AHIP TRAINING EXAM QUESTIONS AND ANSWERS
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? - CORRECT 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.
Anthony Boniface turned 65 in 2024. He was not receiving Social Security or Railroad Retirement
Benefits on his 65th birthday. He was interested in obtaining Medicare coverage and is eligible for
premium-free Part A. Before he could enroll in Medicare, his entire area was impacted by a hurricane
causing massive flooding and severe wind damage. The Federal government declared this to be a natural
disaster which has recently ended. During this period Anthony's initial enrollment period expired.
Anthony asks you how he can now obtain Medicare coverage. What should you say? - CORRECT
ANSWER✅✅Anthony is eligible for a special enrollment period (SEP) because he missed an enrollment
period due to the impact of the Federally declared disaster. This SEP will allow Anthony to enroll in Part
B up to six months after the end of the emergency declaration. Anthony may enroll in premium-free
Part A at any time and his Part A coverage will be retroactive for up to 6 months.
Mrs. Ellis recently turned 66 and decided after many years of work to retire and begin receiving Social
Security benefits. Shortly thereafter Mrs. Ellis received a letter informing her that she had been
automatically enrolled in Medicare Part B. She wants to understand what this means. What should you
tell Mrs. Ellis? - CORRECT ANSWER✅✅Part B primarily covers physician services. She will be paying a
monthly premium and, except for many preventive and screening tests, generally will have 20% co-
payments for these services, in addition to an annual deductible.
Mr. Vasquez is in good health and is preparing a budget in anticipation of his retirement when he turns
66. He wants to understand the health care costs he might be exposed to under Medicare if he were to
require hospitalization because of an illness. In general terms, what could you tell him about his costs
for inpatient hospital services under Original Medicare? - CORRECT ANSWER✅✅Under Original
Medicare, there is a single deductible amount due for the first 60 days of any inpatient hospital stay,
after which it converts into a per-day coinsurance amount through day 90. After day 90, he would pay a
daily amount up to 60 days over his lifetime, after which he would be responsible for all costs.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could you tell Mrs. Cook that
might be of assistance? - CORRECT 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.
,Mrs. Thomas 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? - CORRECT 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.
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? - CORRECT 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.
Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent health and will have
considerable income when she retires. She is concerned that her income will make it impossible for her
to qualify for Medicare. What could you tell her to address her concern? - CORRECT
ANSWER✅✅Medicare is a program for people age 65 or older and those under age 65 with certain
disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for Medicare.
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? - CORRECT ANSWER✅✅Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present coverage.
Mr. Moy will soon turn age 65. He is slightly younger than his wife. Mr. Moy's wife has a Medicare
Advantage plan, but he wants to understand what coverage Medicare Supplemental Insurance provides
since his health care needs are different from his wife's needs. What could you tell Mr. Moy? - CORRECT
ANSWER✅✅Medicare Supplemental Insurance would cover all of his IRS approved health care
expenditures not covered under Original Fee-for-Service (FFS) Medicare.
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? - CORRECT 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.
Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap,
Incorporated. Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare
coverage. Juan is a naturalized citizen and has contributed to the Medicare system for over 20 years.
Juan asks you if he will be entitled to Medicare and if he enrolls how that will impact his employer-
sponsored healthcare coverage. How would you respond? - CORRECT ANSWER✅✅Juan is likely to be
eligible for Medicare once he turns age 65 and if he enrolls, Medicare would become the primary payor
of his healthcare claims and Smallcap does not have to continue to offer him coverage comparable to
those under age 65 under its employer-sponsored group health plan and would become a secondary
payor.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan.
What should you tell him? - CORRECT ANSWER✅✅Mr. Singh can enroll in a stand-alone prescription
drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service
Medicare.
Ms. Lewis has aggressive cancer and would like to know if Medicare will cover hospice services in case
she needs them. What should you tell her? - CORRECT ANSWER✅✅Medicare covers hospice services,
and they will be available for her.
Mrs. Foster is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay, she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - CORRECT ANSWER✅✅Medicare will cover
Mrs. Foster's skilled nursing services provided during the first 20 days of her stay, after which she would
have a copay until she has been in the facility for 100 days.
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? - CORRECT 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.
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
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? - CORRECT 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.
