AHIP - 2026 - MODULES 1-5
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? - ✔✔ CORRECT ANSWER ✔✔ 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? - ✔✔
CORRECT ANSWER ✔✔ -Tell prospect Jerry Smith that he should
consider adding a standalone Part D prescription drug coverage
policy to his present coverage.
,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? - ✔✔ CORRECT ANSWER ✔✔ -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? - ✔✔ CORRECT ANSWER
✔✔ -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? - ✔✔ CORRECT ANSWER ✔✔ -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
workforce of 15 employees and offers employersponsored 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? - ✔✔
CORRECT ANSWER ✔✔ -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
employersponsored 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
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? - ✔✔ CORRECT ANSWER ✔✔ 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? - ✔✔
CORRECT ANSWER ✔✔ -Tell prospect Jerry Smith that he should
consider adding a standalone Part D prescription drug coverage
policy to his present coverage.
,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? - ✔✔ CORRECT ANSWER ✔✔ -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? - ✔✔ CORRECT ANSWER
✔✔ -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? - ✔✔ CORRECT ANSWER ✔✔ -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
workforce of 15 employees and offers employersponsored 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? - ✔✔
CORRECT ANSWER ✔✔ -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
employersponsored 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
