AHIP Exam Questions Verified and Provided with A+ Graded
Answers Latest Updated 2026
Mrs. Andrews is comparing her employer's retiree Original Medicare covers ambulance services.
insurance to Original Medicare and would like to
know which of the following services Original
Medicare will cover if the appropriate criteria are
met. What could you tell her?
What impact, if any, have recent regulatory The Part B deductible is no longer covered for individuals newly eligible
changes had on Medigap plans? for Medicare starting January 1, 2020.
Joan and Loretta are both enrolled in Medicare. Joan worked only a short time and did not accumulate sufficient work
Joan pays a premium for Part A coverage. Loretta credits. Loretta worked for well over 10 years accumulating credit for
does not. Which of the following statements best more than 40 quarters of contributions to the Medicare program.
explains this difference?
Larry Miller is an Original Medicare beneficiary Larry will be responsible for three Part A deductibles.
with Parts A and B coverage. Larry is admitted to
Good Care Hospital in January with pneumonia
and stays for three days before being
discharged. Six months later in July, Larry takes a
bad fall and is admitted to Good Care Hospital with
a broken leg. After emergency surgery to repair
his broken leg,
Larry is hospitalized for a week before being
discharged home. In December, Larry is
admitted to Mount Wellness Hospital once
again with a serious case of the flu. For how
many Part A
deductibles will Larry be responsible for?
Kevin Birch enrolled in Original Medicare (Parts A He should follow the directions on the notice to file a fast appeal.
and B). Mr. Birch has been receiving Mr. Birch should file it by noon of the calendar day following receipt of
rehabilitation services in a skilled nursing facility. the provider's notice of termination of services.
He calls you to
say that he has just received a notice that
Medicare will no longer cover his stay and he
still cannot
walk properly. He thinks they are ending his
services too soon. What do you tell
him?
Mr. Ray would like drug coverage but does not Mr. Ray can enroll in a stand-alone prescription drug plan and continue
want to be enrolled in a Medicare Advantage plan. to be covered for Part A and Part B services through Original Fee-
What should you tell him? for-Service Medicare.
Mrs. Sanders will be 65 soon, has been a citizen Most individuals who are citizens and age 65 or over are covered under
for twelve years, has been employed full-time, and Part A by virtue of having paid Medicare taxes while working, though
paid taxes during that entire period. She is some may be covered as a result of paying monthly premiums.
concerned that she will not qualify for coverage
under Part A because she was not born in
the
United States. What should you tell her?
Mrs. Carpenter is enrolled in Original Medicare Mrs. Carpenter should file an appeal of this initial determination within
Parts A and B. She has recently reviewed 120 days of the date she received the MSN in the mail.
her
Medicare Summary Notice (MSN) and disagrees
with a determination that partially denied one of
her claims for services. What advice would
, you give her?
Mr. Hoffman receives some help paying for his two He generally would pay a monthly premium, annual deductible,
generic prescription drugs from his employer's and per-prescription cost-sharing.
retiree coverage, but he wants to compare it to a
Part D prescription drug plan. He asks you
what costs he would generally expect to
encounter when enrolling into a standard
Medicare Part D prescription drug plan. What
should you tell him?
Mrs. Larson is enrolled in Original Medicare and Mrs. Larson cannot purchase a Medigap plan that covers drugs, but she
has a Medigap policy as well, but it provides no could keep her Medigap policy and enroll in a Part D prescription drug
drug coverage. She would like to keep the plan.
coverage she has but replace her existing
Medigap plan with one that provides drug
coverage. What should you tell her?
Mary Alice is covered by Original Medicare Parts A I. Coverage for Part A hospital coinsurance amount
and B. During her initial enrollment period she II. Coverage for 365 additional days during an insured's lifetime
purchased a standard Medigap Plan A policy from after Medicare benefits end
you because of its relatively low cost. After III. Coverage for 3 pints of blood
speaking to her friend Stan, she asks whether
any of the following are "core benefits" covered
in her plan?
Mr. Ellis continued working with his company and Mr. Ellis will not pay any penalty because he had continuous coverage
was insured under his employer's group plan under his employer's plan and he enrolled in Part B within the 8-
until he reached age 68 when he retired. Five month period immediately following the last month he had group
months later Mr. Ellis enrolled in Part B. He has coverage.
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?
Mrs. Georgia is concerned about the deductibles Medigap plans do not cover Original Medicare benefits, but they
and co-payments associated with Original coordinate with Original Medicare coverage.
Medicare. What can you tell her about Medigap as
an option to address this concern?
Mr. Turner will soon turn age 65 and has come to Beneficiaries under Original Medicare have no cost-sharing for most
you for advice as to what services are provided preventive services.
under Original Medicare. What should you tell Mr.
Turner that best describes the health coverage
provided to Medicare beneficiaries?
Mr. Harvey would like to purchase a Medicare It is illegal for you to sell Mr. Harvey a Medigap plan if he is enrolled in
Advantage (MA) plan and a Medigap plan to pick an MA plan, and besides, Medigap only works with Original Medicare.
up costs not covered by that plan. What should
you tell him?
Annie Mills will turn age 65 in August 2026. You are sorry to disappoint Annie, but a Medigap F plan is no longer
Annie intends to enroll in Original Medicare available to those who turn 65 after January 1, 2020. Annie might instead
Part A and Part B. She would also like to enroll consider other Medigap plans that offer foreign travel benefits but
in a Medicare Supplement (Medigap) plan. do not cover the Part B deductible.
Annie's older
neighbor John, has told her about the Medigap
Plan F in which he is enrolled. It not only provides
foreign travel emergency benefits but also covers
his Medicare Part B deductible. Annie comes to
you for advice. What should you tell her?
