AHIP FINAL NEWEST 2025-2026
VERSION EXAM With Comprehensive
Questions and Well Elaborated Correct
Answers GRADED A+
,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? - correct ans:Mr. Wu
may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program.
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 ans:After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare, regardless of age.
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 ans: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.
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 ans: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.
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 ans:Tell prospect Jerry Smith that he should consider adding a standalone
Part D prescription drug coverage policy to his present coverage.
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? - correct ans:He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
, 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? - correct
ans:Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan.
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 ans: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.
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? - correct ans: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. 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? -
correct ans: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.
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 ans: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
tell her? - correct ans:To obtain Part B coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher incomes.
VERSION EXAM With Comprehensive
Questions and Well Elaborated Correct
Answers GRADED A+
,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? - correct ans:Mr. Wu
may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program.
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 ans:After receiving such disability
payments for 24 months, he will be automatically enrolled in Medicare, regardless of age.
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 ans: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.
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 ans: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.
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 ans:Tell prospect Jerry Smith that he should consider adding a standalone
Part D prescription drug coverage policy to his present coverage.
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? - correct ans:He may sign-up for Medicare at any time however coverage usually begins on the
fourth month after dialysis treatments start.
, 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? - correct
ans:Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan.
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 ans: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.
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? - correct ans: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. 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? -
correct ans: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.
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 ans: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
tell her? - correct ans:To obtain Part B coverage, she must pay a standard monthly premium, though it is
higher for individuals with higher incomes.
