AHIP Final Exam 2026/2027
Exam Questions and Answers |
Already 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? - ANSWER ✔✔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? - ANSWER ✔✔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? - 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.
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.
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? - ANSWER ✔✔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? - ANSWER ✔✔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? - ANSWER ✔✔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
3
COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
, 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.
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.
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? -
Exam Questions and Answers |
Already 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? - ANSWER ✔✔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? - ANSWER ✔✔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? - 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.
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.
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? - ANSWER ✔✔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? - ANSWER ✔✔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? - ANSWER ✔✔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
3
COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
, 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.
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.
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? -
