AHIP EXAM 2026 CERTIFICATION EVALUATION
REVIEW SUCCESS GUARANTEED
◉ Medicare-Medicaid plans Answer: Serve both Medicare and Medicaid
individuals. Include Part D coverage. Individuals sometimes referred to
as dual eligibles
◉ Medicare Cost Plan Answer: Type of Medicare health plan. Have Part
B to enroll. Can join anytime plan is accepting new members. A non
network provider will can charge higher coinsurances and deuctibles.
Different enrollment/disenrollment periods apply. Can get Part D Rx
coverage if available, or apply for a separate PDP.
◉ Medicare Entitlement/Enrollment - Part A & Part B Answer:
Individuals with ESRD may sign up at anytime. Date on which coverage
begins is the fourth month after dialysis begins.
◉ Medicare Enrollment Period Answer: Individuals who do not enroll in
Part B when first eligible can enroll during a General Enrollment Period,
Jan 1st to Mar 31st each year. Coverage begins July 1st of that year.
◉ Medicare Enrollment Period - Group Health Coverage Answer:
Individuals who have group health coveage through employer may
enroll in Part A and/or Part B anytime while on group coverage during a
Special Enrollment Period. Occurs during the 8 month period following
last month of group coverage.
, ◉ Medicare Part A Premium Answer: Free if worked 40 quarters of your
life and paid Medicare taxes. Premium is $240.00 for individuals or
spouses who paid Medicare taxes for 30 - 39 quarters. Premium is
$437.00 for less than 30 quarters.
◉ Medicare Part A Penalty Answer: Don't enroll in Part A when fist
eligible, will pay a late penalty of up to 10% unless enroll during a
Special Enrollment Period.
◉ Medicare Part B Premium Answer: In 2019, the standard monthly
premium is $135.50 or higher depending on income. Deducted from S.S.
check or Railroad Retirement check. Do not enroll when first eligible,
premium is increased 10% for each 12 month period not enrolled.
Deductible for 2019 is $185.00
◉ Part C Medicare Advantage plans Answer: Entiled to benefits under
Part A AND enrolled in Part B.
◉ Part D Prescription Drug benefits Answer: Entitled to benefits under
Part A but not enrolled in Part B. Must be entitled to Part A AND/OR
enrolled in Part B.
◉ Part D Low Income Subsidy Answer: Do not qualify for Part D Low
Income Subsidy, but are of limited means, may qualify for help in Part D
costs through State Pharmaceutical Assistance Program.
REVIEW SUCCESS GUARANTEED
◉ Medicare-Medicaid plans Answer: Serve both Medicare and Medicaid
individuals. Include Part D coverage. Individuals sometimes referred to
as dual eligibles
◉ Medicare Cost Plan Answer: Type of Medicare health plan. Have Part
B to enroll. Can join anytime plan is accepting new members. A non
network provider will can charge higher coinsurances and deuctibles.
Different enrollment/disenrollment periods apply. Can get Part D Rx
coverage if available, or apply for a separate PDP.
◉ Medicare Entitlement/Enrollment - Part A & Part B Answer:
Individuals with ESRD may sign up at anytime. Date on which coverage
begins is the fourth month after dialysis begins.
◉ Medicare Enrollment Period Answer: Individuals who do not enroll in
Part B when first eligible can enroll during a General Enrollment Period,
Jan 1st to Mar 31st each year. Coverage begins July 1st of that year.
◉ Medicare Enrollment Period - Group Health Coverage Answer:
Individuals who have group health coveage through employer may
enroll in Part A and/or Part B anytime while on group coverage during a
Special Enrollment Period. Occurs during the 8 month period following
last month of group coverage.
, ◉ Medicare Part A Premium Answer: Free if worked 40 quarters of your
life and paid Medicare taxes. Premium is $240.00 for individuals or
spouses who paid Medicare taxes for 30 - 39 quarters. Premium is
$437.00 for less than 30 quarters.
◉ Medicare Part A Penalty Answer: Don't enroll in Part A when fist
eligible, will pay a late penalty of up to 10% unless enroll during a
Special Enrollment Period.
◉ Medicare Part B Premium Answer: In 2019, the standard monthly
premium is $135.50 or higher depending on income. Deducted from S.S.
check or Railroad Retirement check. Do not enroll when first eligible,
premium is increased 10% for each 12 month period not enrolled.
Deductible for 2019 is $185.00
◉ Part C Medicare Advantage plans Answer: Entiled to benefits under
Part A AND enrolled in Part B.
◉ Part D Prescription Drug benefits Answer: Entitled to benefits under
Part A but not enrolled in Part B. Must be entitled to Part A AND/OR
enrolled in Part B.
◉ Part D Low Income Subsidy Answer: Do not qualify for Part D Low
Income Subsidy, but are of limited means, may qualify for help in Part D
costs through State Pharmaceutical Assistance Program.
