AHIP 2026 FInAl ExAm ACTUAl QUEsTIons And vErIFIEd
AnsWErs (lATEsT UPdATE) A+ GrAdE 100%
GUArAnTEE vErIFIEd By ExPErTs
Mr. Arias, a naturalized citizen, previously enrolled in Medicare Part B but has recently
stopped paying his Part B premium. Mr. Arias is still covered by Part A. He would like to
enroll in a Medicare Advantage (MA) plan and is still covered by Part A. What should you
tell him? - AnsWEr-He is not eligible to enroll in a Medicare Advantage plan until he re-
enrolls in Medicare Part B.
Mrs. Joy, age 65, is entitled to Part A but has not yet enrolled in Part B. She is
considering enrolling in a Medicare Advantage plan (Part C). What should you advise her
to do before she can enroll in a Medicare Advantage plan? - AnsWEr-To join a Medicare
Advantage plan, she also must enroll in Part B.
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability
to access providers. What should you tell him? - AnsWEr-In most Medicare Advantage
HMOs, Mr. Kumar must generally obtain his services only from providers within the
plan's network (except in an emergency or where care is unavailable within the network).
Mrs. Robles is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care. What should you tell her? - AnsWEr-Mrs.
Robles can obtain care from any provider who participates in Original Medicare, but
generally will have a higher cost-sharing amount if she sees a provider who/that is not a
part of the PPO network.
Mrs. Lester is age 75 and enjoys a comfortable but not extremely high-income level. She
wishes to enroll in an MA MSA plan that she heard about from her neighbor. She also
wants to have prescription drug coverage since her doctor recently prescribed several
expensive medications. Currently, she is enrolled in Original Medicare and a standalone
Part D plan. How would you advise Mrs. Lester? - AnsWEr-Mrs. Lester may enroll in an
MA MSA plan and remain in her current standalone Part D prescription drug plan.
Mr. Dalton is in excellent health, lives in his own home, and has a sizeable income from
his investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan
(SNP). His friend has mentioned that the SNP charges very low cost-sharing amounts
, and Mr. Dalton would like to join that plan. What should you tell him? - AnsWEr-SNPs
limit enrollment to certain subpopulations of beneficiaries. Given his current situation, he
is unlikely to qualify and would not be able to enroll in the SNP.
Mr. Anderson wants to know whether he is eligible to sign up for a Private fee-for-service
(PFFS) plan. What questions would you need to ask to determine his eligibility? -
AnsWEr-You would need to ask Mr. Anderson if he is entitled to Part A, enrolled in Part B,
and if he lives in the PFFS plan's service area.
Herber Noble is turning 65 next month, Herber legally entered the United States over
twenty years ago but is not a citizen. Since his entry into the country, Herber has worked
at Smallcap Incorporated and contributed to the Medicare system. Herber suffers from
diabetes. He will soon retire and asks you if he can enroll in a Medicare Advantage plan
that you represent. How would you respond? - AnsWEr-Herber is eligible to enroll in
Medicare Advantage as long as he is entitled to Part A and enrolled in Part B. Herber
should go to the Social Security website to enroll in Medicare Part A and B if he has not
done so already. Once he is enrolled, he can choose a Medicare Advantage plan.
Which of the following individuals is most likely to be eligible to enroll in a Part D Plan? -
AnsWEr-Jose, a grandfather who was granted asylum and has worked in the United
States for many years.
Mrs. Castro has just turned 65, is in excellent health and has a relatively high income.
She uses no medications and sees no reason to spend money on a Medicare
prescription drug plan if she does not need the coverage. She currently does not have
creditable coverage. What could you tell her about the implications of such a decision? -
AnsWEr-If she does not sign up for a Medicare prescription drug plan as soon as she is
eligible to do so, and if she does sign up at a later date, her premium will be permanently
increased by 1% of the national average premium for every month that she was not
covered.
Mr. Chen was still working when he first qualified for Medicare. At that time, he had
employer group coverage that was creditable. During his initial Part D eligibility period,
he decided not to enroll because he was satisfied with his drug coverage. It is now a year
later and Mr. Chen has lost his employer group coverage within the last two weeks. How
would you advise him? - AnsWEr-Mr. Chen should enroll in a Part D plan before he has a
63-day break in coverage in order to avoid a premium penalty.
