AHIP 2026: Modules 1–5, Final Exam & FWA
Study Guide
What happens after Mr. Bauer has received disability payments for 24 months? - correct answers He will be
N N N N N N N N N N N N N N N N N N
automatically enrolled in Medicare, regardless of age. N N N N N N
Why did Edward become eligible for Medicare coverage? - correct answers Due to end-stage renal disease
N N N N N N N N N N N N N N N N
(ESRD).
How long does Medicare coverage generally last for individuals eligible based on ESRD after a kidney
N N N N N N N N N N N N N N N N
transplant? - correct answers Eligibility generally lasts for 36 months after the month in which the individual
N N N N N N N N N N N N N N N N N
receives a kidney transplant.
N N N
What can Edward do regarding Part B coverage after his kidney transplant? - correct answers He may remain
N N N N N N N N N N N N N N N N N N
enrolled in Part B solely for coverage of immunosuppressive drugs if he has no other health care coverage for
N N N N N N N N N N N N N N N N N N N
those drugs.N
What special enrollment option does Anthony have after missing his initial enrollment period due to a
N N N N N N N N N N N N N N N N
disaster? - correct answers He is eligible for a special enrollment period (SEP) to enroll in Part B up to six
N N N N N N N N N N N N N N N N N N N N N
months after the end of the emergency declaration.
N N N N N N N
When can Anthony enroll in premium-free Part A? - correct answers He may enroll in premium-free Part A at
N N N N N N N N N N N N N N N N N N N
any time, with coverage retroactive for up to 6 months.
N N N N N N N N N
,What should you tell Mr. Capadona about purchasing a Medigap plan while enrolled in a Medicare Advantage
N N N N N N N N N N N N N N N N
plan? - correct answers It is illegal to sell him a Medigap plan if he is enrolled in an MA plan, as Medigap only
N N N N N N N N N N N N N N N N N N N N N N N N N
works with Original Medicare. N N N
Will Mildred's hospice care be covered under her Allcare Medicare Advantage plan? - correct answers Yes,
N N N N N N N N N N N N N N N N
hospice benefits will be paid for by Original Medicare under Part A, and Allcare will continue to pay for any
N N N N N N N N N N N N N N N N N N N N
non-hospice services. N
What must Ms. Henderson do to obtain Part B coverage? - correct answers She must pay a standard monthly
N N N N N N N N N N N N N N N N N N N
premium, which may be higher for individuals with higher incomes.
N N N N N N N N N
What assistance can Mrs. Cook seek due to her low fixed income? - correct answers She should contact her
N N N N N N N N N N N N N N N N N N N
state Medicaid agency to see if she qualifies for programs that help with Medicare costs.
N N N N N N N N N N N N N N
What does Medicare Supplemental Insurance cover for Mr. Moy? - correct answers It helps cover his Part A
N N N N N N N N N N N N N N N N N N
deductible and Part B coinsurance or copayments in Original Fee-for-Service (FFS) Medicare.
N N N N N N N N N N N
What is Juan Perez's situation regarding Medicare as he turns 65? - correct answers He intends to work for
N N N N N N N N N N N N N N N N N N N
several more years at Smallcap, which offers employer-sponsored healthcare coverage.
N N N N N N N N N
What is the eligibility requirement for premium-free Part A? - correct answers Individuals must have worked
N N N N N N N N N N N N N N N N
and paid Medicare taxes for a sufficient period, typically 40 quarters.
N N N N N N N N N N
What happens if an individual does not enroll in Medicare during their initial enrollment period? - correct
N N N N N N N N N N N N N N N N N
answers They may qualify for a special enrollment period if they missed it due to certain circumstances, such
N N N N N N N N N N N N N N N N N N
as a natural disaster.
N N N
How does Medicare coverage differ for individuals based on age versus disability? - correct answers
N N N N N N N N N N N N N N N
Individuals under 65 can qualify for Medicare due to disability after 24 months of receiving disability
N N N N N N N N N N N N N N N N
payments, while those 65 and older qualify based on age. N N N N N N N N N
What is the role of Medigap insurance? - correct answers Medigap insurance helps cover costs not covered
N N N N N N N N N N N N N N N N N
by Original Medicare, such as deductibles and coinsurance.
N N N N N N N
, What is the maximum duration of Medicare coverage after a kidney transplant for those eligible due to ESRD?
