AHIP FINAL TEST EXAM LATEST 2026 STUDY QUESTIONS
NEWEST VERSION WITH VERIFIED ANSWERS UPDATE
100% GUARANTEED PASS | RATED A+
Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from his
investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His
friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would
like to join that plan. What should you tell him? - Answer>>> SNPs limit enrollment to certain
subpopulations of beneficiaries. Given his current situation, he is unlikely to qualify and would
not be able to enroll in the SNP.
You have approached a hospital administrator about marketing in her facility. The administrator
is uncomfortable with the suggestion. How could you address her concerns? - Answer>>> Tell
her that Medicare guidelines allow you to conduct marketing activities in common areas of a
provider's facility.
You are visiting with Mr. Tully and his daughter at her request. He has advanced Alzheimer's
and is incapable of understanding the implications of choosing a Medicare Advantage or
prescription drug plan. Can his daughter fill out the enrollment form and sign it for him? -
Answer>>> Mr. Tully's daughter can do so only, if she is authorized under state law as a court-
appointed legal guardian, has a durable power of attorney for health care decisions, or is
authorized under state surrogate consent laws to make health decisions.
Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is concerned
about the Part D premium penalty if he does not enroll in a Medicare prescription drug plan, but
does not want to purchase extra coverage that he will not need. What should you tell him? -
Answer>>> If the drug coverage he has is not expected to pay, on average, at least as much as
Medicare's standard Part D coverage expects to pay, then he will need to enroll in Medicare Part
D during his initial eligibility period to avoid the late enrollment penalty.
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. Shapiro gets by on a very small amount of fixed income. He has heard there may be extra
help paying for Part D prescription drugs for Medicare beneficiaries with limited income. He
wants to know whether he might qualify. What should you tell him? - Answer>>> The extra help
is available to beneficiaries whose income and assets do not exceed annual limits specified by
the government.
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.
Mrs. Quinn has just turned 65, is in excellent health and has a relatively high income. She uses
no medications and sees no reason to spend money on a Medicare prescription drug plan if she
does not need the coverage. She currently does not have creditable coverage. What could you tell
her about the implications of such a decision? - Answer>>> If she does not sign up for a
Medicare prescription drug plan as soon as she is eligible to do so, and if she does sign up at a
later date, her premium will be permanently increased by 1% of the national average premium
for every month that she was not covered.
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.
, Mr. Ziegler is turning 65 next month and has asked you what he can do, and when he must do it,
with respect to enrolling in Part D. What could you tell him? - Answer>>> He is currently in the
Part D Initial Enrollment Period (IEP) and, during this time, he may make one Part D enrollment
choice, including enrollment in a stand-alone Part D plan or an MA-PD plan.
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to work and is
covered by an employer health plan, he has not enrolled in Part B or Part D. He receives a notice
on June 1 that his employer is cutting back on prescription drug benefits and that as of July 1 his
coverage will no longer be creditable. He has come to you for advice. What advice would you
give Mr. Rockwell about special election periods (SEPs)? - Answer>>> Mr. Rockwell is eligible
for a SEP due to his involuntary loss of creditable drug coverage; the SEP begins in June and
ends on September 1- two months after the loss of creditable coverage.
This year you decide to focus your efforts on marketing to employer and union groups. Which of
the following statements best describes what you can and cannot do in order to stay in
compliance? - Answer>>> You are not required to submit communication and marketing
materials specific only to those employer plans to CMS at the time of use, but CMS may request
and review copies if employee complaints occur.
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? - Answer>>> To obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher incomes.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - Answer>>> She should contact her state Medicaid agency to see if
she qualifies for one of several programs that can help with Medicare costs for which she is
responsible.
Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE). This
coverage has recently been terminated due to the end of the PHE. While Shirley was enrolled in
Medicaid, she missed an opportunity to enroll in Medicare and now wants Part B. Which of the
following statements best describes Shirley's ability to now enroll in Medicare Part B? -
Answer>>> Shirley is eligible for a Special Enrollment Period (SEP) for up to six months after
NEWEST VERSION WITH VERIFIED ANSWERS UPDATE
100% GUARANTEED PASS | RATED A+
Mr. Greco is in excellent health, lives in his own home, and has a sizeable income from his
investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan (SNP). His
friend has mentioned that the SNP charges very low cost-sharing amounts and Mr. Greco would
like to join that plan. What should you tell him? - Answer>>> SNPs limit enrollment to certain
subpopulations of beneficiaries. Given his current situation, he is unlikely to qualify and would
not be able to enroll in the SNP.
