2026 AHIP Modules 1–5 Study Guide (Latest Update) |Questions
and Correct Detailed Answers for Medicare Training, Insurance
Certification Preparation, and AHIP Exam |Brand New!!!Already
Graded A+
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?
To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes.
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?
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?
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
pg. 1
,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?
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?
Medicare covers hospice services, and they will be available for her.
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?
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.
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?
Tell prospect Jerry Smith that he should consider adding a standalone
Part D prescription drug coverage policy to his present coverage.
pg. 2
,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?
Mr. Wu may still qualify for help in paying Part D costs through his
State Pharmaceutical Assistance Program (SPAP).
Mr. Vasquez is in good health and is preparing a budget in
anticipation of his retirement when he turns 66. He wants to
understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization because of an illness. In
general terms, what could you tell him about his costs for inpatient
hospital services under Original Medicare?
Under Original Medicare, there is a single deductible amount due for
the first 60 days of any inpatient hospital stay, after which it converts
into a per-day coinsurance amount through day 90. After day 90, he
would pay a daily amount up to 60 days over his lifetime, after which
he would be responsible for all costs.
Mr. Moy will soon turn age 65. He is slightly younger than his wife.
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?
Medicare Supplemental Insurance would help cover his Part A
deductible and Part B coinsurance or copayments in Original Fee-for-
Service (FFS) Medicare as well as possibly some services that
Medicare does not cover.
Juan Perez, who is turning age 65 next month, intends to work for
several more years at Smallcap, Incorporated. Smallcap has a
pg. 3
, 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?
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. 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 but Smallcap must continue to
offer him coverage under its employer-sponsored group health plan
and would become a secondary payor.
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?
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.
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 had been
automatically enrolled in Medicare Part B. She wants to understand
what this means. What should you tell Mrs. Ellis?
Part B primarily covers physician services. She will be paying a
monthly premium and, except for many preventive and screening
tests, generally will have 20% co-payments for these services, in
addition to an annual deductible.
pg. 4
and Correct Detailed Answers for Medicare Training, Insurance
Certification Preparation, and AHIP Exam |Brand New!!!Already
Graded A+
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?
To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes.
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?
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?
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
pg. 1
,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?
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?
Medicare covers hospice services, and they will be available for her.
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?
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.
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?
Tell prospect Jerry Smith that he should consider adding a standalone
Part D prescription drug coverage policy to his present coverage.
pg. 2
,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?
Mr. Wu may still qualify for help in paying Part D costs through his
State Pharmaceutical Assistance Program (SPAP).
Mr. Vasquez is in good health and is preparing a budget in
anticipation of his retirement when he turns 66. He wants to
understand the health care costs he might be exposed to under
Medicare if he were to require hospitalization because of an illness. In
general terms, what could you tell him about his costs for inpatient
hospital services under Original Medicare?
Under Original Medicare, there is a single deductible amount due for
the first 60 days of any inpatient hospital stay, after which it converts
into a per-day coinsurance amount through day 90. After day 90, he
would pay a daily amount up to 60 days over his lifetime, after which
he would be responsible for all costs.
Mr. Moy will soon turn age 65. He is slightly younger than his wife.
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?
Medicare Supplemental Insurance would help cover his Part A
deductible and Part B coinsurance or copayments in Original Fee-for-
Service (FFS) Medicare as well as possibly some services that
Medicare does not cover.
Juan Perez, who is turning age 65 next month, intends to work for
several more years at Smallcap, Incorporated. Smallcap has a
pg. 3
, 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?
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. 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 but Smallcap must continue to
offer him coverage under its employer-sponsored group health plan
and would become a secondary payor.
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?
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.
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 had been
automatically enrolled in Medicare Part B. She wants to understand
what this means. What should you tell Mrs. Ellis?
Part B primarily covers physician services. She will be paying a
monthly premium and, except for many preventive and screening
tests, generally will have 20% co-payments for these services, in
addition to an annual deductible.
pg. 4