Anthony Boniface turned 65 in 2024. He was not receiving Social Security or Railroad Retirement
Benefits on his 65th birthday. He was interested in obtaining Medicare coverage and is eligible for
premium-free Part A. Before he could enroll in Medicare, his entire area was impacted by a hurricane
causing massive flooding and severe wind damage. The Federal government declared this to be a natural
disaster which has recently ended. During this period Anthony's initial enrollment period expired.
Anthony asks you how he can now obtain Medicare coverage. What should you say? - CORRECT
ANSWER✅✅Anthony is eligible for a special enrollment period (SEP) because he missed an enrollment
period due to the impact of the Federally declared disaster. This SEP will allow Anthony to enroll in Part
B up to six months after the end of the emergency declaration. Anthony may enroll in premium-free
Part A at any time and his Part A coverage will be retroactive for up to 6 months.
Mrs. Ellis recently turned 66 and decided after many years of work to retire and begin receiving Social
Security benefits. Shortly thereafter Mrs. Ellis received a letter informing her that she had been
automatically enrolled in Medicare Part B. She wants to understand what this means. What should you
tell Mrs. Ellis? - CORRECT ANSWER✅✅Part B primarily covers physician services. She will be paying a
monthly premium and, except for many preventive and screening tests, generally will have 20% co-
payments for these services, in addition to an annual deductible.
Mr. Vasquez is in good health and is preparing a budget in anticipation of his retirement when he turns
66. He wants to understand the health care costs he might be exposed to under Medicare if he were to
require hospitalization because of an illness. In general terms, what could you tell him about his costs
for inpatient hospital services under Original Medicare? - CORRECT ANSWER✅✅Under Original
Medicare, there is a single deductible amount due for the first 60 days of any inpatient hospital stay,
after which it converts into a per-day coinsurance amount through day 90. After day 90, he would pay a
daily amount up to 60 days over his lifetime, after which he would be responsible for all costs.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could you tell Mrs. Cook that
might be of assistance? - CORRECT 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.
,Mrs. Thomas 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? - CORRECT 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.
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? - CORRECT 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.
Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent health and will have
considerable income when she retires. She is concerned that her income will make it impossible for her
to qualify for Medicare. What could you tell her to address her concern? - CORRECT
ANSWER✅✅Medicare is a program for people age 65 or older and those under age 65 with certain
disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for Medicare.
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? - CORRECT ANSWER✅✅Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present coverage.
Mr. Moy will soon turn age 65. He is slightly younger than his wife. Mr. Moy's wife has a Medicare
Advantage plan, but he wants to understand what coverage Medicare Supplemental Insurance provides
since his health care needs are different from his wife's needs. What could you tell Mr. Moy? - CORRECT
ANSWER✅✅Medicare Supplemental Insurance would cover all of his IRS approved health care
expenditures not covered under Original Fee-for-Service (FFS) Medicare.
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? - CORRECT 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.
Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap,
Incorporated. Smallcap has a workforce of 15 employees and offers employer-sponsored healthcare
coverage. Juan is a naturalized citizen and has contributed to the Medicare system for over 20 years.
Juan asks you if he will be entitled to Medicare and if he enrolls how that will impact his employer-
sponsored healthcare coverage. How would you respond? - CORRECT ANSWER✅✅Juan is likely to be
eligible for Medicare once he turns age 65 and if he enrolls, Medicare would become the primary payor
of his healthcare claims and Smallcap does not have to continue to offer him coverage comparable to
those under age 65 under its employer-sponsored group health plan and would become a secondary
payor.
Mr. Singh would like drug coverage but does not want to be enrolled in a Medicare Advantage plan.
What should you tell him? - CORRECT ANSWER✅✅Mr. Singh can enroll in a stand-alone prescription
drug plan and continue to be covered for Part A and Part B services through Original Fee-for-Service
Medicare.
Ms. Lewis has aggressive cancer and would like to know if Medicare will cover hospice services in case
she needs them. What should you tell her? - CORRECT ANSWER✅✅Medicare covers hospice services,
and they will be available for her.
Mrs. Foster is covered by Original Medicare. She sustained a hip fracture and is being successfully
treated for that condition. However, she and her physicians feel that after her lengthy hospital stay, she
will need a month or two of nursing and rehabilitative care. What should you tell them about Original
Medicare's coverage of care in a skilled nursing facility? - CORRECT ANSWER✅✅Medicare will cover
Mrs. Foster's skilled nursing services provided during the first 20 days of her stay, after which she would
have a copay until she has been in the facility for 100 days.
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? - CORRECT 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.
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