AnsWErs (lATEsT UPdATE) A+ GrAdE 100%
GUArAnTEE vErIFIEd By ExPErTs
Mr. Arias, a naturalized citizen, previously enrolled in Medicare Part B but has recently
stopped paying his Part B premium. Mr. Arias is still covered by Part A. He would like to
enroll in a Medicare Advantage (MA) plan and is still covered by Part A. What should you
tell him? - AnsWEr-He is not eligible to enroll in a Medicare Advantage plan until he re-
enrolls in Medicare Part B.
Mrs. Joy, age 65, is entitled to Part A but has not yet enrolled in Part B. She is
considering enrolling in a Medicare Advantage plan (Part C). What should you advise her
to do before she can enroll in a Medicare Advantage plan? - AnsWEr-To join a Medicare
Advantage plan, she also must enroll in Part B.
Mr. Kumar is considering a Medicare Advantage HMO and has questions about his ability
to access providers. What should you tell him? - AnsWEr-In most Medicare Advantage
HMOs, Mr. Kumar must generally obtain his services only from providers within the
plan's network (except in an emergency or where care is unavailable within the network).
Mrs. Robles is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care. What should you tell her? - AnsWEr-Mrs.
Robles can obtain care from any provider who participates in Original Medicare, but
generally will have a higher cost-sharing amount if she sees a provider who/that is not a
part of the PPO network.
Mrs. Lester is age 75 and enjoys a comfortable but not extremely high-income level. She
wishes to enroll in an MA MSA plan that she heard about from her neighbor. She also
wants to have prescription drug coverage since her doctor recently prescribed several
expensive medications. Currently, she is enrolled in Original Medicare and a standalone
Part D plan. How would you advise Mrs. Lester? - AnsWEr-Mrs. Lester may enroll in an
MA MSA plan and remain in her current standalone Part D prescription drug plan.
Mr. Dalton is in excellent health, lives in his own home, and has a sizeable income from
his investments. He has a friend enrolled in a Medicare Advantage Special Needs Plan
(SNP). His friend has mentioned that the SNP charges very low cost-sharing amounts
, and Mr. Dalton would like to join that plan. What should you tell him? - AnsWEr-SNPs
limit enrollment to certain subpopulations of beneficiaries. Given his current situation, he
is unlikely to qualify and would not be able to enroll in the SNP.
Mr. Anderson wants to know whether he is eligible to sign up for a Private fee-for-service
(PFFS) plan. What questions would you need to ask to determine his eligibility? -
AnsWEr-You would need to ask Mr. Anderson if he is entitled to Part A, enrolled in Part B,
and if he lives in the PFFS plan's service area.
Herber Noble is turning 65 next month, Herber legally entered the United States over
twenty years ago but is not a citizen. Since his entry into the country, Herber has worked
at Smallcap Incorporated and contributed to the Medicare system. Herber suffers from
diabetes. He will soon retire and asks you if he can enroll in a Medicare Advantage plan
that you represent. How would you respond? - AnsWEr-Herber is eligible to enroll in
Medicare Advantage as long as he is entitled to Part A and enrolled in Part B. Herber
should go to the Social Security website to enroll in Medicare Part A and B if he has not
done so already. Once he is enrolled, he can choose a Medicare Advantage plan.
Which of the following individuals is most likely to be eligible to enroll in a Part D Plan? -
AnsWEr-Jose, a grandfather who was granted asylum and has worked in the United
States for many years.
Mrs. Castro has just turned 65, is in excellent health and has a relatively high income.
She uses no medications and sees no reason to spend money on a Medicare
prescription drug plan if she does not need the coverage. She currently does not have
creditable coverage. What could you tell her about the implications of such a decision? -
AnsWEr-If she does not sign up for a Medicare prescription drug plan as soon as she is
eligible to do so, and if she does sign up at a later date, her premium will be permanently
increased by 1% of the national average premium for every month that she was not
covered.
Mr. Chen was still working when he first qualified for Medicare. At that time, he had
employer group coverage that was creditable. During his initial Part D eligibility period,
he decided not to enroll because he was satisfied with his drug coverage. It is now a year
later and Mr. Chen has lost his employer group coverage within the last two weeks. How
would you advise him? - AnsWEr-Mr. Chen should enroll in a Part D plan before he has a
63-day break in coverage in order to avoid a premium penalty.
