AHIP 2026 FINAL Mr. Schmidt would like to plan for re-
tirement and has asked you what is
EXAM
covered under Original Fee-for-Service
Mrs. Park is an elderly retiree. Mrs. (FFS) Medicare? What could you tell
Park has a low fixed income. What him?
could you tell Mrs. Park that might be She should contact her state Medicaid
of assis- tance? agency to see if she qualifies forpro-
Madeline Martinez was widowed sev- grams that can help with Medicare costs
eral years ago. Her husband worked for for which she is responsible.
many years and contributed into the
Medicare system. He also left a sub- You should tell Madeline that she will be
stantial estate which provides Madeline able to enroll in Medicare Part A
with an annual income of approximate- without paying monthly premiums due
ly $130,000. Madeline, who has only to her husband's long work record and
worked part-time for the last three participation in the Medicare system.
years, will soon turn age 65 and hopes You should also tell Madeline that she
to enroll in Original Medicare. She will pay Part B premiums at more than
comes to you for advice. What should the standard lowest rate but less than
you tell her? the highest rate due her substantial
Mr. Bauer is 49 years old, but eighteen income.
months ago he was declared disabled
by the Social Security Administration
and has been receiving disability
payments. He is wondering whether he
After receiving such disability
can obtain coverage under Medicare.
payments for 24 months, he will be
What should you tell him
,automatically enrolled in Medicare, employ- er's group plan until he
regardless of age. 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
Part A, which covers hospital, skilled and wants to know how much he will
nursing facility, hospice and home have to pay. What should you tell him?
health services and Part B, which covers Ms. Moore plans to retire when she
pro- fessional services such as those turns 65 in a few months. She is in excel-
provid- ed by a doctor are covered lent health and will have considerable
Mrs. PeHa is 66 years old, has coverage She may enroll at any time while she
under an employer plan, and will retire is covered under her employer plan, but
next year. She heard she must enroll in she will have a special eight month en-
Part B at the beginning of the year to rollment period that differs from the stan-
ensure no gap in coverage. What can dard general enrollment period, during you
tell her? 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 Parts A and B.
Jerry
under Origi- nal Medicare. income when she retires. She is con-
has also purchased a Medicare Supple- cerned that her income will make it im-
ment (Medigap) plan which he has had possible for her to qualify for Medicare.
for several years. However, the plan What could you tell her to address her
does not provide drug benefits. How concern?
would you advise Agent John Miller to
Mildred Savage enrolled in Allcare
proceed? Medicare Advantage plan several years
Mr. Diaz continued working with his ago. Mildred recently learned that she is
com- pany and was insured under his suffering from inoperable cancer and
, has just a few months to live. She would
like to spend these final months in Medicare is a program for people age 65
hospice care. Mildred's family asks you or older and those under age 65 with
whether hospice benefits will be paid cer- tain disabilities, end-stage renal
for under the Allcare Medicare disease, and Lou Gehrig's disease so she
Advantage plan. What should you say? will be eligible for Medicare.
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 doctors in a
Mildred may remain enrolled in Allcare
network as his current HMO plan
and make a hospice election. Hospice
requires him to do. What should you
benefits will be paid for by Original
tell him?
Medicare under Part A and Allcare will
Tell prospect Jerry Smith that he should
continue to pay for any non-hospice ser-
consider adding a standalone Part D
vices.
pre- scription drug coverage policy to
his pre- sent coverage.
He may receive health care services
from any doctor allowed to bill
The penalty will be a permanent 10%
Medicare, as long as he shows the doctor
increase in his Part B premium for every
the plan's identification card and the
12-month period that passed dur- ing
doctor agrees to accept the PFFS plan's
which he could have enrolled and did
payment terms and conditions, which
not.
could include bal- ance billing.
Mr. Kelly wants to know whether he is el-
tirement and has asked you what is
EXAM
covered under Original Fee-for-Service
Mrs. Park is an elderly retiree. Mrs. (FFS) Medicare? What could you tell
Park has a low fixed income. What him?
could you tell Mrs. Park that might be She should contact her state Medicaid
of assis- tance? agency to see if she qualifies forpro-
Madeline Martinez was widowed sev- grams that can help with Medicare costs
eral years ago. Her husband worked for for which she is responsible.
many years and contributed into the
Medicare system. He also left a sub- You should tell Madeline that she will be
stantial estate which provides Madeline able to enroll in Medicare Part A
with an annual income of approximate- without paying monthly premiums due
ly $130,000. Madeline, who has only to her husband's long work record and
worked part-time for the last three participation in the Medicare system.
years, will soon turn age 65 and hopes You should also tell Madeline that she
to enroll in Original Medicare. She will pay Part B premiums at more than
comes to you for advice. What should the standard lowest rate but less than
you tell her? the highest rate due her substantial
Mr. Bauer is 49 years old, but eighteen income.
months ago he was declared disabled
by the Social Security Administration
and has been receiving disability
payments. He is wondering whether he
After receiving such disability
can obtain coverage under Medicare.
payments for 24 months, he will be
What should you tell him
,automatically enrolled in Medicare, employ- er's group plan until he
regardless of age. 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
Part A, which covers hospital, skilled and wants to know how much he will
nursing facility, hospice and home have to pay. What should you tell him?
health services and Part B, which covers Ms. Moore plans to retire when she
pro- fessional services such as those turns 65 in a few months. She is in excel-
provid- ed by a doctor are covered lent health and will have considerable
Mrs. PeHa is 66 years old, has coverage She may enroll at any time while she
under an employer plan, and will retire is covered under her employer plan, but
next year. She heard she must enroll in she will have a special eight month en-
Part B at the beginning of the year to rollment period that differs from the stan-
ensure no gap in coverage. What can dard general enrollment period, during you
tell her? 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 Parts A and B.
Jerry
under Origi- nal Medicare. income when she retires. She is con-
has also purchased a Medicare Supple- cerned that her income will make it im-
ment (Medigap) plan which he has had possible for her to qualify for Medicare.
for several years. However, the plan What could you tell her to address her
does not provide drug benefits. How concern?
would you advise Agent John Miller to
Mildred Savage enrolled in Allcare
proceed? Medicare Advantage plan several years
Mr. Diaz continued working with his ago. Mildred recently learned that she is
com- pany and was insured under his suffering from inoperable cancer and
, has just a few months to live. She would
like to spend these final months in Medicare is a program for people age 65
hospice care. Mildred's family asks you or older and those under age 65 with
whether hospice benefits will be paid cer- tain disabilities, end-stage renal
for under the Allcare Medicare disease, and Lou Gehrig's disease so she
Advantage plan. What should you say? will be eligible for Medicare.
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 doctors in a
Mildred may remain enrolled in Allcare
network as his current HMO plan
and make a hospice election. Hospice
requires him to do. What should you
benefits will be paid for by Original
tell him?
Medicare under Part A and Allcare will
Tell prospect Jerry Smith that he should
continue to pay for any non-hospice ser-
consider adding a standalone Part D
vices.
pre- scription drug coverage policy to
his pre- sent coverage.
He may receive health care services
from any doctor allowed to bill
The penalty will be a permanent 10%
Medicare, as long as he shows the doctor
increase in his Part B premium for every
the plan's identification card and the
12-month period that passed dur- ing
doctor agrees to accept the PFFS plan's
which he could have enrolled and did
payment terms and conditions, which
not.
could include bal- ance billing.
Mr. Kelly wants to know whether he is el-
