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AHIP - 2026 - MODULES 1-5|
COMPLETE EXAM SET WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS
2026
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 -After receiving such disability payments for 24 months,
he will be automatically enrolled in Medicare, regardless of age.
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-
answer -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.
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.
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What should you say? - correct-answer -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.
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-
answer -Medicare covers hospice services, and they will be available for her.
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-answer -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. 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
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of care in a skilled nursing facility? - correct-answer -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.
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 -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.
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-answer -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.
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.
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Mildred's family asks you whether hospice benefits will be paid for under the
Allcare Medicare Advantage plan. What should you say? - correct-answer -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.
Which of the following statement(s) 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-answer -I, II, and IV only
Mr. Arias, a naturalized citizen, previously enrolled in Medicare Part B but has
recently stopped paying his Part B premium. Mr. Arias is still covered by Part A. He
would like to enroll in a Medicare Advantage (MA) plan and is still covered by Part
A. What should you tell him? - correct-answer -He is not eligible to enroll in a
Medicare Advantage plan until he re-enrolls in Medicare Part B.
AHIP - 2026 - MODULES 1-5|
COMPLETE EXAM SET WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS
2026
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 -After receiving such disability payments for 24 months,
he will be automatically enrolled in Medicare, regardless of age.
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-
answer -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.
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.
,2|Page
What should you say? - correct-answer -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.
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-
answer -Medicare covers hospice services, and they will be available for her.
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-answer -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. 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
,3|Page
of care in a skilled nursing facility? - correct-answer -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.
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 -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.
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-answer -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.
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.
, 4|Page
Mildred's family asks you whether hospice benefits will be paid for under the
Allcare Medicare Advantage plan. What should you say? - correct-answer -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.
Which of the following statement(s) 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-answer -I, II, and IV only
Mr. Arias, a naturalized citizen, previously enrolled in Medicare Part B but has
recently stopped paying his Part B premium. Mr. Arias is still covered by Part A. He
would like to enroll in a Medicare Advantage (MA) plan and is still covered by Part
A. What should you tell him? - correct-answer -He is not eligible to enroll in a
Medicare Advantage plan until he re-enrolls in Medicare Part B.
