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AHIP EXAM 1 (FULL TEST) || 2025 ACTUAL
EXAM ALL QUESTIONS AND 100% CORRECT
ANSWERS GRADE A+|| LATEST AND COMPLETE
UPDATED VERSION 2025|| GUARANTEED PASS!!!
Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan
and was disappointed with the service she received from her primary care
physician because she was told she would have to wait five weeks to get an
appointment when she was feeling ill. She called you to ask what she could do so
she would not have to put up with such poor access to care.
What could you tell her? ANSWER- She could file a grievance with her plan to
complain about the lack of timeliness in getting an appointment.
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.
Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the
paper that explains what he could do during the SEP. What can you tell him?
ANSWER- If the SEP is for MA coverage, he will generally have one opportunity
to change his MA coverage.
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Mr. Yoo's employer has recently dropped comprehensive creditable prescription
drug coverage that was offered to company retirees. The company told Mr. Yoo
that, because he was affected by this change, he would qualify for a special
election period. Mr. Yoo contacted you to find out more about what this means.
What can you tell him? ANSWER- It means that he qualifies for a one-time
opportunity to enroll in an MA-PD or Part D prescription drug plan.
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon.
He would like to know his options since he has decided to drop his retiree coverage
and is eligible for Medicare. What should you tell him? ANSWER- Mr. Chen can
disenroll from his employer- sponsored coverage to elect a Medicare Advantage or
Part D plan within 2 months of his disenrollment.
Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to
come to their home to clear up a few questions. During the presentation, Mrs.
Nunez feels tired and tells you that her husband can finish things up. She goes to
bed. At the end of your discussion, Mr. Nunez says that he wants to enroll both
himself and his wife. What should you do? ANSWER- As long as she can do so,
only Mrs. Nunez can sign her enrollment form. Mrs. Nunez will have to wake up
to sign her form or do so at another time.
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible
for Medicare Part A and did not enroll for Part B when first eligible because she
has insurance through her employer - Coffee Brew, Inc. She also did not enroll in
Part D because she had creditable coverage. She would like to retire in June and
enroll in a Medicare Advantage plan. She has been informed that her group
coverage will end on her retirement effective date. How would you advise Ms.
Thomas? ANSWER- Ms. Thomas can enroll in Part B without a late penalty at
any time she is still covered by her employer group and 8 months after her last
month of employer group coverage without a penalty. However, because she wants
to enroll in a MA plan after retirement, she should make sure her Part B coverage
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is effective in t ime to use the Medicare Advantage/Part D special election period
for individuals changing from employer group coverage to enroll in a MA plan or
MA-PD. The SEP begins while she has employer group coverage and will last
until 2 months after the month after the month her employer coverage ends. If she
wants Part D coverage she should enroll in an MA-PD or a PDP (depending on
how she decides to receive her Part A and B benefits) during this time.
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his
first Medicare eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin
on March 1 and end on September 30. He wants prescription drug coverage with
his Part A and Part B benefits. What advice can you provide him? ANSWER- He
can enroll in a MA-PD as long as he enrolls in Part B and is entitled to Part A.
Which of the following individuals are likely to qualify for a special election
period (SEP) for either a MA and/or Part D due to a change of residence?
I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside
her existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan
available to him from a service area where no Part D plan was available.
IV. Henry makes a permanent move to a new state providing him with new MA
and Part D options. ANSWER- II, III, and IV only.
Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D
prescription drug coverage. She comes to you for advice about when she can enroll
in a plan you have previously discussed. What should you tell her? ANSWER-
Enrollment in Cost plans offering Part D
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coverage is available only during enrollment periods under the Part D program,
and Cost plans must accept enrollments during these periods.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original
Medicare for the last six years due to her disability and has never been enrolled in
a Medicare Advantage or a Part D plan before. She wants to enroll in a Part D plan.
She knows that there is such a thing as the "Part D Initial Enrollment Period" (IEP)
and has concluded that, since she has never enrolled in such a plan before, she
should be eligible to enroll under this period. What should you tell her about how
the Part D Initial Enrollment Period applies to her situation? ANSWER- Ms.
Claggett has had two IEPs and missed them both. The first occurred three months
before and three months after the month when she was first entitled to Part A OR
enrolled in Part B. Because she was eligible for Medicare before age 65, Ms.
Claggett had a second IEP based on turning age 65, which has also expired.
Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage following her
retirement several years ago. Four months ago, Mrs. Ridgeway dropped her
Medigap policy to enroll in a Medicare Advantage (MA) plan for the first time.
Unfortunately, Mrs. Ridgeway has found that many of her providers are not in the
MA plan's network. She has come to you for advice. What should you tell her?
ANSWER- She qualifies for a special election period (SEP) that will allow her to
make a one-time election to return to Original Medicare and she also has a
guaranteed eligibility period to rejoin her Medigap plan.
Ms. Lee is enrolled in an MA-PD plan but will be moving out of the plan's service
area next month. She is worried that she will not be able to enroll in another plan
available in her new residence until the Annual Election Period. What should you
tell her? ANSWER- She is eligible for a special election period (SEP) that begins
AHIP EXAM 1 (FULL TEST) || 2025 ACTUAL
EXAM ALL QUESTIONS AND 100% CORRECT
ANSWERS GRADE A+|| LATEST AND COMPLETE
UPDATED VERSION 2025|| GUARANTEED PASS!!!
Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD plan
and was disappointed with the service she received from her primary care
physician because she was told she would have to wait five weeks to get an
appointment when she was feeling ill. She called you to ask what she could do so
she would not have to put up with such poor access to care.
What could you tell her? ANSWER- She could file a grievance with her plan to
complain about the lack of timeliness in getting an appointment.
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.
Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the
paper that explains what he could do during the SEP. What can you tell him?
ANSWER- If the SEP is for MA coverage, he will generally have one opportunity
to change his MA coverage.
,2|Page
Mr. Yoo's employer has recently dropped comprehensive creditable prescription
drug coverage that was offered to company retirees. The company told Mr. Yoo
that, because he was affected by this change, he would qualify for a special
election period. Mr. Yoo contacted you to find out more about what this means.
What can you tell him? ANSWER- It means that he qualifies for a one-time
opportunity to enroll in an MA-PD or Part D prescription drug plan.
Mr. Chen is enrolled in his employer's group health plan and will be retiring soon.
He would like to know his options since he has decided to drop his retiree coverage
and is eligible for Medicare. What should you tell him? ANSWER- Mr. Chen can
disenroll from his employer- sponsored coverage to elect a Medicare Advantage or
Part D plan within 2 months of his disenrollment.
Mr. and Mrs. Nunez attended one of your sales presentations. They've asked you to
come to their home to clear up a few questions. During the presentation, Mrs.
Nunez feels tired and tells you that her husband can finish things up. She goes to
bed. At the end of your discussion, Mr. Nunez says that he wants to enroll both
himself and his wife. What should you do? ANSWER- As long as she can do so,
only Mrs. Nunez can sign her enrollment form. Mrs. Nunez will have to wake up
to sign her form or do so at another time.
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible
for Medicare Part A and did not enroll for Part B when first eligible because she
has insurance through her employer - Coffee Brew, Inc. She also did not enroll in
Part D because she had creditable coverage. She would like to retire in June and
enroll in a Medicare Advantage plan. She has been informed that her group
coverage will end on her retirement effective date. How would you advise Ms.
Thomas? ANSWER- Ms. Thomas can enroll in Part B without a late penalty at
any time she is still covered by her employer group and 8 months after her last
month of employer group coverage without a penalty. However, because she wants
to enroll in a MA plan after retirement, she should make sure her Part B coverage
,3|Page
is effective in t ime to use the Medicare Advantage/Part D special election period
for individuals changing from employer group coverage to enroll in a MA plan or
MA-PD. The SEP begins while she has employer group coverage and will last
until 2 months after the month after the month her employer coverage ends. If she
wants Part D coverage she should enroll in an MA-PD or a PDP (depending on
how she decides to receive her Part A and B benefits) during this time.
Mr. Liu turns 65 on June 19. He has never previously qualified for Medicare so his
first Medicare eligibility date will be June 1. Mr. Liu's ICEP and Part D IEP begin
on March 1 and end on September 30. He wants prescription drug coverage with
his Part A and Part B benefits. What advice can you provide him? ANSWER- He
can enroll in a MA-PD as long as he enrolls in Part B and is entitled to Part A.
Which of the following individuals are likely to qualify for a special election
period (SEP) for either a MA and/or Part D due to a change of residence?
I. Edward (enrolled in MA and Part D) moves to a new home within the same
neighborhood in his existing plan's service area.
II. Fiona (enrolled in MA and Part D) moves cross-country to an area outside
her existing plan's service area.
III. Gilbert moves into a plan service area where there is now a Part D plan
available to him from a service area where no Part D plan was available.
IV. Henry makes a permanent move to a new state providing him with new MA
and Part D options. ANSWER- II, III, and IV only.
Mrs. Pierce would like to enroll in a Medicare Cost plan that offers Part D
prescription drug coverage. She comes to you for advice about when she can enroll
in a plan you have previously discussed. What should you tell her? ANSWER-
Enrollment in Cost plans offering Part D
, 4|Page
coverage is available only during enrollment periods under the Part D program,
and Cost plans must accept enrollments during these periods.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original
Medicare for the last six years due to her disability and has never been enrolled in
a Medicare Advantage or a Part D plan before. She wants to enroll in a Part D plan.
She knows that there is such a thing as the "Part D Initial Enrollment Period" (IEP)
and has concluded that, since she has never enrolled in such a plan before, she
should be eligible to enroll under this period. What should you tell her about how
the Part D Initial Enrollment Period applies to her situation? ANSWER- Ms.
Claggett has had two IEPs and missed them both. The first occurred three months
before and three months after the month when she was first entitled to Part A OR
enrolled in Part B. Because she was eligible for Medicare before age 65, Ms.
Claggett had a second IEP based on turning age 65, which has also expired.
Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage following her
retirement several years ago. Four months ago, Mrs. Ridgeway dropped her
Medigap policy to enroll in a Medicare Advantage (MA) plan for the first time.
Unfortunately, Mrs. Ridgeway has found that many of her providers are not in the
MA plan's network. She has come to you for advice. What should you tell her?
ANSWER- She qualifies for a special election period (SEP) that will allow her to
make a one-time election to return to Original Medicare and she also has a
guaranteed eligibility period to rejoin her Medigap plan.
Ms. Lee is enrolled in an MA-PD plan but will be moving out of the plan's service
area next month. She is worried that she will not be able to enroll in another plan
available in her new residence until the Annual Election Period. What should you
tell her? ANSWER- She is eligible for a special election period (SEP) that begins
