AHIP Exam Latest (2025/2026) Complete Questions and Correct Answers Complete GRADED A+

AHIP Exam
Latest (2025/2026) Complete Questions and Correct
Answers Complete GRADED A+
•
Contains 250+ Questions & Answers
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1. Mrs.Burtonisaretireewithsubstantialincome.SheisenrolledinanMA-PD plan
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and was disappointed with the service she received from her primary care
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physicianbecauseshewastoldshewouldhavetowaitfiveweekstoget an
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appointmentwhenshewasfeelingill.Shecalledyoutoaskwhatshecould dososhe
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wouldnothavetoputupwithsuchpooraccesstocare.Whatcould youtellher?
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Ans>> :Shecouldfileagrievancewithherplantocomplainaboutthelackof timeliness in
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getting an appointment.
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2. Edward IP suffered from serious kidney disease. As a result. Edward be- came
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eligible for Medicare coverage due to end-stage renal disease (ESRD). A close
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relative donated their kidney and Edward successfully underwent transplant
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surgery 12 months ago.Edward is now age 50 and asks you if his Medicare
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coverage will continue,what should you say?
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Ans>>:Individuals eligible for Medicare based on ESRD generally lose eligibility 36
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months after the month in whichtheindividualreceivesakidneytransplantunlesstheyare
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,eligibleforMedicare onanotherbasissuchasageordisability.Edwardmay,however,
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remainenrolledin PartBbutsolelyforcoverageofimmunosuppressivedrugsifhehasno
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otherhealth care coverage that would cover the drugs.
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3. Mildred Savage enrolled in Allcare Medicare Advantage plan several years kz kz kz kz kz kz kz kz kz




ago.Mildredrecentlylearnedthatsheissufferingfrominoperablecancerand has
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just a few months to live. She would like to spend these final months in hospice
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care.Mildred'sfamilyasksyouwhetherhospicebenefitswillbepaid forunderthe
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AllcareMedicareAdvantageplan.Whatshouldyousay?
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Ans>>:Mildred may remain enrolled in Allcare and make a hospice election.Hospice
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benefits will be paid for by Original Medicare under Part A and Allcare will continue to pay
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for any non-hospice services.
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4. Mr. Diaz continued working with his company and was insured under his
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employer's group plan until he reached age 68. He has heard that there is a
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premiumpenaltyforthosewhodidnotsignupforPartBwhenfirsteligibleand wants
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to know how much he will have to pay.What should you tell him?
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Ans>>:Mr. Diaz will not pay any penalty because he had continuous coverage under his
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employer's plan.
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5. Mr.Moy's wife has a Medicare Advantage plan,but he wants to under- stand
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what coverage Medicare Supplemental Insurance provides since his health
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careneedsaredifferentfromhiswife'sneeds.WhatcouldyoutellMr. Moy?
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Ans>>:Medicare Supplemental Insurance would help cover his Part A and Part B
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deductibles or coinsurance in Original Fee-for-Service (FFS) Medicare as well as
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possibly some services that Medicare does not cover.
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6. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been
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employedfulltime,andpaidtaxesduringthatentireperiod.Sheisconcerned
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,thatshewillnotqualifyforcoverageunderpartAbecauseshewasnotbornin the
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United States.What should you tell her?
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Ans>>: Most individuals who are citizens and age 65 or over are covered under Part A
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by virtue of having paid Medicare taxes while working, though some may be covered as
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a result of paying monthly premiums.
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7. Mr.Bauer is 49 years old,but eighteen months ago he was declared dis- abled
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bytheSocialSecurityAdministrationandhasbeenreceivingdisability payments.
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He is wondering whether he can obtain coverage under Medicare. Whatshould
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youtellhim?
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Ans>>:Afterreceivingsuchdisabilitypaymentsfor24months, he will be automatically z
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enrolled in Medicare, regardless of age.
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8. Mr.Xi will soon turn age 65 and has come to you for advice as to what services
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areprovidedunderOriginalMedicare.WhatshouldyoutellMr.Xithat best
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describesthehealthcoverageprovidedtoMedicarebeneficiaries?:Ben- eficiaries
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underOriginalMedicarehavenocost-sharingformostpreventiveservices which include
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immunizations such as annual flu shots.
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9. Mrs.PeaH is 66yearsold,hascoverageunderanemployerplan,andwillretirenext
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year.She heard she must enroll in Part B at the beginning of the year to ensure no
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gap in coverage.What can you tell her?
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Ans>>:She may enroll at any time whilesheiscoveredunderheremployerplan,butshe z
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willhaveaspecialeight-monthenrollment period after the last month on her employer
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plan that differs from the standard general enrollment period, during which she may
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enroll in Medicare Part B.
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10. Mr.Davisis 52 yearsoldandhasrecentlybeendiagnosed withend-stage renalz
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disease (ESRD) and will soon begin dialysis.He is wondering if he can obtain
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coverage under Medicare.What should you tell him?
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Ans>>: He may sign-up forMedicareatanytimehowevercoverageusuallybeginsonthe kz kz kz kz kz kz kz kz kz kz kz kz kz kz




fourthmonthafter dialysis treatments start.
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11. Madeline Martinez was widowed several years ago. Her husband worked for kz kz kz kz kz kz kz kz kz kz




many years and contributed into the Medicare system. He also left a substantial
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estatewhichprovidesMadelinewithanannualincomeofapprox- imately
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, kz $130,000.Madeline,who has only worked part-time for the last three years, will
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kz soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for
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kz advice.What should you tell her? z
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Ans>>:You should tell Madeline that she will be able to enroll in Medicare Part A without
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paying monthly premiums due to her husband's long work record and participation in
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the Medicare system. You should also tell Madeline that she will pay Part B premiums at
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more than the standard lowest rate but less than the highest rate due her substantial
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income.
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12. Ms.Hendersonbelievesthatshewillqualify forMedicareCoveragewhen she
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turns 65, without paying any premiums, because she has been working
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