AHIP Final Exam (2026/2027) – America’s
Health Insurance Plans Medicare
Certification | Verified Multiple-Choice
Questions with Rationales ALREADY
GRADED A+|| PASS!!
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? - 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.
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? - ANSWERS-To obtain Part B coverage, she must pay a
standard monthly premium, though it is higher for individuals with
higher incomes.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance? - ANSWERS-She
should contact her state Medicaid agency to see if she qualifies for
one of several programs that can help with Medicare costs for which
she is responsible.
,Shirly Thomas was enrolled in Medicaid during the Public Health
Emergency (PHE). This coverage has recently been terminated due to
the end of the PHE. While Shirley was enrolled in Medicaid, she missed
an opportunity to enroll in Medicare and now wants Part B. Which of
the following statements best describes Shirley's ability to now enroll
in Medicare Part B? - ANSWERS-Shirley is eligible for a Special
Enrollment Period (SEP) for up to six months after the termination of
her Medicaid coverage. Under this SEP, Shirley can choose retroactive
coverage back to the date of termination from Medicaid or coverage
beginning the month after the month of enrollment.
Ms. Moore 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? -
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.
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? - ANSWERS-Mr. Wu may
still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program.
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? - ANSWERS-After receiving
such disability payments for 24 months, he will be automatically
enrolled in Medicare, regardless of age.
, 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? - ANSWERS-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.
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? - ANSWERS-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.
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? - ANSWERS-Tell
prospect Jerry Smith that he should consider adding a standalone Part
D prescription drug coverage policy to his present coverage.
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? - ANSWERS-He may sign-up for Medicare at any time however
Health Insurance Plans Medicare
Certification | Verified Multiple-Choice
Questions with Rationales ALREADY
GRADED A+|| PASS!!
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? - 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.
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? - ANSWERS-To obtain Part B coverage, she must pay a
standard monthly premium, though it is higher for individuals with
higher incomes.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What
could you tell Mrs. Park that might be of assistance? - ANSWERS-She
should contact her state Medicaid agency to see if she qualifies for
one of several programs that can help with Medicare costs for which
she is responsible.
,Shirly Thomas was enrolled in Medicaid during the Public Health
Emergency (PHE). This coverage has recently been terminated due to
the end of the PHE. While Shirley was enrolled in Medicaid, she missed
an opportunity to enroll in Medicare and now wants Part B. Which of
the following statements best describes Shirley's ability to now enroll
in Medicare Part B? - ANSWERS-Shirley is eligible for a Special
Enrollment Period (SEP) for up to six months after the termination of
her Medicaid coverage. Under this SEP, Shirley can choose retroactive
coverage back to the date of termination from Medicaid or coverage
beginning the month after the month of enrollment.
Ms. Moore 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? -
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.
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? - ANSWERS-Mr. Wu may
still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance Program.
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? - ANSWERS-After receiving
such disability payments for 24 months, he will be automatically
enrolled in Medicare, regardless of age.
, 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? - ANSWERS-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.
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? - ANSWERS-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.
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? - ANSWERS-Tell
prospect Jerry Smith that he should consider adding a standalone Part
D prescription drug coverage policy to his present coverage.
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? - ANSWERS-He may sign-up for Medicare at any time however
