AHIP 2026 Final Exam
100 Questions and answers
100 QUESTIONS
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-fo
Service (FFS) Medicare. What could you tell him? - ANS>>Part A, which covers hospital, skilled nursin
facility, hospice, and home health services and Part B, which covers professional services such as thos
provided by a doctor are covered under Original Medicare.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could you tell Mrs. Cook that migh
be of assistance? - ANS>>She should contact her state Medicaid agency to see if she qualifies for one o
the several programs that can help with Medicare costs for which she is responsible.
Mr. Moy will soon turn age 65. He is slightly younger than his wife. Mr. Moy's wife has a Medicar
Advantage plan, but he wants to understand what coverage Medicare Supplemental insurance provide
since his health care needs are different from his wife's needs. What could you tell Mr. Moy?
ANS>>Medicare supplemental insurance would help cover his Part A deductible and Part B coinsuranc
or copayments in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicar
does not cover
Mr. Vasquez is in good health and is preparing a budget in anticipation of his retirement when he turn
66. He wants to understand the health care costs he might be exposed to under Medicare is he were t
require hospitalization because of an illness. In general terms, what could you tell him about his costs fo
inpatient hospital services under Original Medicare? - ANS>>Under Original Medicare, there is a singl
deductible amount due for the first 60 days of any inpatient hospital stay, after which it converts into
per-day coinsurance amount through day 90. After day 90, he would pay a daily amount up to 60 day
over his lifetime, after which he would be responsible for all costs
, 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? - ANS>>Mr. Wu may sti
qualify for help in paying Part D costs through his State Pharmaceutical Assistance program (SPAP)
Ms. Henderson believes that she will qualify for Medicare Coverage when she turns 65, without payin
any premiums, because she has been working for 40 years and paying Medicare taxes. What should yo
tell her? - ANS>>To obtain Part B coverage, she must pay a standard monthly premium, though it is highe
for individuals with higher income
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled in Medicar
Parts A and B. Jerry has also purchased a Medicare Supplement (Medigap) plan which he has had fo
several years. However, the plan does not provide drug benefits. How would you advise Agent John Mille
to proceed? - ANS>>Tell prospect Jerry Smith that he should consider adding a standalone Part
prescription drug coverage policy to his present coverage
Madeline Martinez was widowed several years ago. Her husband worked for many years and contribute
into the Medicare system. He also left a substantial estate which provides Madeline with an annual incom
of approximately $130,000. Madeline, who has only worked part-time for the last three years, will soo
turn age 65 and hopes to enroll in Original Medicare. She comes to you for advice. What should you te
her? - ANS>>You should tell Madeline that she will be able to enroll in Medicare Part A without payin
monthly premiums due to her husband's long work record and participation in the Medicare system. Yo
should also tell Madeline that she will pay Part B premiums at more than the standard lowest rate but les
than the highest rate due her substantial income
Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent health and will hav
considerable income when she retires. She is concerned that her income will make it impossible for he
to qualify for Medicare. What could you tell her to address her concern? - ANS>>Medicare is a program
for people age 65 or older and those under age 65 with certain disabilities, end-stage renal disease, an
Lou Gehrig's disease so she will be eligible for Medicare
Edward suffered from serious kidney disease. As a result. Edward became eligible for Medicare coverag
due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward successfull
underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicar
coverage will continue, what should you say? - ANS>>Individuals eligible for Medicare based on ESR
generally lose eligibility 36 months after the month in which the individual receives a kidney transplan
unless they are eligible for Medicare on another basis such as age or disability. Edward may, howeve
remain enrolled in Part B but solely for coverage of immunosuppressive drugs if he has no other healt
care coverage that would cover the drugs.
Mrs. Thomas is 66 years old, has coverage under an employer plan, and will retire next year. She hear
she must enroll in Part B at the beginning of the year to ensure no gap in coverage. What can you tell her
- ANS>>She may enroll at any time while she is covered under her employer plan, but she will have
special eight-month enrollment period after the last month on her employer plan that differs from th
standard general enrollment period, during which she may enroll in Medicare Part B.