N N N N N N N N N N N N N N N N N
- correct answers 36 months after the month of the transplant.
N N N N N N N N N N N
What should individuals do if they are unsure about their Medicare eligibility? - correct answers They should
N N N N N N N N N N N N N N N N N
contact the Social Security Administration or their state Medicaid agency for guidance.
N N N N N N N N N N N
What is the significance of a Federally declared disaster in relation to Medicare enrollment? - correct answers
N N N N N N N N N N N N N N N N N
It allows individuals who missed their enrollment period to qualify for a special enrollment period.
N N N N N N N N N N N N N N
What is the difference between Medicare Advantage and Original Medicare regarding coverage? - correct
N N N N N N N N N N N N N N
answers Medicare Advantage plans may offer additional benefits but cannot be combined with Medigap
N N N N N N N N N N N N N N
plans.
What is the importance of immunosuppressive drug coverage for kidney transplant patients? - correct
N N N N N N N N N N N N N N
answers It is critical for preventing organ rejection and maintaining health post-transplant.
N N N N N N N N N N N
How does income affect the premium for Part B coverage? - correct answers Individuals with higher incomes
N N N N N N N N N N N N N N N N N
may pay a higher monthly premium for Part B.
N N N N N N N N
What is Juan likely entitled to when he turns age 65 regarding Medicare? - correct answers Juan is likely to be
N N N N N N N N N N N N N N N N N N N N N
eligible for Medicare. N N
How would enrolling in Medicare impact Juan's employer-sponsored healthcare coverage? - correct answers
N N N N N N N N N N N N
If Juan enrolls, Medicare becomes the primary payor of his healthcare claims, and his employer's plan
N N N N N N N N N N N N N N N N N
becomes a secondary payor. N N N
What eligibility criteria does Ms. Kumar meet for Medicare despite her concerns about income? - correct
N N N N N N N N N N N N N N N N
answers Medicare is available for people age 65 or older, so Ms. Kumar will be eligible regardless of her
N N N N N N N N N N N N N N N N N N N
income.
Will Medicare cover hospice services for Ms. Lewis, who has aggressive cancer? - correct answers Yes,
N N N N N N N N N N N N N N N N
Medicare covers hospice services. N N N
Study Guide
What happens after Mr. Bauer has received disability payments for 24 months? - correct answers He will be
N N N N N N N N N N N N N N N N N N
automatically enrolled in Medicare, regardless of age. N N N N N N
Why did Edward become eligible for Medicare coverage? - correct answers Due to end-stage renal disease
N N N N N N N N N N N N N N N N
(ESRD).
How long does Medicare coverage generally last for individuals eligible based on ESRD after a kidney
N N N N N N N N N N N N N N N N
transplant? - correct answers Eligibility generally lasts for 36 months after the month in which the individual
N N N N N N N N N N N N N N N N N
receives a kidney transplant.
N N N
What can Edward do regarding Part B coverage after his kidney transplant? - correct answers He may remain
N N N N N N N N N N N N N N N N N N
enrolled in Part B solely for coverage of immunosuppressive drugs if he has no other health care coverage for
N N N N N N N N N N N N N N N N N N N
those drugs.N
What special enrollment option does Anthony have after missing his initial enrollment period due to a
N N N N N N N N N N N N N N N N
disaster? - correct answers He is eligible for a special enrollment period (SEP) to enroll in Part B up to six
N N N N N N N N N N N N N N N N N N N N N
months after the end of the emergency declaration.
N N N N N N N
When can Anthony enroll in premium-free Part A? - correct answers He may enroll in premium-free Part A at
N N N N N N N N N N N N N N N N N N N
any time, with coverage retroactive for up to 6 months.
N N N N N N N N N
,What should you tell Mr. Capadona about purchasing a Medigap plan while enrolled in a Medicare Advantage
N N N N N N N N N N N N N N N N
plan? - correct answers It is illegal to sell him a Medigap plan if he is enrolled in an MA plan, as Medigap only
N N N N N N N N N N N N N N N N N N N N N N N N N
works with Original Medicare. N N N
Will Mildred's hospice care be covered under her Allcare Medicare Advantage plan? - correct answers Yes,
N N N N N N N N N N N N N N N N
hospice benefits will be paid for by Original Medicare under Part A, and Allcare will continue to pay for any
N N N N N N N N N N N N N N N N N N N N
non-hospice services. N
What must Ms. Henderson do to obtain Part B coverage? - correct answers She must pay a standard monthly
N N N N N N N N N N N N N N N N N N N
premium, which may be higher for individuals with higher incomes.
