AHIP 2025-2026 FINAL EXAM UPDATED
QUESTIONS AND VERIFIED ANSWERS, 100%
GUARANTEE PASS
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that mig ht be of
assistance? - correct answer-
She should contact her state Medicaid agency to see if she qualifies forprograms that can help with Med icare costs
for which she is responsible.
Madeline Martinez was widowed several years ago. Her husband worked for many years and contribute d into the
Medicare system. He also left a substantial estate which provides Madeline with an annual inc ome 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 t o you for
advice. What should you tell her? - correct answer-
You should tell Madeline that she will be able to enroll in Medicare Part ABwithout paying monthly prem iums due to
her husband's long work record and participation in the Medicare system. You should also t ell 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 Adm inistration
and has been receiving disability payments. He is wondering whether he can obtain coverage under Medicare. What
should you tell him - correct answer-
After receivingBsuch disability payments for 24 months, he will be automatically enrolled in Medicare, re gardlessBof
age.
Mr. Schmidt would like to plan for retirement and has asked you what isBcovered under Original Fee-for- Service
(FFS) Medicare? What could you tell him? - correct answer-
Part A, which covers hospital, skilled nursingBfacility, hospice and home health services and Part B, whic h covers
professional services such as those provided by a doctor are covered under Original Medicare.
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? - correct answer-
She may enroll at any time while she is covered under her employer plan, but she will have a special eig
, ht month enrollment period that differs from the standard general enrollment period, during which she may enroll in
Medicare Part B.
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled in Medicare Pa rts A and B.
Jerry has also purchased a Medicare Supplement (Medigap) plan which he has had for sever al years. However, the
plan does not provide drug benefits. How would you advise Agent John Miller to proceed? - correct answer-
Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription drug coverage policy to his
present coverage.
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-The penalty will be a permanent 10% increase in his Part B premium for every 12- month period that
passed during which he could have enrolled and did not.
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have co nsiderable
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 answer-
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.
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 t hese final months in
hospice care. Mildred's family asks you whether hospice benefits will be paid for u nder 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.
Mr. Gomez notes that a Private Fee-for-
Service (PFFS) plan available in his area has an attractive premium. He wants to know if he must use doc tors in a
network as his current HMO plan requires him to do. What should you tell him? -
correct answer-
He may receive health care services from any doctor allowed to bill Medicare, as long as he shows the d octor the
plan's identification card and the doctor agrees to accept the PFFS plan's payment terms and c onditions, which
could include balance billing.
QUESTIONS AND VERIFIED ANSWERS, 100%
GUARANTEE PASS
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park that mig ht be of
assistance? - correct answer-
She should contact her state Medicaid agency to see if she qualifies forprograms that can help with Med icare costs
for which she is responsible.
Madeline Martinez was widowed several years ago. Her husband worked for many years and contribute d into the
Medicare system. He also left a substantial estate which provides Madeline with an annual inc ome 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 t o you for
advice. What should you tell her? - correct answer-
You should tell Madeline that she will be able to enroll in Medicare Part ABwithout paying monthly prem iums due to
her husband's long work record and participation in the Medicare system. You should also t ell 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 Adm inistration
and has been receiving disability payments. He is wondering whether he can obtain coverage under Medicare. What
should you tell him - correct answer-
After receivingBsuch disability payments for 24 months, he will be automatically enrolled in Medicare, re gardlessBof
age.
Mr. Schmidt would like to plan for retirement and has asked you what isBcovered under Original Fee-for- Service
(FFS) Medicare? What could you tell him? - correct answer-
Part A, which covers hospital, skilled nursingBfacility, hospice and home health services and Part B, whic h covers
professional services such as those provided by a doctor are covered under Original Medicare.
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? - correct answer-
She may enroll at any time while she is covered under her employer plan, but she will have a special eig
, ht month enrollment period that differs from the standard general enrollment period, during which she may enroll in
Medicare Part B.
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled in Medicare Pa rts A and B.
Jerry has also purchased a Medicare Supplement (Medigap) plan which he has had for sever al years. However, the
plan does not provide drug benefits. How would you advise Agent John Miller to proceed? - correct answer-
Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription drug coverage policy to his
present coverage.
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-The penalty will be a permanent 10% increase in his Part B premium for every 12- month period that
passed during which he could have enrolled and did not.
Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have co nsiderable
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 answer-
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.
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 t hese final months in
hospice care. Mildred's family asks you whether hospice benefits will be paid for u nder 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.
Mr. Gomez notes that a Private Fee-for-
Service (PFFS) plan available in his area has an attractive premium. He wants to know if he must use doc tors in a
network as his current HMO plan requires him to do. What should you tell him? -
correct answer-
He may receive health care services from any doctor allowed to bill Medicare, as long as he shows the d octor the
plan's identification card and the doctor agrees to accept the PFFS plan's payment terms and c onditions, which
could include balance billing.