100 Questions and answers
100 QUESTIONS
Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-fo
Service (FFS) Medicare. What could you tell him? - ANS>>Part A, which covers hospital, skilled nursin
facility, hospice, and home health services and Part B, which covers professional services such as thos
provided by a doctor are covered under Original Medicare.
Mrs. Cook is an elderly retiree. Mrs. Cook has a low fixed income. What could you tell Mrs. Cook that migh
be of assistance? - ANS>>She should contact her state Medicaid agency to see if she qualifies for one o
the several programs that can help with Medicare costs for which she is responsible.
Mr. Moy will soon turn age 65. He is slightly younger than his wife. Mr. Moy's wife has a Medicar
Advantage plan, but he wants to understand what coverage Medicare Supplemental insurance provide
since his health care needs are different from his wife's needs. What could you tell Mr. Moy?
ANS>>Medicare supplemental insurance would help cover his Part A deductible and Part B coinsuranc
or copayments in Original Fee-for-Service (FFS) Medicare as well as possibly some services that Medicar
does not cover
Mr. Vasquez is in good health and is preparing a budget in anticipation of his retirement when he turn
66. He wants to understand the health care costs he might be exposed to under Medicare is he were t
require hospitalization because of an illness. In general terms, what could you tell him about his costs fo
inpatient hospital services under Original Medicare? - ANS>>Under Original Medicare, there is a singl
deductible amount due for the first 60 days of any inpatient hospital stay, after which it converts into
per-day coinsurance amount through day 90. After day 90, he would pay a daily amount up to 60 day
over his lifetime, after which he would be responsible for all costs
, 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? - ANS>>Mr. Wu may sti
qualify for help in paying Part D costs through his State Pharmaceutical Assistance program (SPAP)
Ms. Henderson believes that she will qualify for Medicare Coverage when she turns 65, without payin
any premiums, because she has been working for 40 years and paying Medicare taxes. What should yo
tell her? - ANS>>To obtain Part B coverage, she must pay a standard monthly premium, though it is highe
for individuals with higher income
Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled in Medicar
Parts A and B. Jerry has also purchased a Medicare Supplement (Medigap) plan which he has had fo
several years. However, the plan does not provide drug benefits. How would you advise Agent John Mille
to proceed? - ANS>>Tell prospect Jerry Smith that he should consider adding a standalone Part
prescription drug coverage policy to his present coverage
Madeline Martinez was widowed several years ago. Her husband worked for many years and contribute
into the Medicare system. He also left a substantial estate which provides Madeline with an annual incom
of approximately $130,000. Madeline, who has only worked part-time for the last three years, will soo
turn age 65 and hopes to enroll in Original Medicare. She comes to you for advice. What should you te
her? - ANS>>You should tell Madeline that she will be able to enroll in Medicare Part A without payin
monthly premiums due to her husband's long work record and participation in the Medicare system. Yo
should also tell Madeline that she will pay Part B premiums at more than the standard lowest rate but les
than the highest rate due her substantial income
Ms. Kumar plans to retire when she turns 65 in a few months. She is in excellent health and will hav
considerable income when she retires. She is concerned that her income will make it impossible for he
to qualify for Medicare. What could you tell her to address her concern? - ANS>>Medicare is a program
for people age 65 or older and those under age 65 with certain disabilities, end-stage renal disease, an
Lou Gehrig's disease so she will be eligible for Medicare
Edward suffered from serious kidney disease. As a result. Edward became eligible for Medicare coverag
due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward successfull
underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicar
coverage will continue, what should you say? - ANS>>Individuals eligible for Medicare based on ESR
generally lose eligibility 36 months after the month in which the individual receives a kidney transplan
unless they are eligible for Medicare on another basis such as age or disability. Edward may, howeve
remain enrolled in Part B but solely for coverage of immunosuppressive drugs if he has no other healt
care coverage that would cover the drugs.
Mrs. Thomas is 66 years old, has coverage under an employer plan, and will retire next year. She hear
she must enroll in Part B at the beginning of the year to ensure no gap in coverage. What can you tell her
- ANS>>She may enroll at any time while she is covered under her employer plan, but she will have
special eight-month enrollment period after the last month on her employer plan that differs from th
standard general enrollment period, during which she may enroll in Medicare Part B.
