AHIP 2026 Final Exam
AHIP 2026 Final Exam
Study online at https://quizlet.com/_hlcd2p
1. Mr. Arias, a naturalized citizen, previously He is not eligible to enroll in a Medicare Ad-
enrolled in Medicare Part B but has re- vantage plan until he re-enrolls in Medicare
cently stopped paying his Part B premi- Part B.
um. Mr. Arias is still covered by Part A. He
would like to enroll in a Medicare Advan-
tage (MA) plan and is still covered by Part
A. What should you tell him?
2. Mrs. Joy, age 65, is entitled to Part A but To join a Medicare Advantage plan, she also
has not yet enrolled in Part B. She is con- must enroll in Part B.
sidering enrolling in a Medicare Advan-
tage plan (Part C). What should you ad-
vise her to do before she can enroll in a
Medicare Advantage plan?
3. Mr. Kumar is considering a Medicare Ad- In most Medicare Advantage HMOs, Mr. Ku-
vantage HMO and has questions about mar must generally obtain his services only
his ability to access providers. What from providers within the plan's network (ex-
should you tell him? cept in an emergency or where care is un-
available within the network).
4. Mrs. Robles is considering a Medicare Ad- Mrs. Robles can obtain care from any provider
vantage PPO and has questions about who participates in Original Medicare, but
which providers she can go to for her generally will have a higher cost-sharing
health care. What should you tell her? amount if she sees a provider who/that is not
a part of the PPO network.
5. Mrs. Lester is age 75 and enjoys a com- Mrs. Lester may enroll in an MA MSA plan
fortable but not extremely high-income and remain in her current standalone Part D
level. She wishes to enroll in an MA MSA prescription drug plan.
plan that she heard about from her neigh-
bor. She also wants to have prescription
, AHIP 2026 Final Exam
AHIP 2026 Final Exam
Study online at https://quizlet.com/_hlcd2p
drug coverage since her doctor recent-
ly prescribed several expensive medica-
tions. Currently, she is enrolled in Original
Medicare and a standalone Part D plan.
How would you advise Mrs. Lester?
6. Mr. Dalton is in excellent health, lives in SNPs limit enrollment to certain subpopula-
his own home, and has a sizeable in- tions of beneficiaries. Given his current situ-
come from his investments. He has a ation, he is unlikely to qualify and would not
friend enrolled in a Medicare Advantage be able to enroll in the SNP.
Special Needs Plan (SNP). His friend has
mentioned that the SNP charges very
low cost-sharing amounts and Mr. Dalton
would like to join that plan. What should
you tell him?
7. Mr. Anderson wants to know whether he is You would need to ask Mr. Anderson if he is
eligible to sign up for a Private fee-for-ser- entitled to Part A, enrolled in Part B, and if he
vice (PFFS) plan. What questions would lives in the PFFS plan's service area.
you need to ask to determine his eligibili-
ty?
8. Herber Noble is turning 65 next month, Herber is eligible to enroll in Medicare Advan-
Herber legally entered the United States tage as long as he is entitled to Part A and en-
over twenty years ago but is not a citizen. rolled in Part B. Herber should go to the Social
Since his entry into the country, Herber Security website to enroll in Medicare Part A
has worked at Smallcap Incorporated and and B if he has not done so already. Once he
contributed to the Medicare system. Her- is enrolled, he can choose a Medicare Advan-
ber suffers from diabetes. He will soon tage plan.
retire and asks you if he can enroll in a
Medicare Advantage plan that you repre-
sent. How would you respond?
AHIP 2026 Final Exam
Study online at https://quizlet.com/_hlcd2p
1. Mr. Arias, a naturalized citizen, previously He is not eligible to enroll in a Medicare Ad-
enrolled in Medicare Part B but has re- vantage plan until he re-enrolls in Medicare
cently stopped paying his Part B premi- Part B.
um. Mr. Arias is still covered by Part A. He
would like to enroll in a Medicare Advan-
tage (MA) plan and is still covered by Part
A. What should you tell him?
2. Mrs. Joy, age 65, is entitled to Part A but To join a Medicare Advantage plan, she also
has not yet enrolled in Part B. She is con- must enroll in Part B.
sidering enrolling in a Medicare Advan-
tage plan (Part C). What should you ad-
vise her to do before she can enroll in a
Medicare Advantage plan?
3. Mr. Kumar is considering a Medicare Ad- In most Medicare Advantage HMOs, Mr. Ku-
vantage HMO and has questions about mar must generally obtain his services only
his ability to access providers. What from providers within the plan's network (ex-
should you tell him? cept in an emergency or where care is un-
available within the network).
4. Mrs. Robles is considering a Medicare Ad- Mrs. Robles can obtain care from any provider
vantage PPO and has questions about who participates in Original Medicare, but
which providers she can go to for her generally will have a higher cost-sharing
health care. What should you tell her? amount if she sees a provider who/that is not
a part of the PPO network.
5. Mrs. Lester is age 75 and enjoys a com- Mrs. Lester may enroll in an MA MSA plan
fortable but not extremely high-income and remain in her current standalone Part D
level. She wishes to enroll in an MA MSA prescription drug plan.
plan that she heard about from her neigh-
bor. She also wants to have prescription
, AHIP 2026 Final Exam
AHIP 2026 Final Exam
Study online at https://quizlet.com/_hlcd2p
drug coverage since her doctor recent-
ly prescribed several expensive medica-
tions. Currently, she is enrolled in Original
Medicare and a standalone Part D plan.
How would you advise Mrs. Lester?
6. Mr. Dalton is in excellent health, lives in SNPs limit enrollment to certain subpopula-
his own home, and has a sizeable in- tions of beneficiaries. Given his current situ-
come from his investments. He has a ation, he is unlikely to qualify and would not
friend enrolled in a Medicare Advantage be able to enroll in the SNP.
Special Needs Plan (SNP). His friend has
mentioned that the SNP charges very
low cost-sharing amounts and Mr. Dalton
would like to join that plan. What should
you tell him?
7. Mr. Anderson wants to know whether he is You would need to ask Mr. Anderson if he is
eligible to sign up for a Private fee-for-ser- entitled to Part A, enrolled in Part B, and if he
vice (PFFS) plan. What questions would lives in the PFFS plan's service area.
you need to ask to determine his eligibili-
ty?
8. Herber Noble is turning 65 next month, Herber is eligible to enroll in Medicare Advan-
Herber legally entered the United States tage as long as he is entitled to Part A and en-
over twenty years ago but is not a citizen. rolled in Part B. Herber should go to the Social
Since his entry into the country, Herber Security website to enroll in Medicare Part A
has worked at Smallcap Incorporated and and B if he has not done so already. Once he
contributed to the Medicare system. Her- is enrolled, he can choose a Medicare Advan-
ber suffers from diabetes. He will soon tage plan.
retire and asks you if he can enroll in a
Medicare Advantage plan that you repre-
sent. How would you respond?
