AHIP - 2026 - Modules 1-5 Questions Verified and Provided
with A+ Graded Answers Latest Updated 2026
Mr. Capadona would like to purchase a It is illegal for you to sell Mr. Capadona a Medigap plan if he is
Medicare Advantage (MA) plan and a Medigap enrolled in an MA plan, and besides, Medigap only works with Original
plan to pick up costs not covered by that plan. Medicare.
What should you tell him?
Agent John Miller is meeting with Jerry Smith, a Tell prospect Jerry Smith that he should consider adding a standalone
new prospect. Jerry is currently enrolled in Part D prescription drug coverage policy to his present coverage.
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?
Mr. Wu is eligible for Medicare. He has limited Mr. Wu may still qualify for help in paying Part D costs through his State
financial resources but failed to qualify for the Part Pharmaceutical Assistance Program (SPAP).
D low-income subsidy. Where might he turn for
help with his prescription drug costs?
Mr. Vasquez is in good health and is preparing a Under Original Medicare, there is a single deductible amount due for
budget in anticipation of his retirement when he the first 60 days of any inpatient hospital stay, after which it converts
turns 66. He wants to understand the health care into a per-day coinsurance amount through day 90. After day 90, he
costs he might be exposed to under Medicare would pay a daily amount up to 60 days over his lifetime, after which he
if he were to require hospitalization because of would be responsible for all costs.
an illness. In general terms, what could you tell
him about his costs for inpatient hospital
services
under Original Medicare?
Mr. Moy will soon turn age 65. He is slightly Medicare Supplemental Insurance would help cover his Part A
younger than his wife. Mr. Moy's wife has a deductible and Part B coinsurance or copayments in Original Fee-
Medicare Advantage plan, but he wants to for-Service (FFS) Medicare as well as possibly some services that
understand what coverage Medicare Medicare does not cover.
Supplemental Insurance provides since his
health care needs are different from his wife's
needs.
What could you tell Mr. Moy?
Juan Perez, who is turning age 65 next month, Juan is likely to be eligible for Medicare once he turns age 65 and if he
intends to work for several more years at Smallcap, enrolls, Medicare would become the primary payor of his healthcare
Incorporated. Smallcap has a workforce of 15 claims and Smallcap does not have to continue to offer him coverage
employees and offers employer-sponsored comparable to those under age 65 under its employer-sponsored
healthcare coverage. Juan is a naturalized citizen group health plan. Juan is likely to be eligible for Medicare once
and has contributed to the Medicare system for he turns age 65 and if he enrolls, Medicare would become the
over 20 years. Juan asks you if he will be entitled to primary payor of his healthcare claims but Smallcap must continue to
Medicare and if he enrolls how that will impact offer him coverage under its employer-sponsored group health plan
his employer- sponsored healthcare coverage. and would become a secondary payor.
How would you respond?
Ms. Kumar plans to retire when she turns 65 in Medicare is a program for people age 65 or older and those under
a few months. She is in excellent health and will age 65 with certain disabilities, end-stage renal disease, and Lou
have considerable income when she retires. Gehrig's disease so she will be eligible for Medicare.
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?
, Mrs. Ellis recently turned 66 and decided Part B primarily covers physician services. She will be paying a monthly
after many years of work to retire and begin premium and, except for many preventive and screening tests,
receiving Social Security benefits. Shortly generally will have 20% co-payments for these services, in addition to
thereafter Mrs. Ellis received a letter informing an annual
her that she had been automatically enrolled in deductible.
Medicare Part B. She wants to understand what
this means. What should you tell Mrs. Ellis?
Mr. Singh would like drug coverage but does not Mr. Singh can enroll in a stand-alone prescription drug plan and
want to be enrolled in a Medicare Advantage plan. continue to be covered for Part A and Part B services through Original
What should you tell him? Fee-for-Service Medicare.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low She should contact her state Medicaid agency to see if she qualifies for
fixed income. What could you tell Mrs. Cook that one of several programs that can help with Medicare costs for
might be of assistance? which she is responsible.
