AHIP Final Exam with Question And
Answers 100% Verified (Guarantee A+)
2025/2026
1. 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? - ANSWER>>Mr. Wu may still qualify for
help in paying Part D costs through his State Pharmaceutical Assistance
Program.
2. 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? - ANSWER>>After receiving
such disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age.
3. Mildred Savage enrolled in Allcare Medicare Advantage plan several years
ago. Mildred recently learned that she is suffering from inoperable cancer
and has just a few months to live. She would like to spend these final
months in hospice care. Mildred's family asks you whether hospice benefits
will be paid for under the Allcare Medicare Advantage plan. What should
you say? - ANSWER>>Mildred may remain enrolled in Allcare and make a
hospice election. Hospice benefits will be paid for by Original Medicare
under Part A and Allcare will continue to pay for any non-hospice services.
4. 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? - ANSWER>>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.
5. 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? - ANSWER>>Tell prospect Jerry Smith that he
should consider adding a standalone Part D prescription drug coverage
policy to his present coverage.
6. Mr. Davis is 52 years old and has recently been diagnosed with end-stage
renal disease (ESRD) and will soon begin dialysis. He is wondering if he can
obtain coverage under Medicare. What should you tell him? -
ANSWER>>He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
7. Mr. Diaz continued working with his company and was insured under his
employer's group plan until he reached age 68. He has heard that there is a
premium penalty for those who did not sign up for Part B when first eligible
and wants to know how much he will have to pay. What should you tell
him? - ANSWER>>Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's plan.
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? -
, ANSWER>>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. 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.
10.Mrs. Peňa 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? - ANSWER>>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.
11.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? - 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.
Answers 100% Verified (Guarantee A+)
2025/2026
1. 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? - ANSWER>>Mr. Wu may still qualify for
help in paying Part D costs through his State Pharmaceutical Assistance
Program.
2. 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? - ANSWER>>After receiving
such disability payments for 24 months, he will be automatically enrolled in
Medicare, regardless of age.
3. Mildred Savage enrolled in Allcare Medicare Advantage plan several years
ago. Mildred recently learned that she is suffering from inoperable cancer
and has just a few months to live. She would like to spend these final
months in hospice care. Mildred's family asks you whether hospice benefits
will be paid for under the Allcare Medicare Advantage plan. What should
you say? - ANSWER>>Mildred may remain enrolled in Allcare and make a
hospice election. Hospice benefits will be paid for by Original Medicare
under Part A and Allcare will continue to pay for any non-hospice services.
4. 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? - ANSWER>>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.
5. 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? - ANSWER>>Tell prospect Jerry Smith that he
should consider adding a standalone Part D prescription drug coverage
policy to his present coverage.
6. Mr. Davis is 52 years old and has recently been diagnosed with end-stage
renal disease (ESRD) and will soon begin dialysis. He is wondering if he can
obtain coverage under Medicare. What should you tell him? -
ANSWER>>He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
7. Mr. Diaz continued working with his company and was insured under his
employer's group plan until he reached age 68. He has heard that there is a
premium penalty for those who did not sign up for Part B when first eligible
and wants to know how much he will have to pay. What should you tell
him? - ANSWER>>Mr. Diaz will not pay any penalty because he had
continuous coverage under his employer's plan.
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? -
, ANSWER>>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. 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.
10.Mrs. Peňa 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? - ANSWER>>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.
11.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? - 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.
