AHIP 2026- MODULES 1-5, FINAL, AND
FWA JACKPOT EXAM QUESTIONS &
DETAILED COMPLETE SOLUTIONS
What happens after Mr. Bauer has received disability payments for 24 months? - correct answer
✔✔He will be automatically enrolled in Medicare, regardless of age.
Why did Edward become eligible for Medicare coverage? - correct answer ✔✔Due to end-stage
renal disease (ESRD).
How long does Medicare coverage generally last for individuals eligible based on ESRD after a
kidney transplant? - correct answer ✔✔Eligibility generally lasts for 36 months after the month
in which the individual receives a kidney transplant.
What can Edward do regarding Part B coverage after his kidney transplant? - correct answer
✔✔He may remain enrolled in Part B solely for coverage of immunosuppressive drugs if he has
no other health care coverage for those drugs.
What special enrollment option does Anthony have after missing his initial enrollment period
due to a disaster? - correct answer ✔✔He is eligible for a special enrollment period (SEP) to
enroll in Part B up to six months after the end of the emergency declaration.
When can Anthony enroll in premium-free Part A? - correct answer ✔✔He may enroll in
premium-free Part A at any time, with coverage retroactive for up to 6 months.
What should you tell Mr. Capadona about purchasing a Medigap plan while enrolled in a
Medicare Advantage plan? - correct answer ✔✔It is illegal to sell him a Medigap plan if he is
enrolled in an MA plan, as Medigap only works with Original Medicare.
,Will Mildred's hospice care be covered under her Allcare Medicare Advantage plan? - correct
answer ✔✔Yes, hospice benefits will be paid for by Original Medicare under Part A, and Allcare
will continue to pay for any non-hospice services.
What must Ms. Henderson do to obtain Part B coverage? - correct answer ✔✔She must pay a
standard monthly premium, which may be higher for individuals with higher incomes.
What assistance can Mrs. Cook seek due to her low fixed income? - correct answer ✔✔She
should contact her state Medicaid agency to see if she qualifies for programs that help with
Medicare costs.
What does Medicare Supplemental Insurance cover for Mr. Moy? - correct answer ✔✔It helps
cover his Part A deductible and Part B coinsurance or copayments in Original Fee-for-Service
(FFS) Medicare.
What is Juan Perez's situation regarding Medicare as he turns 65? - correct answer ✔✔He
intends to work for several more years at Smallcap, which offers employer-sponsored
healthcare coverage.
What is the eligibility requirement for premium-free Part A? - correct answer ✔✔Individuals
must have worked and paid Medicare taxes for a sufficient period, typically 40 quarters.
What happens if an individual does not enroll in Medicare during their initial enrollment
period? - correct answer ✔✔They may qualify for a special enrollment period if they missed it
due to certain circumstances, such as a natural disaster.
How does Medicare coverage differ for individuals based on age versus disability? - correct
answer ✔✔Individuals under 65 can qualify for Medicare due to disability after 24 months of
receiving disability payments, while those 65 and older qualify based on age.
, What is the role of Medigap insurance? - correct answer ✔✔Medigap insurance helps cover
costs not covered by Original Medicare, such as deductibles and coinsurance.
What is the maximum duration of Medicare coverage after a kidney transplant for those eligible
due to ESRD? - correct answer ✔✔36 months after the month of the transplant.
What should individuals do if they are unsure about their Medicare eligibility? - correct answer
✔✔They should contact the Social Security Administration or their state Medicaid agency for
guidance.
What is the significance of a Federally declared disaster in relation to Medicare enrollment? -
correct answer ✔✔It allows individuals who missed their enrollment period to qualify for a
special enrollment period.
What is the difference between Medicare Advantage and Original Medicare regarding coverage?
- correct answer ✔✔Medicare Advantage plans may offer additional benefits but cannot be
combined with Medigap plans.
What is the importance of immunosuppressive drug coverage for kidney transplant patients? -
correct answer ✔✔It is critical for preventing organ rejection and maintaining health post-
transplant.
How does income affect the premium for Part B coverage? - correct answer ✔✔Individuals with
higher incomes may pay a higher monthly premium for Part B.
What is Juan likely entitled to when he turns age 65 regarding Medicare? - correct answer
✔✔Juan is likely to be eligible for Medicare.
How would enrolling in Medicare impact Juan's employer-sponsored healthcare coverage? -
correct answer ✔✔If Juan enrolls, Medicare becomes the primary payor of his healthcare
claims, and his employer's plan becomes a secondary payor.