You have approached a hospital administrator about marketing in her facility. The administrator
is uncomfortable with the suggestion. How could you address her concerns? - Answer>>> Tell
her that Medicare guidelines allow you to conduct marketing activities in common areas of a
provider's facility.
You are visiting with Mr. Tully and his daughter at her request. He has advanced Alzheimer's
and is incapable of understanding the implications of choosing a Medicare Advantage or
prescription drug plan. Can his daughter fill out the enrollment form and sign it for him? -
Answer>>> Mr. Tully's daughter can do so only, if she is authorized under state law as a court-
appointed legal guardian, has a durable power of attorney for health care decisions, or is
authorized under state surrogate consent laws to make health decisions.
Mr. Hutchinson has drug coverage through his former employer's retiree plan. He is concerned
about the Part D premium penalty if he does not enroll in a Medicare prescription drug plan, but
does not want to purchase extra coverage that he will not need. What should you tell him? -
Answer>>> If the drug coverage he has is not expected to pay, on average, at least as much as
Medicare's standard Part D coverage expects to pay, then he will need to enroll in Medicare Part
D during his initial eligibility period to avoid the late enrollment penalty.
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. Shapiro gets by on a very small amount of fixed income. He has heard there may be extra
help paying for Part D prescription drugs for Medicare beneficiaries with limited income. He
wants to know whether he might qualify. What should you tell him? - Answer>>> The extra help
is available to beneficiaries whose income and assets do not exceed annual limits specified by
the government.
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.
Mrs. Quinn has just turned 65, is in excellent health and has a relatively high income. She uses
no medications and sees no reason to spend money on a Medicare prescription drug plan if she
does not need the coverage. She currently does not have creditable coverage. What could you tell
her about the implications of such a decision? - Answer>>> If she does not sign up for a
Medicare prescription drug plan as soon as she is eligible to do so, and if she does sign up at a
later date, her premium will be permanently increased by 1% of the national average premium
for every month that she was not covered.
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.
, Mr. Ziegler is turning 65 next month and has asked you what he can do, and when he must do it,
with respect to enrolling in Part D. What could you tell him? - Answer>>> He is currently in the
Part D Initial Enrollment Period (IEP) and, during this time, he may make one Part D enrollment
choice, including enrollment in a stand-alone Part D plan or an MA-PD plan.
Mr. Rockwell, age 67, is enrolled in Medicare Part A, but because he continues to work and is
covered by an employer health plan, he has not enrolled in Part B or Part D. He receives a notice
on June 1 that his employer is cutting back on prescription drug benefits and that as of July 1 his
coverage will no longer be creditable. He has come to you for advice. What advice would you
give Mr. Rockwell about special election periods (SEPs)? - Answer>>> Mr. Rockwell is eligible
for a SEP due to his involuntary loss of creditable drug coverage; the SEP begins in June and
ends on September 1- two months after the loss of creditable coverage.
This year you decide to focus your efforts on marketing to employer and union groups. Which of
the following statements best describes what you can and cannot do in order to stay in
compliance? - Answer>>> You are not required to submit communication and marketing
materials specific only to those employer plans to CMS at the time of use, but CMS may request
and review copies if employee complaints occur.
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? - Answer>>> To obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher incomes.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs. Park
that might be of assistance? - Answer>>> She should contact her state Medicaid agency to see if
she qualifies for one of several programs that can help with Medicare costs for which she is
responsible.
Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE). This
coverage has recently been terminated due to the end of the PHE. While Shirley was enrolled in
Medicaid, she missed an opportunity to enroll in Medicare and now wants Part B. Which of the
following statements best describes Shirley's ability to now enroll in Medicare Part B? -
Answer>>> Shirley is eligible for a Special Enrollment Period (SEP) for up to six months after
