AHIP - 2026 - Modules 1-5
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see if she qualifies for one of several programs that can help with Medicare costs for which she
is responsible.
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? - correct answer To obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher incomes.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social
Security Administration and has been receiving disability payments. He is wondering whether
he can obtain coverage under Medicare. What should you tell him? - correct answer After
receiving such disability payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age.
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.
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.
Edward 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? - correct 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.
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.
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.
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.
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.
Which of the following statement(s) is/are correct about a Medicare Savings Account (MSA)
Plans?
I. MSAs may have either a partial network, full network, or no network of providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal deductible of $500
indexed for inflation.
IV. Non-network providers must accept the same amount that Original Medicare would pay
them as payment in full. - correct answer I, II, and IV only
Exam Questions With Verified
Correct Answers 100%
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see if she qualifies for one of several programs that can help with Medicare costs for which she
is responsible.
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? - correct answer To obtain Part B coverage, she must pay a standard
monthly premium, though it is higher for individuals with higher incomes.
Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled by the Social
Security Administration and has been receiving disability payments. He is wondering whether
he can obtain coverage under Medicare. What should you tell him? - correct answer After
receiving such disability payments for 24 months, he will be automatically enrolled in Medicare,
regardless of age.
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.
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.
Edward 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? - correct 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.
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.
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.
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.
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.
Which of the following statement(s) is/are correct about a Medicare Savings Account (MSA)
Plans?
I. MSAs may have either a partial network, full network, or no network of providers.
II. MSA plans cover Part A and Part B benefits but not Part D prescription drug benefits.
III. An individual who is enrolled in an MSA plan is responsible for a minimal deductible of $500
indexed for inflation.
IV. Non-network providers must accept the same amount that Original Medicare would pay
them as payment in full. - correct answer I, II, and IV only
