Social Science Business Insurance
AHIP MEDICARE TRAINING 2026 Questions Verified and Provided
with A+ Graded Answers Latest Updated 2026
Ms. Jensen has heard about "Original Fee-for- PFFS plans are a type of Medicare Advantage plan offered by private
Service Medicare" and "Private Fee-for-Service" companies.
plans. She wants to know what the difference is if
any. What should you tell her?
This year you decide to focus your efforts on You are not required to submit communication and marketing materials
marketing to employer and union groups. Which of specific only to those employer plans to CMS at the time of use, but
the following statements best describes what you CMS may request and review copies if employee complaints occur.
can and cannot do in order to stay in compliance?
Agent Suma has recently had several clients Agent Suma is only permitted to fill out the applicant's name and
request his assistance in completing their paper contact information. The applicant must fill in the remaining information
enrollment form. What advice would you give him? in order to protect his or her privacy.
Mrs. Quinn recently turned 66 and decided after Part B primarily covers physician services. She will be paying a
many years of work to begin receiving Social monthly premium and, with the exception of many preventive and
Security benefits. Shortly thereafter Mrs. Quinn screening tests, generally will have 20% coinsurance for these services,
received a letter informing her that she has been in addition to an annual deductible.
automatically enrolled in Medicare Part B. She
wants to understand what this means. What should
you tell Mrs. Quinn?
Mrs. Turner is comparing her employer's retiree Original Medicare covers ambulance services.
insurance to Original Medicare and would like to
know which of the following services Original
Medicare will cover if the appropriate criteria are
met? What could you tell her?
Mr. Diaz continued working with his company Mr. Diaz will not pay any penalty because he had continuous coverage
and was insured under his employer's group plan under his employer's plan.
until he 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 and wants to know how
much he will have to pay. What should you tell
him?
Anita Magri will turn age 65 in August 2020. You are sorry to disappoint Anita but a Medigap Part F plan is no longer
Anita intends to enroll in Original Medicare available to those who turn age 65 after January 1,2020. Anita might
Part A and Part B. She would also like to enroll instead consider other Medigap plans that offer foreign travel benefits
in a Medicare but do not cover the Part B deductible.
Supplement (Medigap) plan. Anita's older neighbor
Mel has told her about the Medigap Part F plan in
which he is enrolled. It not only provides foreign
travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for
advice. What should you tell her
Mr. Moy's wife has a Medicare Advantage plan, but Medicare Supplemental Insurance would help cover his Part A and Part
he wants to understand what coverage B cost sharing in Original Fee-for-Service (FFS) Medicare as well as
Medicare Supplemental Insurance provides since possibly some services that Medicare does not cover.
his health care needs are different from his
wife's needs.
What could you tell Mr. Moy?
, Mr. Bauer is 49 years old, but eighteen months After receiving such disability payments for 24 months, he will be
ago he was declared disabled by the Social automatically enrolled in 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?
Mr. Schmidt would like to plan for retirement Part A, which covers hospital, skilled nursing facility, hospice, and
and has asked you what is covered under Original home health services and Part B, which covers professional services
Fee-for-Service (FFS) Medicare? What could such as those provided by a doctor are covered under Original
you tell him? Medicare.
Ms. Moore plans to retire when she turns 65 in Medicare is a program for people age 65 or older and those under
a few months. She is in excellent health and will age 65 with certain disabilities, end-stage renal disease, and Lou
have considerable income when she retires. Gehrig's disease so she will be eligible for Medicare.
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?
Mrs. Shields is covered by Original Medicare. She Medicare will cover Mrs. Shield's skilled nursing services provided
sustained a hip fracture and is being successfully during the first 20 days of her stay, after which she would have a copay
treated for that condition. However, she and her until she has been in the facility for 100 days.
physicians feel that after her lengthy hospital stay
she will need a month or two of nursing and
rehabilitative care. What should you tell them
about Original Medicare's coverage of care in a
skilled nursing facility?
Mr. Xi will soon turn age 65 and has come to Beneficiaries under Original Medicare have no cost-sharing for most
you for advice as to what services are provided preventive services which include immunizations such as annual flu
under Original Medicare. What should you tell Mr. shots.
Xi that best describes the health coverage
provided to Medicare beneficiaries?
Mrs. Geisler's neighbor told her she should look at Part D covers prescription drugs and she should look at her premiums,
her Part D options during the annual Medicare formulary, and cost-sharing among other factors to see if they have
enrollment period because features of Part D changed.
might have changed. Mrs. Geisler can't remember
what Part D is so she called you to ask what
her
neighbor was talking about. What could you tell
her?
What impact, if any, will recent regulatory The Part B deductible will no longer be covered for individuals newly
changes have upon Medigap plans? eligible for Medicare starting January 1, 2020.
Mr. Wu is eligible for Medicare. He has limited Mr. Wu may still qualify for help in paying Part D costs through his State
financial resources but failed to qualify for the Pharmaceutical Assistance Program.
Part D low-income subsidy. Where might he
turn for
help with his prescription drug costs?