Ms. Henderson believes that she will qualify To obtain Part B coverage, she must pay a standard monthly premium,
for Medicare Coverage when she turns 65, though it is higher for individuals with higher incomes.
without paying any premiums, because she
has been working for 40 years and paying
Medicare taxes. What should you tell her?
Mr. Bauer is 49 years old, but eighteen months After receiving such disability payments for 24 months, he will be
ago he was declared disabled by the Social automatically enrolled in Medicare, regardless of age.
Security Administration and has been
receiving disability payments. He is wondering
whether he can obtain coverage under
Medicare. What should you tell him?
Mr. Schmidt would like to plan for retirement Part A, which covers hospital, skilled nursing facility, hospice, and
and has asked you what is covered under Original home health services and Part B, which covers professional services
Fee-for-Service (FFS) Medicare. What could you such as those provided by a doctor are covered under Original
tell him? Medicare.
Anthony Boniface turned 65 in 2024. He was not Anthony is eligible for a special enrollment period (SEP) because he
receiving Social Security or Railroad Retirement missed an enrollment period due to the impact of the Federally
Benefits on his 65th birthday. He was interested in declared disaster. This SEP will allow Anthony to enroll in Part B up to
obtaining Medicare coverage and is eligible six months after the end of the emergency declaration. Anthony may
for enroll in premium-free Part A at any time and his Part A coverage
premium-free Part A. Before he could enroll in will be
Medicare, his entire area was impacted by a retroactive for up to 6 months.
hurricane causing massive flooding and severe
wind damage. The Federal government declared
this to be a natural disaster which has
recently ended. During this period Anthony's
initial
enrollment period expired. Anthony asks you how
he can now obtain Medicare coverage. What
should you say?
Ms. Lewis has aggressive cancer and would like Medicare covers hospice services, and they will be available for her.
to know if Medicare will cover hospice
services in case she needs them. What should
you tell her?
with A+ Graded Answers Latest Updated 2026
Mr. Capadona would like to purchase a It is illegal for you to sell Mr. Capadona a Medigap plan if he is
Medicare Advantage (MA) plan and a Medigap enrolled in an MA plan, and besides, Medigap only works with Original
plan to pick up costs not covered by that plan. Medicare.
What should you tell him?
Agent John Miller is meeting with Jerry Smith, a Tell prospect Jerry Smith that he should consider adding a standalone
new prospect. Jerry is currently enrolled in Part D prescription drug coverage policy to his present coverage.
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?
Mr. Wu is eligible for Medicare. He has limited Mr. Wu may still qualify for help in paying Part D costs through his State
financial resources but failed to qualify for the Part Pharmaceutical Assistance Program (SPAP).
D low-income subsidy. Where might he turn for
help with his prescription drug costs?
Mr. Vasquez is in good health and is preparing a Under Original Medicare, there is a single deductible amount due for
budget in anticipation of his retirement when he the first 60 days of any inpatient hospital stay, after which it converts
turns 66. He wants to understand the health care into a per-day coinsurance amount through day 90. After day 90, he
costs he might be exposed to under Medicare would pay a daily amount up to 60 days over his lifetime, after which he
if he were to require hospitalization because of would be responsible for all costs.
an illness. In general terms, what could you tell
him about his costs for inpatient hospital
services
under Original Medicare?
Mr. Moy will soon turn age 65. He is slightly Medicare Supplemental Insurance would help cover his Part A
younger than his wife. Mr. Moy's wife has a deductible and Part B coinsurance or copayments in Original Fee-
Medicare Advantage plan, but he wants to for-Service (FFS) Medicare as well as possibly some services that
understand what coverage Medicare Medicare does not cover.
Supplemental Insurance provides since his
health care needs are different from his wife's
needs.
What could you tell Mr. Moy?
