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