AHIP Final Exam 2025/2026 | Complete Test Questions with Verified Correct Answers | Fully Graded A+ Success Guide

AHIP Final Exam 2025/2026 | Complete Test
Questions with Verified Correct Answers |
Fully Graded A+ Success Guide
AHIP Final Exam 2025/2026 Practice Test
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Multiple Choice Questions with Correct Answershg hg hg hg hg




Question 1 hg




Mr. Hildalgo complains that because he takes multiple expensive drugs, he has trouble paying
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his cost sharing for his prescription drugs, particularly at the beginning of the year during the d
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eductible phase. He is happy with his plan and does not want to change. He heard about a ne
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w program called the Medicare Prescription Payment Plan and asks whether it might help. Wha
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t do you tell him?
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A) The Medicare Prescription Payment Plan eliminates all cost-sharing for expensive drugs
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B) The Medicare Prescription Payment Plan helps spread out beneficiary cost-
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sharing payments but does not decrease the total amount owed
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C) The Medicare Prescription Payment Plan reduces the total amount owed by 50%
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D) The Medicare Prescription Payment Plan is only available to dual-eligible beneficiaries
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Correct Answer: B hg hg




Question 2 hg




Mr. Torres has a small savings account. He would like to pay for his monthly Part D premiums
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with an automatic monthly withdrawal from his savings account until it is exhausted, and then
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have his premiums withheld from his Social Security check. What should you tell him?
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A) He can switch payment methods at any time during the year
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B) He must select a single Part D premium payment mechanism that will be used throughout t
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he year hg




C) He can use two payment methods simultaneously
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D) Automatic withdrawals are not permitted for Part D premiums
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Correct Answer: B hg hg

,Question 3 hg




Lauren Nichols has heard about a Medicare concept from one of her neighbors called TrOOP. S
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he asks you to explain it. What do you say?
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A) TrOOP is the total out-of-pocket limit for Medicare Advantage plans
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B) TrOOP stands for true out-of-
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pocket costs that count toward the Medicare Part D catastrophic limit and include not only exp
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enses paid by a beneficiary but also in some instances amounts paid by or through qualified St
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ate Pharmaceutical Assistance Programs
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C) TrOOP is the annual deductible for Medicare Part D
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D) TrOOP is the monthly premium amount for Medicare Part D
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Correct Answer: B hg hg




Question 4 hg




Edward suffered from serious kidney disease and became eligible for Medicare coverage due t
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o end-
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stage renal disease (ESRD). A close relative donated their kidney and Edward successfully under
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went transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicare co
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verage will continue. What should you say?
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A) Medicare coverage ends immediately after the transplant
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B) Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the
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month in which the individual receives a kidney transplant unless they are eligible for Medicare
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on another basis such as age or disability
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C) Medicare coverage continues for life after a kidney transplant
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D) Edward must reapply for Medicare annually
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Correct Answer: B hg hg




Question 5 hg




Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. She recently lea
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rned that she has inoperable cancer and has just a few months to live. She would like to spend
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these final months in hospice care. Mildred's family asks you whether hospice benefits will be
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paid for under the Allcare Medicare Advantage plan. What should you say?
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A) She must disenroll from the MA plan to receive hospice benefits
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B) Mildred may remain enrolled in Allcare and make a hospice election. Hospice benefits will b
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e paid for by Original Medicare under Part A and Allcare will continue to pay for any non-
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hospice services hg

,C) Hospice is not covered for MA plan enrollees
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D) She must switch to Original Medicare entirely to receive hospice benefits
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Correct Answer: B hg hg




Question 6 hg




Mr. Diaz continued working with his company and was insured under his employer's group pla
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n until he reached age 68. He has heard that there is a premium penalty for those who did not
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sign up for Part B when first eligible and wants to know how much he will have to pay. What s
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hould you tell him? hg hg hg




A) He will pay a 10% penalty for each year he delayed enrollment
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B) Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's
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plan
C) He will pay a 20% penalty
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D) He must pay the full Part B premium with no penalty
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Correct Answer: B hg hg




Question 7 hg




Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what coverage Me
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dicare Supplemental Insurance provides since his health care needs are different from his wife's
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needs. What could you tell Mr. Moy?
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A) Medigap plans cover all out-of-pocket costs in Medicare Advantage plans
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B) Medicare Supplemental Insurance would help cover his Part A and Part B deductibles or coin
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surance in Original Fee-for- hg hg hg




Service (FFS) Medicare as well as possibly some services that Medicare does not cover
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C) Medigap plans replace Original Medicare entirely
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D) Medigap plans only cover prescription drugs
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Correct Answer: B hg hg




Question 8 hg




Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, an
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d paid taxes during that entire period. She is concerned that she will not qualify for coverage u
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nder Part A because she was not born in the United States. What should you tell her?
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A) She does not qualify for Part A because she was not born in the U.S.
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B) Most individuals who are citizens and age 65 or over are covered under Part A by virtue of h
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aving paid Medicare taxes while working, though some may be covered because of paying mo
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, nthly premiums hg




C) She must wait until age 67 to qualify
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D) She must have been a citizen for at least 20 years
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Correct Answer: B hg hg




Question 9 hg




Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social Sec
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urity Administration and has been receiving disability payments. He is wondering whether he c
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an obtain coverage under Medicare. What should you tell him?
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A) He is not eligible until age 65
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B) After receiving such disability payments for 24 months, he will be automatically enrolled in
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Medicare, regardless of age hg hg hg




C) He must apply for Medicare separately
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D) Disability does not qualify for Medicare coverage
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Correct Answer: B hg hg




Question 10 hg




Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided u
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nder Original Medicare. What should you tell Mr. Xi that best describes the health coverage pr
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ovided to Medicare beneficiaries?
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A) Beneficiaries pay full cost for all preventive services
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B) Beneficiaries under Original Medicare have no cost-
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sharing for most preventive services which include immunizations such as annual flu shots
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C) Only hospital care is covered under Original Medicare
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D) Preventive services require prior authorization
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Correct Answer: B hg hg




Question 11 hg




Mrs. Peña is 66 years old, has coverage under an employer plan, and will retire next year. She h
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eard she must enroll in Part B at the beginning of the year to ensure no gap in coverage. What
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can you tell her?
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A) She must enroll in Part B before January 1
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B) She may enroll at any time while she is covered under her employer plan, but she will have a
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special eight-
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month enrollment period after the last month on her employer plan that differs from the stand
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