AHIP 2026 FINAL NEWEST EXAM WITH MULTIPLE CHOICE OF
QUESTIONS AND CORRECT ANSWERS ALREADY GRADED A+ AND
100% GUARANTEE PASS (BRAND NEW!!!!!!!!!)
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access
providers. What should you tell him? - CORRECT ANSWERS-In most Medicare Advantage
HMOs, Mr. Kumar must generally obtain his services only from providers within the plan's network
(except in an emergency or where care is unavailable within the network).
Mr. Dalton is in excellent health, lives in his own home, and has a sizeable income from his investments.
He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His friend has mentioned
that the SNP charges very low cost-sharing amounts and Mr. Dalton would like to join that plan. What
should you tell him? - CORRECT ANSWERS-SNPs limit enrollment to certain subpopulations of
beneficiaries. Given his current situation, he is unlikely to qualify and would not be able to enroll in the
SNP.
Which of the following statement is/are correct about a Medicare Savings Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no network of providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal deductible of $500 indexed
for inflation.
IV. Non-network providers must accept the same amount that Original Medicare would pay them as
payment in full. - CORRECT ANSWERS-I, II, and IV only
Mrs. Lester is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to enroll
in a MA MSA plan that she heard about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive medications. Currently, she is enrolled in
Original Medicare and a standalone Part D plan. How would you advise Mrs. Lester? - CORRECT
ANSWERS-Mrs. Lester may enroll in a MA MSA plan and remain in her current standalone Part D
prescription drug plan.
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
Edward 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? - CORRECT ANSWERS-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.
Mrs. Thomas 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? - CORRECT ANSWERS-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.
Ms. Lewis has aggressive cancer and would like to know if Medicare will cover hospice services in case
she needs them. What should you tell her? - CORRECT ANSWERS-Medicare covers hospice
services, and they will be available for her
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 disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of age
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. 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 has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What should you
, tell Mrs. Quinn? - CORRECT ANSWERS-Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive screening and tests, generally will have 20%
co-payments for these services in addition to an annual deductible
Anthony Boniface turned 65 in 2024. He was not receiving Social Security or Railroad Retirement
Benefits on his 65th birthday. He was interested in obtaining Medicare coverage and is eligible for
premium-free Part A. Before he could enroll in Medicare, his entire area was impacted by a hurricane
causing massive flooding and severe wind damage. The Federal government declared this to be a natural
disaster which has recently ended. During this period Anthony's initial enrollment period expired.
Anthony asks you how he can now obtain Medicare coverage. What should you say? - CORRECT
ANSWERS-Anthony is eligible for a special enrollment period (SEP) because he missed an
enrollment period due to the impact of the Federally declared disaster. This SEP will allow Anthony to
enroll in Part B up to six months after the end of the emergency declaration. Anthony may enroll in
premium-free Part A at any time and his Part A coverage will be retroactive for up to 6 months.
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 and would become a secondary
payor
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.
Mrs. Foster is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay, she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - CORRECT ANSWERS-Medicare will
cover Mrs. Foster's skilled nursing services provided during the first 20 days of her stay, after which she
would have a copay until she has been in the facility for 100 days.
QUESTIONS AND CORRECT ANSWERS ALREADY GRADED A+ AND
100% GUARANTEE PASS (BRAND NEW!!!!!!!!!)
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability to access
providers. What should you tell him? - CORRECT ANSWERS-In most Medicare Advantage
HMOs, Mr. Kumar must generally obtain his services only from providers within the plan's network
(except in an emergency or where care is unavailable within the network).
Mr. Dalton is in excellent health, lives in his own home, and has a sizeable income from his investments.
He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His friend has mentioned
that the SNP charges very low cost-sharing amounts and Mr. Dalton would like to join that plan. What
should you tell him? - CORRECT ANSWERS-SNPs limit enrollment to certain subpopulations of
beneficiaries. Given his current situation, he is unlikely to qualify and would not be able to enroll in the
SNP.
Which of the following statement is/are correct about a Medicare Savings Account (MSA) Plans?
I. MSAs may have either a partial network, full network, or no network of providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal deductible of $500 indexed
for inflation.
IV. Non-network providers must accept the same amount that Original Medicare would pay them as
payment in full. - CORRECT ANSWERS-I, II, and IV only
Mrs. Lester is age 75 and enjoys a comfortable but not extremely high-income level. She wishes to enroll
in a MA MSA plan that she heard about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive medications. Currently, she is enrolled in
Original Medicare and a standalone Part D plan. How would you advise Mrs. Lester? - CORRECT
ANSWERS-Mrs. Lester may enroll in a MA MSA plan and remain in her current standalone Part D
prescription drug plan.
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
Edward 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? - CORRECT ANSWERS-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.
Mrs. Thomas 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? - CORRECT ANSWERS-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.
Ms. Lewis has aggressive cancer and would like to know if Medicare will cover hospice services in case
she needs them. What should you tell her? - CORRECT ANSWERS-Medicare covers hospice
services, and they will be available for her
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 disability payments for 24 months, he will be automatically enrolled in Medicare, regardless of age
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. 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 has been
automatically enrolled in Medicare Part B. She wants to understand what this means. What should you
, tell Mrs. Quinn? - CORRECT ANSWERS-Part B primarily covers physician services. She will be
paying a monthly premium and, except for many preventive screening and tests, generally will have 20%
co-payments for these services in addition to an annual deductible
Anthony Boniface turned 65 in 2024. He was not receiving Social Security or Railroad Retirement
Benefits on his 65th birthday. He was interested in obtaining Medicare coverage and is eligible for
premium-free Part A. Before he could enroll in Medicare, his entire area was impacted by a hurricane
causing massive flooding and severe wind damage. The Federal government declared this to be a natural
disaster which has recently ended. During this period Anthony's initial enrollment period expired.
Anthony asks you how he can now obtain Medicare coverage. What should you say? - CORRECT
ANSWERS-Anthony is eligible for a special enrollment period (SEP) because he missed an
enrollment period due to the impact of the Federally declared disaster. This SEP will allow Anthony to
enroll in Part B up to six months after the end of the emergency declaration. Anthony may enroll in
premium-free Part A at any time and his Part A coverage will be retroactive for up to 6 months.
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 and would become a secondary
payor
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.
Mrs. Foster is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay, she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - CORRECT ANSWERS-Medicare will
cover Mrs. Foster's skilled nursing services provided during the first 20 days of her stay, after which she
would have a copay until she has been in the facility for 100 days.
