2026 AHIP Exam Questions and Answers
Complete GRADED A+
1. 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?
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.
2. Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could
you tell Mrs. Cook that might be of assistance?
Answer: She should contact her state Medicaid agency to see if she qualifies for one of the several
programs that can help with Medicare costs for which she is responsible.
3. Mr. Moy will soon turn age 65. He is slightly younger than his wife. 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?
Answer: Medicare supplemental insurance would help cover his Part A deductible and Part B coinsurance
or copayments in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not
cover
4. Mr. Vasquez is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the health care costs he
might be exposed to under Medicare is he were to require hospitalization
because of an illness. In general terms, what could you tell him about his costs
for inpatient hospital services under Original Medicare?
Answer: Under Original Medicare, there is a single deductible amount due for the first 60 days of any
inpatient hospital stay, after which it converts into
a per-day coinsurance amount through day 90. After day 90, he would pay a daily amount up to 60 days over his
lifetime, after which he would be responsible for all costs
5. 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?
Answer: Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical
,Assistance program (SPAP)
6. 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?
Answer: To obtain Part B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher income
7. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is cur-
rently 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?
Answer: Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription drug
coverage policy to his present coverage
8. Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a substan-
tial 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?
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
9. Ms. Kumar 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?
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
10. Edward suffered from serious kidney disease. As a result. Edward became
eligible for Medicare coverage due to end-stage renal disease (ESRD). A close
relative donated their kidney and Edward successfully underwent transplant
surgery 12 months ago. Edward is now age 50 and asks you if his Medicare
coverage will continue, what should you say?
Answer: Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the
month in which the individual receives a kidney transplant unless they are eligible for Medicare on another basis
Complete GRADED A+
1. 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?
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.
2. Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could
you tell Mrs. Cook that might be of assistance?
Answer: She should contact her state Medicaid agency to see if she qualifies for one of the several
programs that can help with Medicare costs for which she is responsible.
3. Mr. Moy will soon turn age 65. He is slightly younger than his wife. 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?
Answer: Medicare supplemental insurance would help cover his Part A deductible and Part B coinsurance
or copayments in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicare does not
cover
4. Mr. Vasquez is in good health and is preparing a budget in anticipation of his
retirement when he turns 66. He wants to understand the health care costs he
might be exposed to under Medicare is he were to require hospitalization
because of an illness. In general terms, what could you tell him about his costs
for inpatient hospital services under Original Medicare?
Answer: Under Original Medicare, there is a single deductible amount due for the first 60 days of any
inpatient hospital stay, after which it converts into
a per-day coinsurance amount through day 90. After day 90, he would pay a daily amount up to 60 days over his
lifetime, after which he would be responsible for all costs
5. 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?
Answer: Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical
,Assistance program (SPAP)
6. 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?
Answer: To obtain Part B coverage, she must pay a standard monthly premium, though it is higher for
individuals with higher income
7. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is cur-
rently 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?
Answer: Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription drug
coverage policy to his present coverage
8. Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a substan-
tial 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?
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
9. Ms. Kumar 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?
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
10. Edward suffered from serious kidney disease. As a result. Edward became
eligible for Medicare coverage due to end-stage renal disease (ESRD). A close
relative donated their kidney and Edward successfully underwent transplant
surgery 12 months ago. Edward is now age 50 and asks you if his Medicare
coverage will continue, what should you say?
Answer: Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the
month in which the individual receives a kidney transplant unless they are eligible for Medicare on another basis
