AHIP FINAL EXAM QUESTIONS WITH CORRECT ANSWERS 2025

AHIP FINAL EXAM QUESTIONS WITH
CORRECT ANSWERS 2025/2026
Mr.AWuAisAeligibleAforAMedicare.AHeAhasAlimitedAfinancialAresourcesAbutAfailedAtoAqualifyAforAth
eAPartADAlow-
incomeAsubsidy.AWhereAmightAheAturnAforAhelpAwithAhisAprescriptionAdrugAcosts?A-
AcorrectAanswersMr.AWuAmayAstillAqualifyAforAhelpAinApayingAPartADAcostsAthroughAhisAStateAPha


rmaceuticalAAssistanceAProgram.

Mr.ABauerAisA49AyearsAold,AbutAeighteenAmonthsAagoAheAwasAdeclaredAdisabledAbyAtheASocialAS
ecurityAAdministrationAandAhasAbeenAreceivingAdisabilityApayments.AHeAisAwonderingAwhether
AheAcanAobtainAcoverageAunderAMedicare.AWhatAshouldAyouAtellAhim?A-


AcorrectAanswersAfterAreceivingAsuchAdisabilityApaymentsAforA24Amonths,AheAwillAbeAautomatic


allyAenrolledAinAMedicare,AregardlessAofAage.

MildredASavageAenrolledAinAAllcareAMedicareAAdvantageAplanAseveralAyearsAago.AMildredArece
ntlyAlearnedAthatAsheAisAsufferingAfromAinoperableAcancerAandAhasAjustAaAfewAmonthsAtoAlive.AS
heAwouldAlikeAtoAspendAtheseAfinalAmonthsAinAhospiceAcare.AMildred'sAfamilyAasksAyouAwhethe
rAhospiceAbenefitsAwillAbeApaidAforAunderAtheAAllcareAMedicareAAdvantageAplan.AWhatAshouldA
youAsay?A-
AcorrectAanswersMildredAmayAremainAenrolledAinAAllcareAandAmakeAaAhospiceAelection.AHospic


eAbenefitsAwillAbeApaidAforAbyAOriginalAMedicareAunderAPartAAAandAAllcareAwillAcontinueAtoApay
AforAanyAnon-hospiceAservices.



Mr.ASchmidtAwouldAlikeAtoAplanAforAretirementAandAhasAaskedAyouAwhatAisAcoveredAunderAOrigi
nalAFee-for-ServiceA(FFS)AMedicare.AWhatAcouldAyouAtellAhim?A-
AcorrectAanswersPartAA,AwhichAcoversAhospital,AskilledAnursingAfacility,Ahospice,AandAhomeAhea


lthAservicesAandAPartAB,AwhichAcoversAprofessionalAservicesAsuchAasAthoseAprovidedAbyAaAdocto
rAareAcoveredAunderAOriginalAMedicare.

AgentAJohnAMillerAisAmeetingAwithAJerryASmith,AaAnewAprospect.AJerryAisAcurrentlyAenrolledAinA
MedicareAPartsAAAandAB.AJerryAhasAalsoApurchasedAaAMedicareASupplementA(Medigap)AplanAw
hichAheAhasAhadAforAseveralAyears.AHowever,AtheAplanAdoesAnotAprovideAdrugAbenefits.AHowAw
ouldAyouAadviseAAgentAJohnAMillerAtoAproceed?A-
AcorrectAanswersTellAprospectAJerryASmithAthatAheAshouldAconsiderAaddingAaAstandaloneAPartA


DAprescriptionAdrugAcoverageApolicyAtoAhisApresentAcoverage.

Mr.ADavisAisA52AyearsAoldAandAhasArecentlyAbeenAdiagnosedAwithAend-
stageArenalAdiseaseA(ESRD)AandAwillAsoonAbeginAdialysis.AHeAisAwonderingAifAheAcanAobtainAcov
erageAunderAMedicare.AWhatAshouldAyouAtellAhim?A-AcorrectAanswersHeAmayAsign-
upAforAMedicareAatAanyAtimeAhoweverAcoverageAusuallyAbeginsAonAtheAfourthAmonthAafterAdial
ysisAtreatmentsAstart.

