Social Science Business Insurance
AHIP Final Exam Questions Verified and Provided with A+ Graded
Answers Latest Updated 2026
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.
D low-income subsidy. Where might he turn for
help with his prescription drug costs?
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?
Mildred Savage enrolled in Allcare Medicare Mildred may remain enrolled in Allcare and make a hospice
Advantage plan several years ago. Mildred election. Hospice benefits will be paid for by Original Medicare
recently learned that she is suffering from under Part A and Allcare will continue to pay for any non-hospice
inoperable cancer and has just a few months services.
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?
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.
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. Davis is 52 years old and has recently been He may sign-up for Medicare at any time however coverage usually
diagnosed with end-stage renal disease (ESRD) begins on the fourth month after dialysis treatments start.
and will soon begin dialysis. He is wondering if he
can obtain coverage under Medicare. What should
you tell him?
Mr. Diaz continued working with his company Mr. Diaz will not pay any penalty because he had continuous coverage
and was insured under his employer's group plan under his employer's 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?
, Madeline Martinez was widowed several years You should tell Madeline that she will be able to enroll in Medicare Part
ago. Her husband worked for many years and A without paying monthly premiums due to her husband's long
contributed into the Medicare system. He also left work
a substantial estate which provides Madeline with record and participation in the Medicare system. You should also tell
an annual income of approximately $130,000. Madeline that she will pay Part B premiums at more than the standard
Madeline, who has only worked part-time for the lowest rate but less than the highest rate due her substantial
last three years, will soon turn age 65 and hopes income.
to enroll in Original Medicare. She comes to you
for advice. What should you tell her?
Edward IP suffered from serious kidney disease. As Individuals eligible for Medicare based on ESRD generally lose
a result. Edward became eligible for Medicare eligibility 36 months after the month in which the individual receives a
coverage due to end-stage renal disease (ESRD). A kidney transplant unless they are eligible for Medicare on another
close relative donated their kidney and Edward basis such as age or disability. Edward may, however, remain enrolled
successfully underwent transplant surgery 12 in Part B but solely for coverage of immunosuppressive drugs if he
months ago. Edward is now age 50 and asks you has no
if his Medicare coverage will continue, what other health care coverage that would cover the drugs.
should you say?
Mrs. Peňa is 66 years old, has coverage under She may enroll at any time while she is covered under her employer
an employer plan, and will retire next year. She plan, but she will have a special eight-month enrollment period after the
heard she must enroll in Part B at the last month on her employer plan that differs from the standard general
beginning of the year to ensure no gap in enrollment period, during which she may enroll in Medicare Part B.
coverage. What can you tell her?
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?
Ms. Henderson believes that she will qualify for To obtain Part B coverage, she must pay a standard monthly premium,
Medicare Coverage when she turns 65, without though it is higher for individuals with higher incomes.
paying any premiums, because she has been
working for 40 years and paying Medicare taxes.
What should you tell her?
Mrs. Park is an elderly retiree. Mrs. Park has a low She should contact her state Medicaid agency to see if she qualifies for
fixed income. What could you tell Mrs. Park that one of several programs that can help with Medicare costs for
might be of assistance? which she is responsible.
Shirly Thomas was enrolled in Medicaid during the Shirley is eligible for a Special Enrollment Period (SEP) for up to six
Public Health Emergency (PHE). This coverage has months after the termination of her Medicaid coverage. Under this SEP,
recently been terminated due to the end of the Shirley can choose retroactive coverage back to the date of termination
PHE. While Shirley was enrolled in Medicaid, she from Medicaid or coverage beginning the month after the month of
missed an opportunity to enroll in Medicare enrollment.
and now wants Part B. Which of the following
statements best describes Shirley's ability to now
enroll in Medicare Part B?
Ms. Moore 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?
AHIP Final Exam Questions Verified and Provided with A+ Graded
Answers Latest Updated 2026
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.
D low-income subsidy. Where might he turn for
help with his prescription drug costs?
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?
Mildred Savage enrolled in Allcare Medicare Mildred may remain enrolled in Allcare and make a hospice
Advantage plan several years ago. Mildred election. Hospice benefits will be paid for by Original Medicare
recently learned that she is suffering from under Part A and Allcare will continue to pay for any non-hospice
inoperable cancer and has just a few months services.
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?
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.
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. Davis is 52 years old and has recently been He may sign-up for Medicare at any time however coverage usually
diagnosed with end-stage renal disease (ESRD) begins on the fourth month after dialysis treatments start.
and will soon begin dialysis. He is wondering if he
can obtain coverage under Medicare. What should
you tell him?
Mr. Diaz continued working with his company Mr. Diaz will not pay any penalty because he had continuous coverage
and was insured under his employer's group plan under his employer's 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?
, Madeline Martinez was widowed several years You should tell Madeline that she will be able to enroll in Medicare Part
ago. Her husband worked for many years and A without paying monthly premiums due to her husband's long
contributed into the Medicare system. He also left work
a substantial estate which provides Madeline with record and participation in the Medicare system. You should also tell
an annual income of approximately $130,000. Madeline that she will pay Part B premiums at more than the standard
Madeline, who has only worked part-time for the lowest rate but less than the highest rate due her substantial
last three years, will soon turn age 65 and hopes income.
to enroll in Original Medicare. She comes to you
for advice. What should you tell her?
Edward IP suffered from serious kidney disease. As Individuals eligible for Medicare based on ESRD generally lose
a result. Edward became eligible for Medicare eligibility 36 months after the month in which the individual receives a
coverage due to end-stage renal disease (ESRD). A kidney transplant unless they are eligible for Medicare on another
close relative donated their kidney and Edward basis such as age or disability. Edward may, however, remain enrolled
successfully underwent transplant surgery 12 in Part B but solely for coverage of immunosuppressive drugs if he
months ago. Edward is now age 50 and asks you has no
if his Medicare coverage will continue, what other health care coverage that would cover the drugs.
should you say?
Mrs. Peňa is 66 years old, has coverage under She may enroll at any time while she is covered under her employer
an employer plan, and will retire next year. She plan, but she will have a special eight-month enrollment period after the
heard she must enroll in Part B at the last month on her employer plan that differs from the standard general
beginning of the year to ensure no gap in enrollment period, during which she may enroll in Medicare Part B.
coverage. What can you tell her?
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?
Ms. Henderson believes that she will qualify for To obtain Part B coverage, she must pay a standard monthly premium,
Medicare Coverage when she turns 65, without though it is higher for individuals with higher incomes.
paying any premiums, because she has been
working for 40 years and paying Medicare taxes.
What should you tell her?
Mrs. Park is an elderly retiree. Mrs. Park has a low She should contact her state Medicaid agency to see if she qualifies for
fixed income. What could you tell Mrs. Park that one of several programs that can help with Medicare costs for
might be of assistance? which she is responsible.
Shirly Thomas was enrolled in Medicaid during the Shirley is eligible for a Special Enrollment Period (SEP) for up to six
Public Health Emergency (PHE). This coverage has months after the termination of her Medicaid coverage. Under this SEP,
recently been terminated due to the end of the Shirley can choose retroactive coverage back to the date of termination
PHE. While Shirley was enrolled in Medicaid, she from Medicaid or coverage beginning the month after the month of
missed an opportunity to enroll in Medicare enrollment.
and now wants Part B. Which of the following
statements best describes Shirley's ability to now
enroll in Medicare Part B?
Ms. Moore 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?
