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AHIP 2026 summer Exam prompts with their correct answers

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AHIP 2026 summer Exam prompts with their correct answers

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, AHIP 2026 summer Exam prompts with their correct answers
1. Mr. Wu is eligible for Medicare. He has limited financial resources
but failed to qualify for the Part D low-income subsidy. Where might
he turn for help with his prescription drug costs? Answer: Mr. Wu may still qualify
for help in paying Part D costs through his State Pharmaceutical Assistance Program.
2. Mr. Bauer is 49 years old, but eighteen months ago he was
declared dis- abled 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? Answer: After receiving
such disability payments for 24 months, he will be automatically enrolled in Medicare, regardless
of age.
3. 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? 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.
4. 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? 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.
5. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry
is cur- rently 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? Answer: Tell prospect Jerry
Smith that he should consider adding a standalone Part D prescription drug coverage policy to his
present coverage.
6. Mr. Davis is 52 years old and has recently been diagnosed with
end-stage renal disease (ESRD) and will soon begin dialysis. He is


,wondering if he can obtain coverage under Medicare. What should
you tell him? Answer: He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
7. Mr. Diaz continued working with his company and was
insured under his employer's group plan until he reached age 68.
He has heard that there is a






, premium penalty for those who did not sign up for Part B when first
eligible and wants to know how much he will have to pay. What should
you tell him? Answer: Mr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
8. Madeline Martinez was widowed several years ago. Her husband
worked for
many years and contributed into the Medicare system. He also left a
substan- tial 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? 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.
9. Edward IP 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? 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.
10. Mrs. Peňa 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? 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 ditters from the standard general enrollment period, during which she may enroll in Medicare
Part B.

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