FWA JACKPOT EXAM QUESTIONS &
DETAILED COMPLETE SOLUTIONS
What happens after Mr. Bauer has received disability payments for 24 months? - correct answer
✔✔He will be automatically enrolled in Medicare, regardless of age.
Why did Edward become eligible for Medicare coverage? - correct answer ✔✔Due to end-stage
renal disease (ESRD).
How long does Medicare coverage generally last for individuals eligible based on ESRD after a
kidney transplant? - correct answer ✔✔Eligibility generally lasts for 36 months after the month
in which the individual receives a kidney transplant.
What can Edward do regarding Part B coverage after his kidney transplant? - correct answer
✔✔He may remain enrolled in Part B solely for coverage of immunosuppressive drugs if he has
no other health care coverage for those drugs.
What special enrollment option does Anthony have after missing his initial enrollment period
due to a disaster? - correct answer ✔✔He is eligible for a special enrollment period (SEP) to
enroll in Part B up to six months after the end of the emergency declaration.
When can Anthony enroll in premium-free Part A? - correct answer ✔✔He may enroll in
premium-free Part A at any time, with coverage retroactive for up to 6 months.
What should you tell Mr. Capadona about purchasing a Medigap plan while enrolled in a
Medicare Advantage plan? - correct answer ✔✔It is illegal to sell him a Medigap plan if he is
enrolled in an MA plan, as Medigap only works with Original Medicare.
,Will Mildred's hospice care be covered under her Allcare Medicare Advantage plan? - correct
answer ✔✔Yes, hospice benefits will be paid for by Original Medicare under Part A, and Allcare
will continue to pay for any non-hospice services.
What must Ms. Henderson do to obtain Part B coverage? - correct answer ✔✔She must pay a
standard monthly premium, which may be higher for individuals with higher incomes.
What assistance can Mrs. Cook seek due to her low fixed income? - correct answer ✔✔She
should contact her state Medicaid agency to see if she qualifies for programs that help with
Medicare costs.
What does Medicare Supplemental Insurance cover for Mr. Moy? - correct answer ✔✔It helps
cover his Part A deductible and Part B coinsurance or copayments in Original Fee-for-Service
(FFS) Medicare.
What is Juan Perez's situation regarding Medicare as he turns 65? - correct answer ✔✔He
intends to work for several more years at Smallcap, which offers employer-sponsored
healthcare coverage.
What is the eligibility requirement for premium-free Part A? - correct answer ✔✔Individuals
must have worked and paid Medicare taxes for a sufficient period, typically 40 quarters.
What happens if an individual does not enroll in Medicare during their initial enrollment
period? - correct answer ✔✔They may qualify for a special enrollment period if they missed it
due to certain circumstances, such as a natural disaster.
How does Medicare coverage differ for individuals based on age versus disability? - correct
answer ✔✔Individuals under 65 can qualify for Medicare due to disability after 24 months of
receiving disability payments, while those 65 and older qualify based on age.
, What is the role of Medigap insurance? - correct answer ✔✔Medigap insurance helps cover
costs not covered by Original Medicare, such as deductibles and coinsurance.
What is the maximum duration of Medicare coverage after a kidney transplant for those eligible
due to ESRD? - correct answer ✔✔36 months after the month of the transplant.
What should individuals do if they are unsure about their Medicare eligibility? - correct answer
✔✔They should contact the Social Security Administration or their state Medicaid agency for
guidance.
What is the significance of a Federally declared disaster in relation to Medicare enrollment? -
correct answer ✔✔It allows individuals who missed their enrollment period to qualify for a
special enrollment period.
What is the difference between Medicare Advantage and Original Medicare regarding coverage?
- correct answer ✔✔Medicare Advantage plans may offer additional benefits but cannot be
combined with Medigap plans.
What is the importance of immunosuppressive drug coverage for kidney transplant patients? -
correct answer ✔✔It is critical for preventing organ rejection and maintaining health post-
transplant.
How does income affect the premium for Part B coverage? - correct answer ✔✔Individuals with
higher incomes may pay a higher monthly premium for Part B.
What is Juan likely entitled to when he turns age 65 regarding Medicare? - correct answer
✔✔Juan is likely to be eligible for Medicare.
How would enrolling in Medicare impact Juan's employer-sponsored healthcare coverage? -
correct answer ✔✔If Juan enrolls, Medicare becomes the primary payor of his healthcare
claims, and his employer's plan becomes a secondary payor.
