceed? - Correct answer-d. 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 answer-a. 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 answer-d. Juan
is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medicare
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,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 answer-b. 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 answer-b. After receiving such disability payments for 24 months,
he will be automatically enrolled in Medicare, regardless of age.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, 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 answer-b. 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
answer-d. 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
answer-b. 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.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
Answers
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 answer-d. 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
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,proceed? - Correct answer-d. 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 answer-a. 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 answer-d. Juan
is likely to be eligible for Medicare once he turns age 65 and if he enrolls Medicare
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,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 answer-b. 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 answer-b. After receiving such disability payments for 24 months,
he will be automatically enrolled in Medicare, regardless of age.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, 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 answer-b. 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
answer-d. 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
answer-b. 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.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
