AHIP 2026 Exams 200 questions and answers graded
A+
AHIP 2026 Exams 200 questions and answers graded
A+
1. 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.
2. Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could you tell
Mrs. Cook that might be of assistance?
- She should contact her state Medicaid agency to see if she qualifies for one of the
several programs that can help with Medicare costs for which she is responsible.
3. 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?
- 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.
4. 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?
- 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.
5. 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?
- Mr. Wu may still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance program (SPAP).
6. Ms. Henderson believes that she will qualify for Medicare Coverage when she turns
65, without paying any premiums, because she has been working for 40 years and
paying Medicare taxes. What should you tell her?
- To obtain Part B coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher income.
7. 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?
- Tell prospect Jerry Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage.
8. Madeline Martinez was widowed several years ago. Her husband worked for many
years and contributed into the Medicare system. He also left a substantial estate which
provides Madeline with an annual income of approximately $130,000. Madeline, who
has only worked part-time for the last three years, will soon turn age 65 and hopes to
enroll in Original Medicare. She comes to you for advice. What should you tell her?
- You should tell Madeline that she will be able to enroll in Medicare Part A without
paying monthly premiums due to her husband's long work record and participation in the
Medicare system. You should also tell Madeline that she will pay Part B premiums at
more than the standard lowest rate but less than the highest rate due her substantial
income.
,9. 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?
- 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.
10. Edward 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?
- 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.
11. Mrs. Thomas is 66 years old, has coverage under an employer plan, and will retire
next year. She heard she must enroll in Part B at the beginning of the year to ensure no
gap in coverage. What can you tell her?
- She may enroll at any time while she is covered under her employer plan, but she
will have a special eight-month enrollment period after the last month on her employer
plan that differs from the standard general enrollment period, during which she may
enroll in Medicare Part B.
12. Ms. Lewis has aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her?
- Medicare covers hospice services, and they will be available for her.
13. 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?
, - After receiving such disability payments for 24 months, he will be automatically
enrolled in Medicare, regardless of age.
14. Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?
- 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.
15. 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 has been automatically enrolled in Medicare Part B. She wants to
understand what this means. What should you tell her?
- Part B primarily covers physician services. She will be paying a monthly premium
and, except for many preventive screening and tests, generally will have 20% co-
payments for these services in addition to an annual deductible.
16. 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?
- 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 premium-free Part A at any time and his Part A
coverage will be retroactive for up to 6 months.
17. 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?
A+
AHIP 2026 Exams 200 questions and answers graded
A+
1. 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.
2. Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could you tell
Mrs. Cook that might be of assistance?
- She should contact her state Medicaid agency to see if she qualifies for one of the
several programs that can help with Medicare costs for which she is responsible.
3. 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?
- 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.
4. 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?
- 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.
5. 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?
- Mr. Wu may still qualify for help in paying Part D costs through his State
Pharmaceutical Assistance program (SPAP).
6. Ms. Henderson believes that she will qualify for Medicare Coverage when she turns
65, without paying any premiums, because she has been working for 40 years and
paying Medicare taxes. What should you tell her?
- To obtain Part B coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher income.
7. 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?
- Tell prospect Jerry Smith that he should consider adding a standalone Part D
prescription drug coverage policy to his present coverage.
8. Madeline Martinez was widowed several years ago. Her husband worked for many
years and contributed into the Medicare system. He also left a substantial estate which
provides Madeline with an annual income of approximately $130,000. Madeline, who
has only worked part-time for the last three years, will soon turn age 65 and hopes to
enroll in Original Medicare. She comes to you for advice. What should you tell her?
- You should tell Madeline that she will be able to enroll in Medicare Part A without
paying monthly premiums due to her husband's long work record and participation in the
Medicare system. You should also tell Madeline that she will pay Part B premiums at
more than the standard lowest rate but less than the highest rate due her substantial
income.
,9. 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?
- 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.
10. Edward 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?
- 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.
11. Mrs. Thomas is 66 years old, has coverage under an employer plan, and will retire
next year. She heard she must enroll in Part B at the beginning of the year to ensure no
gap in coverage. What can you tell her?
- She may enroll at any time while she is covered under her employer plan, but she
will have a special eight-month enrollment period after the last month on her employer
plan that differs from the standard general enrollment period, during which she may
enroll in Medicare Part B.
12. Ms. Lewis has aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her?
- Medicare covers hospice services, and they will be available for her.
13. 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?
, - After receiving such disability payments for 24 months, he will be automatically
enrolled in Medicare, regardless of age.
14. Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare
Advantage plan. What should you tell him?
- 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.
15. 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 has been automatically enrolled in Medicare Part B. She wants to
understand what this means. What should you tell her?
- Part B primarily covers physician services. She will be paying a monthly premium
and, except for many preventive screening and tests, generally will have 20% co-
payments for these services in addition to an annual deductible.
16. 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?
- 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 premium-free Part A at any time and his Part A
coverage will be retroactive for up to 6 months.
17. 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?