,Mr.ADiazAcontinuedAworkingAwithAhisAcompanyAandAwasAinsuredAunderAhisAemployer'sAgroupAp
lanAuntilAheAreachedAageA68.AHeAhasAheardAthatAthereAisAaApremiumApenaltyAforAthoseAwhoAdid
AnotAsignAupAforAPartABAwhenAfirstAeligibleAandAwantsAtoAknowAhowAmuchAheAwillAhaveAtoApay.A


WhatAshouldAyouAtellAhim?A-
AcorrectAanswersMr.ADiazAwillAnotApayAanyApenaltyAbecauseAheAhadAcontinuousAcoverageAunde


rAhisAemployer'sAplan.

MadelineAMartinezAwasAwidowedAseveralAyearsAago.AHerAhusbandAworkedAforAmanyAyearsAan
dAcontributedAintoAtheAMedicareAsystem.AHeAalsoAleftAaAsubstantialAestateAwhichAprovidesAMa
delineAwithAanAannualAincomeAofAapproximatelyA$130,000.AMadeline,AwhoAhasAonlyAworkedAp
art-
timeAforAtheAlastAthreeAyears,AwillAsoonAturnAageA65AandAhopesAtoAenrollAinAOriginalAMedicare.A
SheAcomesAtoAyouAforAadvice.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersYouAshouldAtellAMadelineAthatAsheAwillAbeAableAtoAenrollAinAMedicareAPartAAAw


ithoutApayingAmonthlyApremiumsAdueAtoAherAhusband'sAlongAworkArecordAandAparticipationAin
AtheAMedicareAsystem.AYouAshouldAalsoAtellAMadelineAthatAsheAwillApayAPartABApremiumsAatAm


oreAthanAtheAstandardAlowestArateAbutAlessAthanAtheAhighestArateAdueAherAsubstantialAincome.

EdwardAIPAsufferedAfromAseriousAkidneyAdisease.AAsAaAresult.AEdwardAbecameAeligibleAforAMed
icareAcoverageAdueAtoAend-
stageArenalAdiseaseA(ESRD).AAAcloseArelativeAdonatedAtheirAkidneyAandAEdwardAsuccessfullyAun
derwentAtransplantAsurgeryA12AmonthsAago.AEdwardAisAnowAageA50AandAasksAyouAifAhisAMedica
reAcoverageAwillAcontinue,AwhatAshouldAyouAsay?A-
AcorrectAanswersIndividualsAeligibleAforAMedicareAbasedAonAESRDAgenerallyAloseAeligibilityA36A


monthsAafterAtheAmonthAinAwhichAtheAindividualAreceivesAaAkidneyAtransplantAunlessAtheyAareA
eligibleAforAMedicareAonAanotherAbasisAsuchAasAageAorAdisability.AEdwardAmay,Ahowever,Aremai
nAenrolledAinAPartABAbutAsolelyAforAcoverageAofAimmunosuppressiveAdrugsAifAheAhasAnoAotherAh
ealthAcareAcoverageAthatAwouldAcoverAtheAdrugs.

Mrs.APeňaAisA66AyearsAold,AhasAcoverageAunderAanAemployerAplan,AandAwillAretireAnextAyear.ASh
eAheardAsheAmustAenrollAinAPartABAatAtheAbeginningAofAtheAyearAtoAensureAnoAgapAinAcoverage.A
WhatAcanAyouAtellAher?A-
AcorrectAanswersSheAmayAenrollAatAanyAtimeAwhileAsheAisAcoveredAunderAherAemployerAplan,Ab


utAsheAwillAhaveAaAspecialAeight-
monthAenrollmentAperiodAafterAtheAlastAmonthAonAherAemployerAplanAthatAdiffersAfromAtheAst
andardAgeneralAenrollmentAperiod,AduringAwhichAsheAmayAenrollAinAMedicareAPartAB.

Mr.ACapadonaAwouldAlikeAtoApurchaseAaAMedicareAAdvantageA(MA)AplanAandAaAMedigapAplanAt
oApickAupAcostsAnotAcoveredAbyAthatAplan.AWhatAshouldAyouAtellAhim?A-
AcorrectAanswersItAisAillegalAforAyouAtoAsellAMr.ACapadonaAaAMedigapAplanAifAheAisAenrolledAinAa


nAMAAplan,AandAbesides,AMedigapAonlyAworksAwithAOriginalAMedicare.

