AHIP 2024 Final Exam with Questions, Answers
and Rationales
1. Question: Mrs. Park is an elderly retiree with a low fixed income. What
could you tell Mrs. Park that might be of assistance?
Answer: She should contact her state Medicaid agency to see if she qualifies
for programs that can help with Medicare costs for which she is responsible.
Rationale: Mrs. Park’s low fixed income suggests she may qualify for
Medicaid or other assistance programs like the Medicare Savings Program,
which can help cover premiums, deductibles, and copayments for Medicare
Parts A and B, reducing her out-of-pocket expenses.
2. Question: 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?
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 to her substantial income.
Rationale: Madeline’s husband’s contributions to Medicare qualify her for
premium-free Part A. Her income of $130,000 subjects her to Income-
Related Monthly Adjustment Amount (IRMAA), increasing her Part B
premiums, but not to the highest tier, as IRMAA is tiered based on income
levels.
3. Question: 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?
Answer: After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
Rationale: Individuals under 65 who receive Social Security Disability
Insurance (SSDI) for 24 months are automatically eligible for Medicare,
ensuring coverage for disabilities like Mr. Bauer’s, regardless of his age, to
provide necessary medical support.
4. Question: 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?
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, 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.
Rationale: Original Medicare consists of Part A (inpatient care, hospice,
etc.) and PartDeclined B (outpatient care, doctor visits), providing a
comprehensive baseline for retirees like Mr. Schmidt to understand covered
services when planning healthcare in retirement.
5. Question: Mrs. Peña 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?
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.
Rationale: Mrs. Peña’s employer coverage delays her Part B enrollment
requirement. The Special Enrollment Period (SEP) allows her to enroll in
Part B without penalty during or within eight months after her employment
or coverage ends, avoiding gaps.
6. Question: Agent John Miller is meeting with Jerry Smith, a new prospect.
Jerry is currently enrolled in Medicare Parts A and B. Jerry has also
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and Rationales
1. Question: Mrs. Park is an elderly retiree with a low fixed income. What
could you tell Mrs. Park that might be of assistance?
Answer: She should contact her state Medicaid agency to see if she qualifies
for programs that can help with Medicare costs for which she is responsible.
Rationale: Mrs. Park’s low fixed income suggests she may qualify for
Medicaid or other assistance programs like the Medicare Savings Program,
which can help cover premiums, deductibles, and copayments for Medicare
Parts A and B, reducing her out-of-pocket expenses.
2. Question: 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?
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 to her substantial income.
Rationale: Madeline’s husband’s contributions to Medicare qualify her for
premium-free Part A. Her income of $130,000 subjects her to Income-
Related Monthly Adjustment Amount (IRMAA), increasing her Part B
premiums, but not to the highest tier, as IRMAA is tiered based on income
levels.
3. Question: 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?
Answer: After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
Rationale: Individuals under 65 who receive Social Security Disability
Insurance (SSDI) for 24 months are automatically eligible for Medicare,
ensuring coverage for disabilities like Mr. Bauer’s, regardless of his age, to
provide necessary medical support.
4. Question: 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?
2|Page
, 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.
Rationale: Original Medicare consists of Part A (inpatient care, hospice,
etc.) and PartDeclined B (outpatient care, doctor visits), providing a
comprehensive baseline for retirees like Mr. Schmidt to understand covered
services when planning healthcare in retirement.
5. Question: Mrs. Peña 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?
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.
Rationale: Mrs. Peña’s employer coverage delays her Part B enrollment
requirement. The Special Enrollment Period (SEP) allows her to enroll in
Part B without penalty during or within eight months after her employment
or coverage ends, avoiding gaps.
6. Question: Agent John Miller is meeting with Jerry Smith, a new prospect.
Jerry is currently enrolled in Medicare Parts A and B. Jerry has also
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