AHIP Exam Study Questions
And Answers 2025-2026
GRADED A +
Ms. Moore 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? - ANS-Medicare is a program for people age 65 or older &
those age under 65 with certain disabilities; ESRD, & ALS so she will be eligible
for Medicare.
Mrs. Chen will be 65 soon, has been a citizen for 12 years, has been employed
full-time, & paid taxes during the entire period. She is concerned that she will not
qualify for coverage under Part A because she was not born in the U.S. what
should you tell her? - ANS-Most people who are citizens & age 65 and older are
covered under Part A by virtue of having paid Medicare taxes while working,
though some may be covered as a result of paying monthly premiums.
Mr. Patel is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the healthcare costs he
might be exposed under Medicare if he were to require hospitalization as a result
of an illness. What could you tell him about his costs for inpatient hospital
services under OG Medicare? - ANS-Under OG 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.
Mrs. Park is an elderly retiree and has a low fixed income. Would could you tell
Mrs. Park that may help her? - ANS-She could contact her state Medicaid to see if
she qualifies for one of several programs that can help with Medicare costs for
which she is responsible.
Mr. Schmidt would like to plan for retirement and has asked you what is covered
under OG Medicare? What would you tell him? - ANS-Part A covers hospital, SNF,
hospice, & home health services & Part B, which covers professional services
such as those provided by a doctor are covered under OG Medicare
, Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through massage therapy. She is concerned whether or not
Medicare will cover these items. What should you tell her? - ANS-Medicare does
not cover massage therapy or in general glasses or dentures
Mr. A receives some help paying for his 2 generic prescr. drugs from his
employer's retiree coverage, but he wants to compare it to Part D PDP. He asks
you what costs he would generally encounter when enrolling into a standard
Medicare Pt D drug plan? what should you tell him? - ANS-He would generally
pay a monthly premium, annual ded., & prescr. cost-sharing.
Mrs. P is 66 years old, has coverage under an employer plan, & will retire next
year. She heard she must enroll in Pt B at the beginning of the year to ensure no
gap in coverage. What can you tell her? - ANS-She may enroll at anytime while
she is covered under her employer plan, but she will have an 8 month enrollment
period after the last month her employer plan that differs from the standard GEP,
during which she may enroll in Med Pt B
Mrs. G is enrolled in a OG med & has a Medigap policy as well, but it provides no
drug coverage. She would like to keep the coverage she has but keep the
coverage that she has but replace her existing Medigap with one that provides
drug coverage. What would you tell her? - ANS-Mrs. G can not purchase a
Medigap plan that covers drugs, she she could keep her medigap policy & enroll
in a Pt D PDP
Mr. D is 52 years old & has recently been diagnosed with ESRD & will soon begin
dialysis. He is wondering if he can get coverage under Medicare. What should
you tell him? - ANS-He may sign up for Medicare at anytime, however coverage
usually begins on the 4th month after dialysis tx begins.
Mr. H believes that she will qualify for Medicare when she turns 65 without
paying any premiums bc she has worked 40 years & paid Medicare taxes. What
should you tell her? - ANS-To get Pt B coverage, she must pay a standard
monthly premium, though it is higher for people with higher incomes.
Mr. C would like to purchase a MA plan & a Medigap plan. what should you tell
him? - ANS-It is illegal for you to sell Mr. C a Medigap plan if he is enrolled in an
MA plan. Plus Medigap only works with OG Medicare
And Answers 2025-2026
GRADED A +
Ms. Moore 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? - ANS-Medicare is a program for people age 65 or older &
those age under 65 with certain disabilities; ESRD, & ALS so she will be eligible
for Medicare.
Mrs. Chen will be 65 soon, has been a citizen for 12 years, has been employed
full-time, & paid taxes during the entire period. She is concerned that she will not
qualify for coverage under Part A because she was not born in the U.S. what
should you tell her? - ANS-Most people who are citizens & age 65 and older are
covered under Part A by virtue of having paid Medicare taxes while working,
though some may be covered as a result of paying monthly premiums.
Mr. Patel is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the healthcare costs he
might be exposed under Medicare if he were to require hospitalization as a result
of an illness. What could you tell him about his costs for inpatient hospital
services under OG Medicare? - ANS-Under OG 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.
Mrs. Park is an elderly retiree and has a low fixed income. Would could you tell
Mrs. Park that may help her? - ANS-She could contact her state Medicaid to see if
she qualifies for one of several programs that can help with Medicare costs for
which she is responsible.
Mr. Schmidt would like to plan for retirement and has asked you what is covered
under OG Medicare? What would you tell him? - ANS-Part A covers hospital, SNF,
hospice, & home health services & Part B, which covers professional services
such as those provided by a doctor are covered under OG Medicare
, Mrs. West wears glasses and dentures and has enjoyed considerable pain relief
from arthritis through massage therapy. She is concerned whether or not
Medicare will cover these items. What should you tell her? - ANS-Medicare does
not cover massage therapy or in general glasses or dentures
Mr. A receives some help paying for his 2 generic prescr. drugs from his
employer's retiree coverage, but he wants to compare it to Part D PDP. He asks
you what costs he would generally encounter when enrolling into a standard
Medicare Pt D drug plan? what should you tell him? - ANS-He would generally
pay a monthly premium, annual ded., & prescr. cost-sharing.
Mrs. P is 66 years old, has coverage under an employer plan, & will retire next
year. She heard she must enroll in Pt B at the beginning of the year to ensure no
gap in coverage. What can you tell her? - ANS-She may enroll at anytime while
she is covered under her employer plan, but she will have an 8 month enrollment
period after the last month her employer plan that differs from the standard GEP,
during which she may enroll in Med Pt B
Mrs. G is enrolled in a OG med & has a Medigap policy as well, but it provides no
drug coverage. She would like to keep the coverage she has but keep the
coverage that she has but replace her existing Medigap with one that provides
drug coverage. What would you tell her? - ANS-Mrs. G can not purchase a
Medigap plan that covers drugs, she she could keep her medigap policy & enroll
in a Pt D PDP
Mr. D is 52 years old & has recently been diagnosed with ESRD & will soon begin
dialysis. He is wondering if he can get coverage under Medicare. What should
you tell him? - ANS-He may sign up for Medicare at anytime, however coverage
usually begins on the 4th month after dialysis tx begins.
Mr. H believes that she will qualify for Medicare when she turns 65 without
paying any premiums bc she has worked 40 years & paid Medicare taxes. What
should you tell her? - ANS-To get Pt B coverage, she must pay a standard
monthly premium, though it is higher for people with higher incomes.
Mr. C would like to purchase a MA plan & a Medigap plan. what should you tell
him? - ANS-It is illegal for you to sell Mr. C a Medigap plan if he is enrolled in an
MA plan. Plus Medigap only works with OG Medicare
