AHIP FINAL EXAM 2025/2026 100% TESTED
AND VERIFIED
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.
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.
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. 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.
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. 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.
,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.
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.
Edward IP 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? - correct 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 such as age or disability. Edward may, however,
remain enrolled in Part B but solely for coverage of
immunosuppressive drugs if he has no other health care
coverage that would cover the drugs.
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.
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.
AND VERIFIED
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.
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.
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. 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.
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. 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.
,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.
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.
Edward IP 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? - correct 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 such as age or disability. Edward may, however,
remain enrolled in Part B but solely for coverage of
immunosuppressive drugs if he has no other health care
coverage that would cover the drugs.
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.
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.
