AHIP Final Practice Exam A+ Questions
and Answers Verified Solutions Latest
Update 2026/2027
Answer:
PPO, HMO, MSA, Cost Plan, PFFS
■Medicare-Medicaid plans.
Answer:
Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals sometimes
referred to as dual eligibles
■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?.
Answer:
Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical
Assistance Program.
■Edward IP suffered from serious kidney disease. As a result. Edward became eligible for
Medicare coverage due to end-stage renal disease (ESRD). A close relative donated their kidney
and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50 and
asks you if his Medicare coverage will continue, what should you say?.
Answer:
Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the
month in which the individual receives a kidney transplant unless they are eligible for Medicare on
another basis such as age or disability. Edward may, however, remain enrolled in Part B but solely
for coverage of immunosuppressive drugs if he has no other health care coverage that would cover
the drugs.
■Mrs. Pe■a 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?.
Answer:
,She may enroll at any time while she is covered under her employer plan, but she will have a
special eight-month enrollment period after the last month on her employer plan that differs from
the standard general enrollment period, during which she may enroll in Medicare Part B.
■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?.
Answer:
To obtain Part B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes.
■Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE). This
coverage has recently been terminated due to the end of the PH E. While Shirley was enrolled in
Medicaid, she missed an opportunity to enroll in Medicare and now wants Part
B. Which of the following statements best describes Shirley's ability to now
enroll in Medicare Part B?.
Answer:
Shirley is eligible for a Special Enrollment Period (SEP) for up to six months after the termination
of her Medicaid coverage. Under this SEP, Shirley can choose retroactive coverage back to the date
of termination from Medicaid or coverage beginning the month after the month of enrollment.
■Medicare Cost Plan.
Answer:
Type of Medicare health plan. Have Part B to enroll. Can join anytime plan is accepting new
members. A non network provider will can charge higher coinsurances and deuctibles. Different
enrollment/disenrollment periods apply. Can get Part D Rx coverage if available, or apply for a
separate PDP.
■Medicare Entitlement/Enrollment - Part A & Part B.
Answer:
Individuals with ESRD may sign up at anytime. Date on which coverage begins is the fourth month
after dialysis begins.
■Medicare Enrollment Period.
Answer:
, Individuals who do not enroll in Part B when first eligible can enroll during a General Enrollment
Period, Jan 1st to Mar 31st each year. Coverage begins July 1st of that year.
■Ms. Moore 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?.
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.
■Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided
under Original Medicare. What should you tell Mr. Xi that best describes the health coverage
provided to Medicare beneficiaries?.
Answer:
Beneficiaries under Original Medicare have no cost-sharing for most preventive services which
include immunizations such as annual flu shots.
■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?.
Answer:
Medicare Supplemental Insurance would help cover his Part A and Part B deductibles or
coinsurance in Original Fee-for-Service (FFS) Medicare as well as possibly some services that
Medicare does not cover.
■Medicare Enrollment Period - Group Health Coverage.
Answer:
Individuals who have group health coveage through employer may enroll in Part A and/or Part B
anytime while on group coverage during a Special Enrollment Period. Occurs during the 8 month
period following last month of group coverage.
■Medicare Part A Premium.
Answer:
Free if worked 40 quarters of your life and paid Medicare taxes. Premium is $240.00 for
individuals or spouses who paid Medicare taxes for
30 - 39 quarters. Premium is $437.00 for less than 30 quarters.
and Answers Verified Solutions Latest
Update 2026/2027
Answer:
PPO, HMO, MSA, Cost Plan, PFFS
■Medicare-Medicaid plans.
Answer:
Serve both Medicare and Medicaid individuals. Include Part D coverage. Individuals sometimes
referred to as dual eligibles
■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?.
Answer:
Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical
Assistance Program.
■Edward IP suffered from serious kidney disease. As a result. Edward became eligible for
Medicare coverage due to end-stage renal disease (ESRD). A close relative donated their kidney
and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50 and
asks you if his Medicare coverage will continue, what should you say?.
Answer:
Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the
month in which the individual receives a kidney transplant unless they are eligible for Medicare on
another basis such as age or disability. Edward may, however, remain enrolled in Part B but solely
for coverage of immunosuppressive drugs if he has no other health care coverage that would cover
the drugs.
■Mrs. Pe■a 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?.
Answer:
,She may enroll at any time while she is covered under her employer plan, but she will have a
special eight-month enrollment period after the last month on her employer plan that differs from
the standard general enrollment period, during which she may enroll in Medicare Part B.
■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?.
Answer:
To obtain Part B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes.
■Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE). This
coverage has recently been terminated due to the end of the PH E. While Shirley was enrolled in
Medicaid, she missed an opportunity to enroll in Medicare and now wants Part
B. Which of the following statements best describes Shirley's ability to now
enroll in Medicare Part B?.
Answer:
Shirley is eligible for a Special Enrollment Period (SEP) for up to six months after the termination
of her Medicaid coverage. Under this SEP, Shirley can choose retroactive coverage back to the date
of termination from Medicaid or coverage beginning the month after the month of enrollment.
■Medicare Cost Plan.
Answer:
Type of Medicare health plan. Have Part B to enroll. Can join anytime plan is accepting new
members. A non network provider will can charge higher coinsurances and deuctibles. Different
enrollment/disenrollment periods apply. Can get Part D Rx coverage if available, or apply for a
separate PDP.
■Medicare Entitlement/Enrollment - Part A & Part B.
Answer:
Individuals with ESRD may sign up at anytime. Date on which coverage begins is the fourth month
after dialysis begins.
■Medicare Enrollment Period.
Answer:
, Individuals who do not enroll in Part B when first eligible can enroll during a General Enrollment
Period, Jan 1st to Mar 31st each year. Coverage begins July 1st of that year.
■Ms. Moore 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?.
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.
■Mr. Xi will soon turn age 65 and has come to you for advice as to what services are provided
under Original Medicare. What should you tell Mr. Xi that best describes the health coverage
provided to Medicare beneficiaries?.
Answer:
Beneficiaries under Original Medicare have no cost-sharing for most preventive services which
include immunizations such as annual flu shots.
■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?.
Answer:
Medicare Supplemental Insurance would help cover his Part A and Part B deductibles or
coinsurance in Original Fee-for-Service (FFS) Medicare as well as possibly some services that
Medicare does not cover.
■Medicare Enrollment Period - Group Health Coverage.
Answer:
Individuals who have group health coveage through employer may enroll in Part A and/or Part B
anytime while on group coverage during a Special Enrollment Period. Occurs during the 8 month
period following last month of group coverage.
■Medicare Part A Premium.
Answer:
Free if worked 40 quarters of your life and paid Medicare taxes. Premium is $240.00 for
individuals or spouses who paid Medicare taxes for
30 - 39 quarters. Premium is $437.00 for less than 30 quarters.