Answers Latest Updated 2026
Mrs. Andrews is comparing her employer's retiree Original Medicare covers ambulance services.
insurance to Original Medicare and would like to
know which of the following services Original
Medicare will cover if the appropriate criteria are
met. What could you tell her?
What impact, if any, have recent regulatory The Part B deductible is no longer covered for individuals newly eligible
changes had on Medigap plans? for Medicare starting January 1, 2020.
Joan and Loretta are both enrolled in Medicare. Joan worked only a short time and did not accumulate sufficient work
Joan pays a premium for Part A coverage. Loretta credits. Loretta worked for well over 10 years accumulating credit for
does not. Which of the following statements best more than 40 quarters of contributions to the Medicare program.
explains this difference?
Larry Miller is an Original Medicare beneficiary Larry will be responsible for three Part A deductibles.
with Parts A and B coverage. Larry is admitted to
Good Care Hospital in January with pneumonia
and stays for three days before being
discharged. Six months later in July, Larry takes a
bad fall and is admitted to Good Care Hospital with
a broken leg. After emergency surgery to repair
his broken leg,
Larry is hospitalized for a week before being
discharged home. In December, Larry is
admitted to Mount Wellness Hospital once
again with a serious case of the flu. For how
many Part A
deductibles will Larry be responsible for?
Kevin Birch enrolled in Original Medicare (Parts A He should follow the directions on the notice to file a fast appeal.
and B). Mr. Birch has been receiving Mr. Birch should file it by noon of the calendar day following receipt of
rehabilitation services in a skilled nursing facility. the provider's notice of termination of services.
He calls you to
say that he has just received a notice that
Medicare will no longer cover his stay and he
still cannot
walk properly. He thinks they are ending his
services too soon. What do you tell
him?
Mr. Ray would like drug coverage but does not Mr. Ray can enroll in a stand-alone prescription drug plan and continue
want to be enrolled in a Medicare Advantage plan. to be covered for Part A and Part B services through Original Fee-
What should you tell him? for-Service Medicare.
Mrs. Sanders will be 65 soon, has been a citizen Most individuals who are citizens and age 65 or over are covered under
for twelve years, has been employed full-time, and Part A by virtue of having paid Medicare taxes while working, though
paid taxes during that entire period. She is some may be covered as a result of paying monthly premiums.
concerned that she will not qualify for coverage
under Part A because she was not born in
the
United States. What should you tell her?
Mrs. Carpenter is enrolled in Original Medicare Mrs. Carpenter should file an appeal of this initial determination within
Parts A and B. She has recently reviewed 120 days of the date she received the MSN in the mail.
her
Medicare Summary Notice (MSN) and disagrees
with a determination that partially denied one of
her claims for services. What advice would
, you give her?
Mr. Hoffman receives some help paying for his two He generally would pay a monthly premium, annual deductible,
generic prescription drugs from his employer's and per-prescription cost-sharing.
retiree coverage, but he wants to compare it to a
Part D prescription drug plan. He asks you
what costs he would generally expect to
encounter when enrolling into a standard
Medicare Part D prescription drug plan. What
should you tell him?
Mrs. Larson is enrolled in Original Medicare and Mrs. Larson cannot purchase a Medigap plan that covers drugs, but she
has a Medigap policy as well, but it provides no could keep her Medigap policy and enroll in a Part D prescription drug
drug coverage. She would like to keep the plan.
coverage she has but replace her existing
Medigap plan with one that provides drug
coverage. What should you tell her?
Mary Alice is covered by Original Medicare Parts A I. Coverage for Part A hospital coinsurance amount
and B. During her initial enrollment period she II. Coverage for 365 additional days during an insured's lifetime
purchased a standard Medigap Plan A policy from after Medicare benefits end
you because of its relatively low cost. After III. Coverage for 3 pints of blood
speaking to her friend Stan, she asks whether
any of the following are "core benefits" covered
in her plan?
Mr. Ellis continued working with his company and Mr. Ellis will not pay any penalty because he had continuous coverage
was insured under his employer's group plan under his employer's plan and he enrolled in Part B within the 8-
until he reached age 68 when he retired. Five month period immediately following the last month he had group
months later Mr. Ellis enrolled in Part B. He has coverage.
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?
Mrs. Georgia is concerned about the deductibles Medigap plans do not cover Original Medicare benefits, but they
and co-payments associated with Original coordinate with Original Medicare coverage.
Medicare. What can you tell her about Medigap as
an option to address this concern?
Mr. Turner will soon turn age 65 and has come to Beneficiaries under Original Medicare have no cost-sharing for most
you for advice as to what services are provided preventive services.
under Original Medicare. What should you tell Mr.
Turner that best describes the health coverage
provided to Medicare beneficiaries?
Mr. Harvey would like to purchase a Medicare It is illegal for you to sell Mr. Harvey a Medigap plan if he is enrolled in
Advantage (MA) plan and a Medigap plan to pick an MA plan, and besides, Medigap only works with Original Medicare.
up costs not covered by that plan. What should
you tell him?
Annie Mills will turn age 65 in August 2026. You are sorry to disappoint Annie, but a Medigap F plan is no longer
Annie intends to enroll in Original Medicare available to those who turn 65 after January 1, 2020. Annie might instead
Part A and Part B. She would also like to enroll consider other Medigap plans that offer foreign travel benefits but
in a Medicare Supplement (Medigap) plan. do not cover the Part B deductible.
Annie's older
neighbor John, has told her about the Medigap
Plan F in which he is enrolled. It not only provides
foreign travel emergency benefits but also covers
his Medicare Part B deductible. Annie comes to
you for advice. What should you tell her?