, Ms.AHendersonAbelievesAthatAsheAwillAqualifyAforAMedicareACoverageAwhenAsheAturnsA65,Awith
outApayingAanyApremiums,AbecauseAsheAhasAbeenAworkingAforA40AyearsAandApayingAMedicareAt
axes.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersToAobtainAPartABAcoverage,AsheAmustApayAaAstandardAmonthlyApremium,Athou


ghAitAisAhigherAforAindividualsAwithAhigherAincomes.

Mrs.AParkAisAanAelderlyAretiree.AMrs.AParkAhasAaAlowAfixedAincome.AWhatAcouldAyouAtellAMrs.APa
rkAthatAmightAbeAofAassistance?A-
AcorrectAanswersSheAshouldAcontactAherAstateAMedicaidAagencyAtoAseeAifAsheAqualifiesAforAoneA


ofAseveralAprogramsAthatAcanAhelpAwithAMedicareAcostsAforAwhichAsheAisAresponsible.

ShirlyAThomasAwasAenrolledAinAMedicaidAduringAtheAPublicAHealthAEmergencyA(PHE).AThisAcov
erageAhasArecentlyAbeenAterminatedAdueAtoAtheAendAofAtheAPHE.AWhileAShirleyAwasAenrolledAin
AMedicaid,AsheAmissedAanAopportunityAtoAenrollAinAMedicareAandAnowAwantsAPartAB.AWhichAofA


theAfollowingAstatementsAbestAdescribesAShirley'sAabilityAtoAnowAenrollAinAMedicareAPartAB?A-
AcorrectAanswersShirleyAisAeligibleAforAaASpecialAEnrollmentAPeriodA(SEP)AforAupAtoAsixAmonthsA


afterAtheAterminationAofAherAMedicaidAcoverage.AUnderAthisASEP,AShirleyAcanAchooseAretroacti
veAcoverageAbackAtoAtheAdateAofAterminationAfromAMedicaidAorAcoverageAbeginningAtheAmont
hAafterAtheAmonthAofAenrollment.

Ms.AMooreAplansAtoAretireAwhenAsheAturnsA65AinAaAfewAmonths.ASheAisAinAexcellentAhealthAandA
willAhaveAconsiderableAincomeAwhenAsheAretires.ASheAisAconcernedAthatAherAincomeAwillAmake
AitAimpossibleAforAherAtoAqualifyAforAMedicare.AWhatAcouldAyouAtellAherAtoAaddressAherAconcer


n?A-
AcorrectAanswersMedicareAisAaAprogramAforApeopleAageA65AorAolderAandAthoseAunderAageA65Aw


ithAcertainAdisabilities,Aend-
stageArenalAdisease,AandALouAGehrig'sAdiseaseAsoAsheAwillAbeAeligibleAforAMedicare.

Mrs.AGonzalezAisAenrolledAinAOriginalAMedicareAandAhasAaAMedigapApolicyAasAwell,AbutAitAprovi
desAnoAdrugAcoverage.ASheAwouldAlikeAtoAkeepAtheAcoverageAsheAhasAbutAreplaceAherAexistingA
MedigapAplanAwithAoneAthatAprovidesAdrugAcoverage.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMrs.AGonzalezAcannotApurchaseAaAMedigapAplanAthatAcoversAdrugs,AbutAsheAc


ouldAkeepAherAMedigapApolicyAandAenrollAinAaAPartADAprescriptionAdrugAplan.

Mrs.AChenAwillAbeA65Asoon,AhasAbeenAaAcitizenAforAtwelveAyears,AhasAbeenAemployedAfullAtime,A
andApaidAtaxesAduringAthatAentireAperiod.ASheAisAconcernedAthatAsheAwillAnotAqualifyAforAcover
ageAunderApartAAAbecauseAsheAwasAnotAbornAinAtheAUnitedAStates.AWhatAshouldAyouAtellAher?A-
AcorrectAanswersMostAindividualsAwhoAareAcitizensAandAageA65AorAoverAareAcoveredAunderAPar


tAAAbyAvirtueAofAhavingApaidAMedicareAtaxesAwhileAworking,AthoughAsomeAmayAbeAcoveredAasA
aAresultAofApayingAmonthlyApremiums.

Mr.AXiAwillAsoonAturnAageA65AandAhasAcomeAtoAyouAforAadviceAasAtoAwhatAservicesAareAprovided
AunderAOriginalAMedicare.AWhatAshouldAyouAtellAMr.AXiAthatAbestAdescribesAtheAhealthAcoverag


eAprovidedAtoAMedicareAbeneficiaries?A-