AHIP MEDICARE TRAINING 2026 Questions Verified and Provided
with A+ Graded Answers Latest Updated 2026
Ms. Jensen has heard about "Original Fee-for- PFFS plans are a type of Medicare Advantage plan offered by private
Service Medicare" and "Private Fee-for-Service" companies.
plans. She wants to know what the difference is if
any. What should you tell her?
This year you decide to focus your efforts on You are not required to submit communication and marketing materials
marketing to employer and union groups. Which of specific only to those employer plans to CMS at the time of use, but
the following statements best describes what you CMS may request and review copies if employee complaints occur.
can and cannot do in order to stay in compliance?
Agent Suma has recently had several clients Agent Suma is only permitted to fill out the applicant's name and
request his assistance in completing their paper contact information. The applicant must fill in the remaining information
enrollment form. What advice would you give him? in order to protect his or her privacy.
Mrs. Quinn recently turned 66 and decided after Part B primarily covers physician services. She will be paying a
many years of work to begin receiving Social monthly premium and, with the exception of many preventive and
Security benefits. Shortly thereafter Mrs. Quinn screening tests, generally will have 20% coinsurance for these services,
received a letter informing her that she has been in addition to an annual deductible.
automatically enrolled in Medicare Part B. She
wants to understand what this means. What should
you tell Mrs. Quinn?
Mrs. Turner is comparing her employer's retiree Original Medicare covers ambulance services.
insurance to Original Medicare and would like to
know which of the following services Original
Medicare will cover if the appropriate criteria are
met? What could you tell her?
Mr. Diaz continued working with his company Mr. Diaz will not pay any penalty because he had continuous coverage
and was insured under his employer's group plan under his employer's plan.
until he 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 and wants to know how
much he will have to pay. What should you tell
him?
Anita Magri will turn age 65 in August 2020. You are sorry to disappoint Anita but a Medigap Part F plan is no longer
Anita intends to enroll in Original Medicare available to those who turn age 65 after January 1,2020. Anita might
Part A and Part B. She would also like to enroll instead consider other Medigap plans that offer foreign travel benefits
in a Medicare but do not cover the Part B deductible.
Supplement (Medigap) plan. Anita's older neighbor
Mel has told her about the Medigap Part F plan in
which he is enrolled. It not only provides foreign
travel emergency benefits but also covers his
Medicare Part B deductible. Anita comes to you for
advice. What should you tell her
Mr. Moy's wife has a Medicare Advantage plan, but Medicare Supplemental Insurance would help cover his Part A and Part
he wants to understand what coverage B cost sharing in Original Fee-for-Service (FFS) Medicare as well as
Medicare Supplemental Insurance provides since possibly some services that Medicare does not cover.
his health care needs are different from his
wife's needs.
What could you tell Mr. Moy?
, Mr. Bauer is 49 years old, but eighteen months After receiving such disability payments for 24 months, he will be
ago he was declared disabled by the Social automatically enrolled in 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?
Mr. Schmidt would like to plan for retirement Part A, which covers hospital, skilled nursing facility, hospice, and
and has asked you what is covered under Original home health services and Part B, which covers professional services
Fee-for-Service (FFS) Medicare? What could such as those provided by a doctor are covered under Original
you tell him? Medicare.
Ms. Moore plans to retire when she turns 65 in Medicare is a program for people age 65 or older and those under
a few months. She is in excellent health and will age 65 with certain disabilities, end-stage renal disease, and Lou
have considerable income when she retires. Gehrig's disease so she will be eligible for Medicare.
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?
Mrs. Shields is covered by Original Medicare. She Medicare will cover Mrs. Shield's skilled nursing services provided
sustained a hip fracture and is being successfully during the first 20 days of her stay, after which she would have a copay
treated for that condition. However, she and her until she has been in the facility for 100 days.
physicians feel that after her lengthy hospital stay
she will need a month or two of nursing and
rehabilitative care. What should you tell them
about Original Medicare's coverage of care in a
skilled nursing facility?
Mr. Xi will soon turn age 65 and has come to Beneficiaries under Original Medicare have no cost-sharing for most
you for advice as to what services are provided preventive services which include immunizations such as annual flu
under Original Medicare. What should you tell Mr. shots.
Xi that best describes the health coverage
provided to Medicare beneficiaries?
Mrs. Geisler's neighbor told her she should look at Part D covers prescription drugs and she should look at her premiums,
her Part D options during the annual Medicare formulary, and cost-sharing among other factors to see if they have
enrollment period because features of Part D changed.
might have changed. Mrs. Geisler can't remember
what Part D is so she called you to ask what
her
neighbor was talking about. What could you tell
her?
What impact, if any, will recent regulatory The Part B deductible will no longer be covered for individuals newly
changes have upon Medigap plans? eligible for Medicare starting January 1, 2020.
Mr. Wu is eligible for Medicare. He has limited Mr. Wu may still qualify for help in paying Part D costs through his State
financial resources but failed to qualify for the Pharmaceutical Assistance Program.
Part D low-income subsidy. Where might he
turn for
help with his prescription drug costs?
