AHIP 2024 final exam with Questions and
Correct Answers 2025
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 ,forprograms ,that ,can ,help ,with
,Medicare ,costs ,for ,which ,she ,is ,responsible.
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.
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.
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.
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 ,that ,differs ,from ,the ,standard ,general ,enrollment
,period, ,during ,which ,she ,may ,enroll ,in ,Medicare ,Part ,B.
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.
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-The
,penalty ,will ,be ,a ,permanent ,10% ,increase ,in ,his ,Part ,B ,premium ,for ,every ,12-month
,period ,that ,passed ,during ,which ,he ,could ,have ,enrolled ,and ,did ,not.
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.
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.
Mr. ,Gomez ,notes ,that ,a ,Private ,Fee-for-Service ,(PFFS) ,plan ,available ,in ,his ,area ,has
,an ,attractive ,premium. ,He ,wants ,to ,know ,if ,he ,must ,use ,doctors ,in ,a ,network ,as ,his
,current ,HMO ,plan ,requires ,him ,to ,do. ,What ,should ,you ,tell ,him? ,- ,CORRECT
,ANSWER-He ,may ,receive ,health ,care ,services ,from ,any ,doctor ,allowed ,to ,bill
,Medicare, ,as ,long ,as ,he ,shows ,the ,doctor ,the ,plan's ,identification ,card ,and ,the
,doctor ,agrees ,to ,accept ,the ,PFFS ,plan's ,payment ,terms ,and ,conditions, ,which ,could
,include ,balance ,billing.
Mr. ,Kelly ,wants ,to ,know ,whether ,he ,is ,eligible ,to ,sign ,up ,for ,a ,Private ,fee-for-service
,(PFFS) ,plan. ,What ,questions ,would ,you ,need ,to ,ask ,to ,determine ,his ,eligibility? ,-
,CORRECT ,ANSWER-You ,would ,need ,to ,ask ,Mr. ,Kelly ,if ,he ,is ,enrolled ,in ,Part ,A ,and
,Part ,B ,and ,if ,he ,lives ,in ,the ,PFFS ,plan's ,service ,area.
Correct Answers 2025
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 ,forprograms ,that ,can ,help ,with
,Medicare ,costs ,for ,which ,she ,is ,responsible.
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.
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.
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.
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 ,that ,differs ,from ,the ,standard ,general ,enrollment
,period, ,during ,which ,she ,may ,enroll ,in ,Medicare ,Part ,B.
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.
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-The
,penalty ,will ,be ,a ,permanent ,10% ,increase ,in ,his ,Part ,B ,premium ,for ,every ,12-month
,period ,that ,passed ,during ,which ,he ,could ,have ,enrolled ,and ,did ,not.
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.
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.
Mr. ,Gomez ,notes ,that ,a ,Private ,Fee-for-Service ,(PFFS) ,plan ,available ,in ,his ,area ,has
,an ,attractive ,premium. ,He ,wants ,to ,know ,if ,he ,must ,use ,doctors ,in ,a ,network ,as ,his
,current ,HMO ,plan ,requires ,him ,to ,do. ,What ,should ,you ,tell ,him? ,- ,CORRECT
,ANSWER-He ,may ,receive ,health ,care ,services ,from ,any ,doctor ,allowed ,to ,bill
,Medicare, ,as ,long ,as ,he ,shows ,the ,doctor ,the ,plan's ,identification ,card ,and ,the
,doctor ,agrees ,to ,accept ,the ,PFFS ,plan's ,payment ,terms ,and ,conditions, ,which ,could
,include ,balance ,billing.
Mr. ,Kelly ,wants ,to ,know ,whether ,he ,is ,eligible ,to ,sign ,up ,for ,a ,Private ,fee-for-service
,(PFFS) ,plan. ,What ,questions ,would ,you ,need ,to ,ask ,to ,determine ,his ,eligibility? ,-
,CORRECT ,ANSWER-You ,would ,need ,to ,ask ,Mr. ,Kelly ,if ,he ,is ,enrolled ,in ,Part ,A ,and
,Part ,B ,and ,if ,he ,lives ,in ,the ,PFFS ,plan's ,service ,area.
