AHIP Final Test 2027 Questions and Answers (Updated Verified
Answers)
Question 1.
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?
Correct 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.
Question 2.
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?
Correct Answer: Mr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
Question 3.
Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what
coverage Medicare Supplemental Insurance provides since his health care needs are
different from his wife's needs. What could you tell Mr. Moy?
Correct Answer: Medicare Supplemental Insurance would help cover his Part A
and Part B deductibles or coinsurance in Original Fee-for-Service (FFS)
Medicare as well as possibly some services that Medicare does not cover.
Question 4.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. She is 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?
Correct Answer: Most individuals who are citizens and age 65 or over are
covered under Part A by virtue of having paid Medicare taxes while working,
though some may be covered as a result of paying monthly premiums.
Question 5.
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?
Correct Answer: After receiving such disability payments for 24 months, he
will be automatically enrolled in Medicare, regardless of age.
Question 6.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare. What should you tell Mr. Xi that best describes the
health coverage provided to Medicare beneficiaries?
Correct Answer: Beneficiaries under Original Medicare have no cost-sharing
for most preventive services which include immunizations such as annual flu
shots.
Question 7.
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?
Correct Answer: She may enroll at any time while she is covered under her
employer plan, but she will have a special eight- month enrollment period
after the last month on her employer plan that differs from the standard
general enrollment period, during which she may enroll in Medicare Part B.
Question 8.
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?
Correct Answer: He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
Question 9.
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 Original Medicare. She comes to you for advice. What should you tell her?
Correct 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.
,Question 10.
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?
Correct Answer: To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
• To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes. -✓✓Mrs. Gonzalez
cannot purchase a Medigap plan that covers drugs, but she could keep her
Medigap policy and enroll in a Part D prescription drug plan.
Question 11.
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?
Correct Answer: Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present coverage.
Question 12.
Ms. Moore 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?
Correct Answer: 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.
Question 13.
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?
Correct Answer: 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.
Question 14.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs.
Park that might be of assistance?
Correct Answer: She should contact her state Medicaid agency to see if she
qualifies for one of several programs that can help with Medicare costs for
which she is responsible.
, Question 15.
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?
Correct 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.
Question 16.
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?
Correct Answer: Mr. Wu may still qualify for help in paying Part D costs
through his State Pharmaceutical Assistance Program.
Question 17.
Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE). This
coverage has recently been terminated due to the end of the PHE. While Shirley was
enrolled in Medicaid, she missed an opportunity to enroll in Medicare and now wants
Part B. Which of the following statements best describes Shirley's ability to now enroll in
Medicare Part B?
Correct Answer: Shirley is eligible for a Special Enrollment Period (SEP) for up
to six months after the termination of her Medicaid coverage. Under this SEP,
Shirley can choose retroactive coverage back to the date of termination from
Medicaid or coverage beginning the month after the month of enrollment.
Question 18.
Anthony Boniface turned 65 in 2023. He was not receiving Social Security or Railroad
Retirement Benefits on his 65th birthday. He was interested in obtaining Medicare
coverage and is eligible for premium-free Part A. Before he could enroll in Medicare, his
entire area was impacted by a 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?
Correct Answer: Anthony is eligible for a special enrollment period (SEP)
because he missed an enrollment period due to the impact of the Federally
declared disaster. This SEP will allow Anthony to enroll in Part B up to six
months after the end of the emergency declaration. Anthony may enroll in
premium-free Part A at any time and his Part A coverage will be retroactive for
up to 6 months.
Answers)
Question 1.
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?
Correct 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.
Question 2.
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?
Correct Answer: Mr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
Question 3.
Mr. Moy's wife has a Medicare Advantage plan, but he wants to understand what
coverage Medicare Supplemental Insurance provides since his health care needs are
different from his wife's needs. What could you tell Mr. Moy?
Correct Answer: Medicare Supplemental Insurance would help cover his Part A
and Part B deductibles or coinsurance in Original Fee-for-Service (FFS)
Medicare as well as possibly some services that Medicare does not cover.
Question 4.
Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full
time, and paid taxes during that entire period. She is 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?
Correct Answer: Most individuals who are citizens and age 65 or over are
covered under Part A by virtue of having paid Medicare taxes while working,
though some may be covered as a result of paying monthly premiums.
Question 5.
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?
Correct Answer: After receiving such disability payments for 24 months, he
will be automatically enrolled in Medicare, regardless of age.
Question 6.
Mr. Xi will soon turn age 65 and has come to you for advice as to what services are
provided under Original Medicare. What should you tell Mr. Xi that best describes the
health coverage provided to Medicare beneficiaries?
Correct Answer: Beneficiaries under Original Medicare have no cost-sharing
for most preventive services which include immunizations such as annual flu
shots.
Question 7.
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?
Correct Answer: She may enroll at any time while she is covered under her
employer plan, but she will have a special eight- month enrollment period
after the last month on her employer plan that differs from the standard
general enrollment period, during which she may enroll in Medicare Part B.
Question 8.
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?
Correct Answer: He may sign-up for Medicare at any time however coverage
usually begins on the fourth month after dialysis treatments start.
Question 9.
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 Original Medicare. She comes to you for advice. What should you tell her?
Correct 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.
,Question 10.
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?
Correct Answer: To obtain Part B coverage, she must pay a standard monthly
premium, though it is higher for individuals with higher incomes.
• To obtain Part B coverage, she must pay a standard monthly premium,
though it is higher for individuals with higher incomes. -✓✓Mrs. Gonzalez
cannot purchase a Medigap plan that covers drugs, but she could keep her
Medigap policy and enroll in a Part D prescription drug plan.
Question 11.
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?
Correct Answer: Tell prospect Jerry Smith that he should consider adding a
standalone Part D prescription drug coverage policy to his present coverage.
Question 12.
Ms. Moore 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?
Correct Answer: 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.
Question 13.
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?
Correct Answer: 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.
Question 14.
Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income. What could you tell Mrs.
Park that might be of assistance?
Correct Answer: She should contact her state Medicaid agency to see if she
qualifies for one of several programs that can help with Medicare costs for
which she is responsible.
, Question 15.
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?
Correct 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.
Question 16.
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?
Correct Answer: Mr. Wu may still qualify for help in paying Part D costs
through his State Pharmaceutical Assistance Program.
Question 17.
Shirly Thomas was enrolled in Medicaid during the Public Health Emergency (PHE). This
coverage has recently been terminated due to the end of the PHE. While Shirley was
enrolled in Medicaid, she missed an opportunity to enroll in Medicare and now wants
Part B. Which of the following statements best describes Shirley's ability to now enroll in
Medicare Part B?
Correct Answer: Shirley is eligible for a Special Enrollment Period (SEP) for up
to six months after the termination of her Medicaid coverage. Under this SEP,
Shirley can choose retroactive coverage back to the date of termination from
Medicaid or coverage beginning the month after the month of enrollment.
Question 18.
Anthony Boniface turned 65 in 2023. He was not receiving Social Security or Railroad
Retirement Benefits on his 65th birthday. He was interested in obtaining Medicare
coverage and is eligible for premium-free Part A. Before he could enroll in Medicare, his
entire area was impacted by a 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?
Correct Answer: Anthony is eligible for a special enrollment period (SEP)
because he missed an enrollment period due to the impact of the Federally
declared disaster. This SEP will allow Anthony to enroll in Part B up to six
months after the end of the emergency declaration. Anthony may enroll in
premium-free Part A at any time and his Part A coverage will be retroactive for
up to 6 months.