N N N N N N N N N
What assistance can Mrs. Cook seek due to her low fixed income? - correct answers She should contact her
N N N N N N N N N N N N N N N N N N N
state Medicaid agency to see if she qualifies for programs that help with Medicare costs.
N N N N N N N N N N N N N N
What does Medicare Supplemental Insurance cover for Mr. Moy? - correct answers It helps cover his Part A
N N N N N N N N N N N N N N N N N N
deductible and Part B coinsurance or copayments in Original Fee-for-Service (FFS) Medicare.
N N N N N N N N N N N
What is Juan Perez's situation regarding Medicare as he turns 65? - correct answers He intends to work for
N N N N N N N N N N N N N N N N N N N
several more years at Smallcap, which offers employer-sponsored healthcare coverage.
N N N N N N N N N
What is the eligibility requirement for premium-free Part A? - correct answers Individuals must have worked
N N N N N N N N N N N N N N N N
and paid Medicare taxes for a sufficient period, typically 40 quarters.
N N N N N N N N N N
What happens if an individual does not enroll in Medicare during their initial enrollment period? - correct
N N N N N N N N N N N N N N N N N
answers They may qualify for a special enrollment period if they missed it due to certain circumstances, such
N N N N N N N N N N N N N N N N N N
as a natural disaster.
N N N
How does Medicare coverage differ for individuals based on age versus disability? - correct answers
N N N N N N N N N N N N N N N
Individuals under 65 can qualify for Medicare due to disability after 24 months of receiving disability
N N N N N N N N N N N N N N N N
payments, while those 65 and older qualify based on age. N N N N N N N N N
What is the role of Medigap insurance? - correct answers Medigap insurance helps cover costs not covered
N N N N N N N N N N N N N N N N N
by Original Medicare, such as deductibles and coinsurance.
N N N N N N N
, What is the maximum duration of Medicare coverage after a kidney transplant for those eligible due to ESRD?
N N N N N N N N N N N N N N N N N
- correct answers 36 months after the month of the transplant.
N N N N N N N N N N N
What should individuals do if they are unsure about their Medicare eligibility? - correct answers They should
N N N N N N N N N N N N N N N N N
contact the Social Security Administration or their state Medicaid agency for guidance.
N N N N N N N N N N N
What is the significance of a Federally declared disaster in relation to Medicare enrollment? - correct answers
N N N N N N N N N N N N N N N N N
It allows individuals who missed their enrollment period to qualify for a special enrollment period.
N N N N N N N N N N N N N N
What is the difference between Medicare Advantage and Original Medicare regarding coverage? - correct
N N N N N N N N N N N N N N
answers Medicare Advantage plans may offer additional benefits but cannot be combined with Medigap
N N N N N N N N N N N N N N
plans.
What is the importance of immunosuppressive drug coverage for kidney transplant patients? - correct
N N N N N N N N N N N N N N
answers It is critical for preventing organ rejection and maintaining health post-transplant.
N N N N N N N N N N N
How does income affect the premium for Part B coverage? - correct answers Individuals with higher incomes
N N N N N N N N N N N N N N N N N
may pay a higher monthly premium for Part B.
N N N N N N N N
What is Juan likely entitled to when he turns age 65 regarding Medicare? - correct answers Juan is likely to be
N N N N N N N N N N N N N N N N N N N N N
eligible for Medicare. N N
How would enrolling in Medicare impact Juan's employer-sponsored healthcare coverage? - correct answers
N N N N N N N N N N N N
If Juan enrolls, Medicare becomes the primary payor of his healthcare claims, and his employer's plan
N N N N N N N N N N N N N N N N N
becomes a secondary payor. N N N
What eligibility criteria does Ms. Kumar meet for Medicare despite her concerns about income? - correct
N N N N N N N N N N N N N N N N
answers Medicare is available for people age 65 or older, so Ms. Kumar will be eligible regardless of her
N N N N N N N N N N N N N N N N N N N
income.
Will Medicare cover hospice services for Ms. Lewis, who has aggressive cancer? - correct answers Yes,
N N N N N N N N N N N N N N N N
Medicare covers hospice services. N N N