Juan Perez, who is turning age 65 next month, Juan is likely to be eligible for Medicare once he turns age 65 and if he
intends to work for several more years at Smallcap, enrolls, Medicare would become the primary payor of his healthcare
Incorporated. Smallcap has a workforce of 15 claims and Smallcap does not have to continue to offer him coverage
employees and offers employer-sponsored comparable to those under age 65 under its employer-sponsored
healthcare coverage. Juan is a naturalized citizen group health plan. Juan is likely to be eligible for Medicare once
and has contributed to the Medicare system for he turns age 65 and if he enrolls, Medicare would become the
over 20 years. Juan asks you if he will be entitled to primary payor of his healthcare claims but Smallcap must continue to
Medicare and if he enrolls how that will impact offer him coverage under its employer-sponsored group health plan
his employer- sponsored healthcare coverage. and would become a secondary payor.
How would you respond?
Ms. Kumar plans to retire when she turns 65 in Medicare is a program for people age 65 or older and those under
a few months. She is in excellent health and will age 65 with certain disabilities, end-stage renal disease, and Lou
have considerable income when she retires. Gehrig's disease so she will be eligible for Medicare.
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?
, Mrs. Ellis recently turned 66 and decided Part B primarily covers physician services. She will be paying a monthly
after many years of work to retire and begin premium and, except for many preventive and screening tests,
receiving Social Security benefits. Shortly generally will have 20% co-payments for these services, in addition to
thereafter Mrs. Ellis received a letter informing an annual
her that she had been automatically enrolled in deductible.
Medicare Part B. She wants to understand what
this means. What should you tell Mrs. Ellis?
Mr. Singh would like drug coverage but does not Mr. Singh can enroll in a stand-alone prescription drug plan and
want to be enrolled in a Medicare Advantage plan. continue to be covered for Part A and Part B services through Original
What should you tell him? Fee-for-Service Medicare.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low She should contact her state Medicaid agency to see if she qualifies for
fixed income. What could you tell Mrs. Cook that one of several programs that can help with Medicare costs for
might be of assistance? which she is responsible.
Ms. Henderson believes that she will qualify To obtain Part B coverage, she must pay a standard monthly premium,
for Medicare Coverage when she turns 65, though it is higher for individuals with higher incomes.
without paying any premiums, because she
has been working for 40 years and paying
Medicare taxes. What should you tell her?
Mr. Bauer is 49 years old, but eighteen months After receiving such disability payments for 24 months, he will be
ago he was declared disabled by the Social automatically enrolled in Medicare, regardless of age.
Security Administration and has been
receiving disability payments. He is wondering
whether he can obtain coverage under
Medicare. What should you tell him?
Mr. Schmidt would like to plan for retirement Part A, which covers hospital, skilled nursing facility, hospice, and
and has asked you what is covered under Original home health services and Part B, which covers professional services
Fee-for-Service (FFS) Medicare. What could you such as those provided by a doctor are covered under Original
tell him? Medicare.
Anthony Boniface turned 65 in 2024. He was not Anthony is eligible for a special enrollment period (SEP) because he
receiving Social Security or Railroad Retirement missed an enrollment period due to the impact of the Federally
Benefits on his 65th birthday. He was interested in declared disaster. This SEP will allow Anthony to enroll in Part B up to
obtaining Medicare coverage and is eligible six months after the end of the emergency declaration. Anthony may
for enroll in premium-free Part A at any time and his Part A coverage
premium-free Part A. Before he could enroll in will be
Medicare, his entire area was impacted by a retroactive for up to 6 months.
hurricane causing massive flooding and severe
wind damage. The Federal government declared
this to be a natural disaster which has
recently ended. During this period Anthony's
initial
enrollment period expired. Anthony asks you how
he can now obtain Medicare coverage. What
should you say?
Ms. Lewis has aggressive cancer and would like Medicare covers hospice services, and they will be available for her.
to know if Medicare will cover hospice
services in case she needs them. What should
you tell her?
