AHIP MODULES 1-5 | ACTUAL EXAM
QUESTIONS AND VERIFIED ANSWERS |
GRADED A+| PASS ON FIRST ATTEMPT | BRAND
NEW 2026/2027 UPDATE!!!!!
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Terms in this set (105)
Mr. Capadona would like to It is illegal for you to sell Mr. Capadona a
purchase a Medicare Advantage Medigap plan if he is enrolled in an MA plan, and
(MA) plan and a Medigap plan to besides, Medigap only works with Original
pick up costs not covered by that Medicare.
plan. What should you tell him?
Agent John Miller is meeting with Tell prospect Jerry Smith that he should consider
Jerry Smith, a new prospect. Jerry is adding a standalone Part D prescription drug
currently enrolled in Medicare Parts coverage policy to his present coverage.
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?
,Mr. Wu is eligible for Medicare. He Mr. Wu may still qualify for help in paying Part D
has limited financial resources but costs through his State Pharmaceutical
failed to qualify for the Part D low- Assistance Program (SPAP).
income subsidy. Where might he
turn for help with his prescription
drug costs?
Mr. Vasquez is in good health and is Under Original Medicare, there is a single
preparing a budget in anticipation deductible amount due for the first 60 days of
of his retirement when he turns 66. any inpatient hospital stay, after which it converts
He wants to understand the health into a per-day coinsurance amount through day
care costs he might be exposed to 90. After day 90, he would pay a daily amount up
under Medicare if he were to to 60 days over his lifetime, after which he would
require hospitalization because of be responsible for all costs.
an illness. In general terms, what
could you tell him about his costs
for inpatient hospital services under
Original Medicare?
,Mr. Moy will soon turn age 65. He is Medicare Supplemental Insurance would help
slightly younger than his wife. Mr. cover his Part A deductible and Part B
Moy's wife has a Medicare coinsurance or copayments in Original Fee-for-
Advantage plan, but he wants to Service (FFS) Medicare as well as possibly some
understand what coverage services that Medicare does not cover.
Medicare Supplemental Insurance
provides since his health care
needs are different from his wife's
needs. What could you tell Mr.
Moy?
Juan Perez, who is turning age 65 Juan is likely to be eligible for Medicare once he
next month, intends to work for turns age 65 and if he enrolls, Medicare would
several more years at Smallcap, become the primary payor of his healthcare
Incorporated. Smallcap has a claims and Smallcap does not have to continue
workforce of 15 employees and to offer him coverage comparable to those under
offers employer-sponsored age 65 under its employer-sponsored group
healthcare coverage. Juan is a health plan. Juan is likely to be eligible for
naturalized citizen and has Medicare once he turns age 65 and if he enrolls,
contributed to the Medicare system Medicare would become the primary payor of his
for over 20 years. Juan asks you if healthcare claims but Smallcap must continue to
he will be entitled to Medicare and offer him coverage under its employer-
if he enrolls how that will impact his sponsored group health plan and would become
employer- sponsored healthcare a secondary payor.
coverage. How would you
respond?
Ms. Kumar plans to retire when she Medicare is a program for people age 65 or
turns 65 in a few months. She is in older and those under age 65 with certain
excellent health and will have disabilities, end-stage renal disease, and Lou
considerable income when she Gehrig's disease so she will be eligible for
retires. She is concerned that her Medicare.
income will make it impossible for
her to qualify for Medicare. What
could you tell her to address her
concern?
, Mrs. Ellis recently turned 66 and Part B primarily covers physician services. She
decided after many years of work will be paying a monthly premium and, except for
to retire and begin receiving Social many preventive and screening tests, generally
Security benefits. Shortly thereafter will have 20% co-payments for these services, in
Mrs. Ellis received a letter informing addition to an annual deductible.
her that she had been automatically
enrolled in Medicare Part B. She
wants to understand what this
means. What should you tell Mrs.
Ellis?
Mr. Singh would like drug coverage Mr. Singh can enroll in a stand-alone prescription
but does not want to be enrolled in drug plan and continue to be covered for Part A
a Medicare Advantage plan. What and Part B services through Original Fee-for-
should you tell him? Service Medicare.
Mrs. Cook is an elderly retiree. Mrs. She should contact her state Medicaid agency to
Cook has a low fixed income. What see if she qualifies for one of several programs
could you tell Mrs. Cook that might that can help with Medicare costs for which she is
be of assistance? responsible.
Ms. Henderson believes that she To obtain Part B coverage, she must pay a
will qualify for Medicare Coverage standard monthly premium, though it is higher for
when she turns 65, without paying individuals with higher incomes.
any premiums, because she has
been working for 40 years and
paying Medicare taxes. What
should you tell her?
Mr. Bauer is 49 years old, but After receiving such disability payments for 24
eighteen months ago he was months, he will be automatically enrolled in
declared disabled by the Social Medicare, regardless of age.
Security Administration and has
been receiving disability payments.
He is wondering whether he can
obtain coverage under Medicare.
