AHIP Module 1 2026 eXAMS WITH CoRReCT
SoluTIoNS GRAded A+
1. 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? -
-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.
2. Ms. Lewis has aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her? - -ANS☑☑-
3. Juan Perez, who is turning age 65 next month, intends to work for several more
years at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and
offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and
has contributed to the Medicare system for over 20 years. Juan asks you if he will
be entitled to Medicare and if he enrolls how that will impact his employer-
sponsored healthcare coverage. How would you respond? - -ANS☑☑-Juan is
likely to be eligible for Medicare once he turns age 65 and if he enrolls, Medicare
would become the primary payor of his healthcare claims and Smallcap does not
have to continue to offer him coverage comparable to those under age 65 under its
employer-sponsored group health plan and would become a secondary payor.
4. Mrs. Ellis recently turned 66 and decided after many years of work to retire and
begin receiving Social Security benefits. Shortly thereafter Mrs. Ellis received a
letter informing her that she had been automatically enrolled in Medicare Part B.
She wants to understand what this means. What should you tell Mrs. Ellis? - -
ANS☑☑-Part B primarily covers physician services. She will be paying a monthly
premium and, except for many preventive and screening tests, generally will have
20% co-payments for these services, in addition to an annual deductible.
, 5. 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? - -ANS☑☑-To obtain Part B
coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes.
6. 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? - -ANS☑☑-After receiving such disability payments for 24 months, he will
be automatically enrolled in Medicare, regardless of age.
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? - -ANS☑☑-Tell
prospect Jerry Smith that he should consider adding a standalone Part D prescription
drug coverage policy to his present coverage
7. Edward 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? - -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.
8. Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent
health and will have considerable income when she retires. She is concerned that
her income will make it impossible for her to qualify for Medicare. What could you
tell her to address her concern? - -ANS☑☑-Medicare is a program for people
age 65 or older and those under age 65 with certain disabilities, end-stage renal
disease, and Lou Gehrig's disease so she will be eligible for Medicare.
SoluTIoNS GRAded A+
1. 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? -
-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.
2. Ms. Lewis has aggressive cancer and would like to know if Medicare will cover
hospice services in case she needs them. What should you tell her? - -ANS☑☑-
3. Juan Perez, who is turning age 65 next month, intends to work for several more
years at Smallcap, Incorporated. Smallcap has a workforce of 15 employees and
offers employer-sponsored healthcare coverage. Juan is a naturalized citizen and
has contributed to the Medicare system for over 20 years. Juan asks you if he will
be entitled to Medicare and if he enrolls how that will impact his employer-
sponsored healthcare coverage. How would you respond? - -ANS☑☑-Juan is
likely to be eligible for Medicare once he turns age 65 and if he enrolls, Medicare
would become the primary payor of his healthcare claims and Smallcap does not
have to continue to offer him coverage comparable to those under age 65 under its
employer-sponsored group health plan and would become a secondary payor.
4. Mrs. Ellis recently turned 66 and decided after many years of work to retire and
begin receiving Social Security benefits. Shortly thereafter Mrs. Ellis received a
letter informing her that she had been automatically enrolled in Medicare Part B.
She wants to understand what this means. What should you tell Mrs. Ellis? - -
ANS☑☑-Part B primarily covers physician services. She will be paying a monthly
premium and, except for many preventive and screening tests, generally will have
20% co-payments for these services, in addition to an annual deductible.
, 5. 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? - -ANS☑☑-To obtain Part B
coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher incomes.
6. 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? - -ANS☑☑-After receiving such disability payments for 24 months, he will
be automatically enrolled in Medicare, regardless of age.
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? - -ANS☑☑-Tell
prospect Jerry Smith that he should consider adding a standalone Part D prescription
drug coverage policy to his present coverage
7. Edward 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? - -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.
8. Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent
health and will have considerable income when she retires. She is concerned that
her income will make it impossible for her to qualify for Medicare. What could you
tell her to address her concern? - -ANS☑☑-Medicare is a program for people
age 65 or older and those under age 65 with certain disabilities, end-stage renal
disease, and Lou Gehrig's disease so she will be eligible for Medicare.
