AHIP Final Test UPDATED ACTUAL Exam Questions and
CORRECT Answers (Premium Verified Answers)
Question 1.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage (MA)
and Part D plans that Agent Smith sells at the regular Tuesday brunch the neighbors
have for senior citizens. What should Agent Tom Smith tell Mr. Moreno about the kinds
of food that can be provided to potential enrollees who attend the sales presentation?
Correct Answer: A meal cannot be provided, but light snacks would be
permitted.
Question 2.
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.
Question 3.
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.
Question 4.
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).
Question 5.
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.
Question 6.
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 employer-sponsored 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? -✓✓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
employer-sponsored group health plan and would become a secondary payor.
Question 7.
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 her to qualify for Medicare. What could you tell her to address
her concern?
Correct 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.
Question 8.
Mrs. Ellis recently turned 66 and decided after many years of work to retire and begin
receiving Social Security benefits. Shortly thereafter Mrs. Ellis received a letter informing
her that she had been automatically enrolled in Medicare Part B. She wants to
understand what this means. What should you tell Mrs. Ellis?
, Correct Answer: Part B primarily covers physician services. She will be paying
a monthly premium and, except for many preventive and screening tests,
generally will have 20% co-payments for these services, in addition to an
annual deductible.
Question 9.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?
Correct Answer: Mr. Singh can enroll in a stand-alone prescription drug plan
and continue to be covered for Part A and Part B services through Original
Fee-for-Service Medicare.
Question 10.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could you tell
Mrs. Cook that might be of assistance?
Correct Answer: To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
Question 11.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the
Social Security Administration and has been receiving disability payments. He is
wondering whether he can obtain coverage under Medicare. What should you tell him?
Correct Answer: After receiving such disability payments for 24 months, he
will be automatically enrolled in Medicare, regardless of age.
• Mr. Schmidt would like to plan for retirement and has asked you what is
covered under Original Fee-for-Service (FFS) Medicare. What could you tell
him? -✓✓Part A, which covers hospital, skilled nursing facility, hospice, and
home health services and Part B, which covers professional services such as
those provided by a doctor are covered under Original Medicare.
Question 12.
Anthony Boniface turned 65 in 2024. He was not receiving Social Security or Railroad
Retirement Benefits on his 65th birthday. He was interested in obtaining Medicare
coverage and is eligible for premium-free Part A. Before he could enroll in Medicare, his
entire area was impacted by a hurricane causing massive flooding and severe wind
damage. The Federal government declared this to be a natural disaster which has
recently ended. During this period Anthony's initial enrollment period expired. Anthony
asks you how he can now obtain Medicare coverage. What should you say?
Correct Answer: Anthony is eligible for a special enrollment period (SEP)
because he missed an enrollment period due to the impact of the Federally
declared disaster. This SEP will allow Anthony to enroll in Part B up to six
months after the end of the emergency declaration. Anthony may enroll in
CORRECT Answers (Premium Verified Answers)
Question 1.
Mr. Moreno invited his neighbor, Agent Tom Smith, to discuss Medicare Advantage (MA)
and Part D plans that Agent Smith sells at the regular Tuesday brunch the neighbors
have for senior citizens. What should Agent Tom Smith tell Mr. Moreno about the kinds
of food that can be provided to potential enrollees who attend the sales presentation?
Correct Answer: A meal cannot be provided, but light snacks would be
permitted.
Question 2.
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.
Question 3.
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.
Question 4.
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).
Question 5.
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.
Question 6.
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 employer-sponsored 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? -✓✓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
employer-sponsored group health plan and would become a secondary payor.
Question 7.
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 her to qualify for Medicare. What could you tell her to address
her concern?
Correct 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.
Question 8.
Mrs. Ellis recently turned 66 and decided after many years of work to retire and begin
receiving Social Security benefits. Shortly thereafter Mrs. Ellis received a letter informing
her that she had been automatically enrolled in Medicare Part B. She wants to
understand what this means. What should you tell Mrs. Ellis?
, Correct Answer: Part B primarily covers physician services. She will be paying
a monthly premium and, except for many preventive and screening tests,
generally will have 20% co-payments for these services, in addition to an
annual deductible.
Question 9.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?
Correct Answer: Mr. Singh can enroll in a stand-alone prescription drug plan
and continue to be covered for Part A and Part B services through Original
Fee-for-Service Medicare.
Question 10.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could you tell
Mrs. Cook that might be of assistance?
Correct Answer: To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
Question 11.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the
Social Security Administration and has been receiving disability payments. He is
wondering whether he can obtain coverage under Medicare. What should you tell him?
Correct Answer: After receiving such disability payments for 24 months, he
will be automatically enrolled in Medicare, regardless of age.
• Mr. Schmidt would like to plan for retirement and has asked you what is
covered under Original Fee-for-Service (FFS) Medicare. What could you tell
him? -✓✓Part A, which covers hospital, skilled nursing facility, hospice, and
home health services and Part B, which covers professional services such as
those provided by a doctor are covered under Original Medicare.
Question 12.
Anthony Boniface turned 65 in 2024. He was not receiving Social Security or Railroad
Retirement Benefits on his 65th birthday. He was interested in obtaining Medicare
coverage and is eligible for premium-free Part A. Before he could enroll in Medicare, his
entire area was impacted by a hurricane causing massive flooding and severe wind
damage. The Federal government declared this to be a natural disaster which has
recently ended. During this period Anthony's initial enrollment period expired. Anthony
asks you how he can now obtain Medicare coverage. What should you say?
Correct Answer: Anthony is eligible for a special enrollment period (SEP)
because he missed an enrollment period due to the impact of the Federally
declared disaster. This SEP will allow Anthony to enroll in Part B up to six
months after the end of the emergency declaration. Anthony may enroll in