What should you tell him?
QUESTIONS AND VERIFIED ANSWERS |
GRADED A+| PASS ON FIRST ATTEMPT | BRAND
NEW 2026/2027 UPDATE!!!!!
Save
Terms in this set (105)
Mr. Capadona would like to It is illegal for you to sell Mr. Capadona a
purchase a Medicare Advantage Medigap plan if he is enrolled in an MA plan, and
(MA) plan and a Medigap plan to besides, Medigap only works with Original
pick up costs not covered by that Medicare.
plan. What should you tell him?
Agent John Miller is meeting with Tell prospect Jerry Smith that he should consider
Jerry Smith, a new prospect. Jerry is adding a standalone Part D prescription drug
currently enrolled in Medicare Parts coverage policy to his present coverage.
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?
,Mr. Wu is eligible for Medicare. He Mr. Wu may still qualify for help in paying Part D
has limited financial resources but costs through his State Pharmaceutical
failed to qualify for the Part D low- Assistance Program (SPAP).
income subsidy. Where might he
turn for help with his prescription
drug costs?
Mr. Vasquez is in good health and is Under Original Medicare, there is a single
preparing a budget in anticipation deductible amount due for the first 60 days of
of his retirement when he turns 66. any inpatient hospital stay, after which it converts
He wants to understand the health into a per-day coinsurance amount through day
care costs he might be exposed to 90. After day 90, he would pay a daily amount up
under Medicare if he were to to 60 days over his lifetime, after which he would
require hospitalization because of be responsible for all costs.
an illness. In general terms, what
could you tell him about his costs
for inpatient hospital services under
Original Medicare?
,Mr. Moy will soon turn age 65. He is Medicare Supplemental Insurance would help
slightly younger than his wife. Mr. cover his Part A deductible and Part B
Moy's wife has a Medicare coinsurance or copayments in Original Fee-for-
Advantage plan, but he wants to Service (FFS) Medicare as well as possibly some
understand what coverage services that Medicare does not cover.
Medicare Supplemental Insurance
provides since his health care
needs are different from his wife's
needs. What could you tell Mr.
Moy?
Juan Perez, who is turning age 65 Juan is likely to be eligible for Medicare once he
next month, intends to work for turns age 65 and if he enrolls, Medicare would
several more years at Smallcap, become the primary payor of his healthcare
Incorporated. Smallcap has a claims and Smallcap does not have to continue
workforce of 15 employees and to offer him coverage comparable to those under
offers employer-sponsored age 65 under its employer-sponsored group
healthcare coverage. Juan is a health plan. Juan is likely to be eligible for
naturalized citizen and has Medicare once he turns age 65 and if he enrolls,
contributed to the Medicare system Medicare would become the primary payor of his
for over 20 years. Juan asks you if healthcare claims but Smallcap must continue to
he will be entitled to Medicare and offer him coverage under its employer-
if he enrolls how that will impact his sponsored group health plan and would become
employer- sponsored healthcare a secondary payor.
coverage. How would you
respond?
Ms. Kumar plans to retire when she Medicare is a program for people age 65 or
turns 65 in a few months. She is in older and those under age 65 with certain
excellent health and will have disabilities, end-stage renal disease, and Lou
considerable income when she Gehrig's disease so she will be eligible for
retires. She is concerned that her Medicare.
income will make it impossible for
her to qualify for Medicare. What
could you tell her to address her
concern?
, Mrs. Ellis recently turned 66 and Part B primarily covers physician services. She
decided after many years of work will be paying a monthly premium and, except for
to retire and begin receiving Social many preventive and screening tests, generally
Security benefits. Shortly thereafter will have 20% co-payments for these services, in
Mrs. Ellis received a letter informing addition to an annual deductible.
her that she had been automatically
enrolled in Medicare Part B. She
wants to understand what this
means. What should you tell Mrs.
Ellis?
Mr. Singh would like drug coverage Mr. Singh can enroll in a stand-alone prescription
but does not want to be enrolled in drug plan and continue to be covered for Part A
a Medicare Advantage plan. What and Part B services through Original Fee-for-
should you tell him? Service Medicare.
Mrs. Cook is an elderly retiree. Mrs. She should contact her state Medicaid agency to
Cook has a low fixed income. What see if she qualifies for one of several programs
could you tell Mrs. Cook that might that can help with Medicare costs for which she is
be of assistance? responsible.
Ms. Henderson believes that she To obtain Part B coverage, she must pay a
will qualify for Medicare Coverage standard monthly premium, though it is higher for
when she turns 65, without paying individuals with higher incomes.
any premiums, because she has
been working for 40 years and
paying Medicare taxes. What
should you tell her?
Mr. Bauer is 49 years old, but After receiving such disability payments for 24
eighteen months ago he was months, he will be automatically enrolled in
declared disabled by the Social Medicare, regardless of age.
Security Administration and has
been receiving disability payments.
He is wondering whether he can
obtain coverage under Medicare.
What should you tell him?
