AHIP 2025–2026 Exam Mastery Guide: Practice Questions & Strategies

AHIP 2025–2026 Exam Mastery Guide:
Practice Questions & Strategies




Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assistance Program. -
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correct answers Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for the
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Part D low-income subsidy. Where might he turn for help with his prescription drug costs?
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After receiving such disability payments for 24 months, he will be automatically enrolled in Medicare,
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regardless of age. - correct answers Mr. Bauer is 49 years old, but eighteen months ago he was declared
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disabled by the Social Security Administration and has been receiving disability payments. He is wondering
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whether he can obtain coverage under Medicare. What should you tell him?
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Mildred may remain enrolled in Allcare and make a hospice election. Hospice benefits will be paid for by
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Original Medicare under Part A and Allcare will continue to pay for any non-hospice services. - correct answers
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Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. Mildred recently learned that
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she is suffering from inoperable cancer and has just a few months to live. She would like to spend these final
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months in hospice care. Mildred's family asks you whether hospice benefits will be paid for under the Allcare
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Medicare Advantage plan. What should you say? J J J J J J




Part A, which covers hospital, skilled nursing facility, hospice, and home health services and Part B, which
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covers professional services such as those provided by a doctor are covered under Original Medicare. - correct
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answers Mr. Schmidt would like to plan for retirement and has asked you what is covered under Original Fee-
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for-Service (FFS) Medicare. What could you tell him? J J J J J J J




Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription drug coverage policy
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to his present coverage. - correct answers Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry
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is currently enrolled in Medicare Parts A and B. Jerry has also purchased a Medicare Supplement (Medigap)
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,plan which he has had for several years. However, the plan does not provide drug benefits. How would you
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advise Agent John Miller to proceed? J J J J J




He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis
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treatments start. - correct answers Mr. Davis is 52 years old and has recently been diagnosed with end-stage J J J J J J J J J J J J J J J J J J




renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare.
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What should you tell him? J J J J




Mr. Diaz will not pay any penalty because he had continuous coverage under his employer's plan. - correct
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answers Mr. Diaz continued working with his company and was insured under his employer's group plan until
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he reached age 68. He has heard that there is a premium penalty for those who did not sign up for Part B when
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first eligible and wants to know how much he will have to pay. What should you tell him?
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You should tell Madeline that she will be able to enroll in Medicare Part A without paying monthly premiums
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due to her husband's long work record and participation in the Medicare system. You should also tell Madeline
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that she will pay Part B premiums at more than the standard lowest rate but less than the highest rate due her
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substantial income. - correct answers Madeline Martinez was widowed several years ago. Her husband J J J J J J J J J J J J J J




worked for many years and contributed into the Medicare system. He also left a substantial estate which
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provides Madeline with an annual income of approximately $130,000. Madeline, who has only worked part- J J J J J J J J J J J J J J




time for the last three years, will soon turn age 65 and hopes to enroll in Original Medicare. She comes to you for
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advice. What should you tell her? J J J J J




Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in which J J J J J J J J J J J J J J J J J




the individual receives a kidney transplant unless they are eligible for Medicare on another basis such as age or
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disability. Edward may, however, remain enrolled in Part B but solely for coverage of immunosuppressive J J J J J J J J J J J J J J J




drugs if he has no other health care coverage that would cover the drugs. - correct answers Edward IP suffered
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from serious kidney disease. As a result. Edward became eligible for Medicare coverage due to end-stage renal
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disease (ESRD). A close relative donated their kidney and Edward successfully underwent transplant surgery
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12 months ago. Edward is now age 50 and asks you if his Medicare coverage will continue, what should you say?
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She may enroll at any time while she is covered under her employer plan, but she will have a special eight-
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month enrollment period after the last month on her employer plan that differs from the standard general
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enrollment period, during which she may enroll in Medicare Part B. - correct answers Mrs. Peňa is 66 years old, J J J J J J J J J J J J J J J J J J J J




has coverage under an employer plan, and will retire next year. She heard she must enroll in Part B at the
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beginning of the year to ensure no gap in coverage. What can you tell her? J J J J J J J J J J J J J J

, It is illegal for you to sell Mr. Capadona a Medigap plan if he is enrolled in an MA plan, and besides, Medigap only
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works with Original Medicare. - correct answers Mr. Capadona would like to purchase a Medicare Advantage
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(MA) plan and a Medigap plan to pick up costs not covered by that plan. What should you tell him?
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To obtain Part B coverage, she must pay a standard monthly premium, though it is higher for individuals with
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higher incomes. - correct answers Ms. Henderson believes that she will qualify for Medicare Coverage when
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she turns 65, without paying any premiums, because she has been working for 40 years and paying Medicare
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taxes. What should you tell her? J J J J J




She should contact her state Medicaid agency to see if she qualifies for one of several programs that can help
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with Medicare costs for which she is responsible. - correct answers Mrs. Park is an elderly retiree. Mrs. Park has
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a low fixed income. What could you tell Mrs. Park that might be of assistance?
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Shirley is eligible for a Special Enrollment Period (SEP) for up to six months after the termination of her
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Medicaid coverage. Under this SEP, Shirley can choose retroactive coverage back to the date of termination J J J J J J J J J J J J J J J J




from Medicaid or coverage beginning the month after the month of enrollment. - correct answers Shirly
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Thomas was enrolled in Medicaid during the Public Health Emergency (PHE). This coverage has recently been
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terminated due to the end of the PHE. While Shirley was enrolled in Medicaid, she missed an opportunity to J J J J J J J J J J J J J J J J J J J




enroll in Medicare and now wants Part B. Which of the following statements best describes Shirley's ability to
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now enroll in Medicare Part B? J J J J J




Medicare is a program for people age 65 or older and those under age 65 with certain disabilities, end-stage J J J J J J J J J J J J J J J J J J J




renal disease, and Lou Gehrig's disease so she will be eligible for Medicare. - correct answers Ms. Moore plans
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to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when
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she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could
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you tell her to address her concern?
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Mrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she could keep her Medigap policy and
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enroll in a Part D prescription drug plan. - correct answers Mrs. Gonzalez is enrolled in Original Medicare and
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has a Medigap policy as well, but it provides no drug coverage. She would like to keep the coverage she has but
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replace her existing Medigap plan with one that provides drug coverage. What should you tell her?
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Most individuals who are citizens and age 65 or over are covered under Part A by virtue of having paid Medicare
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taxes while working, though some may be covered as a result of paying monthly premiums. - correct answers
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Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been employed full time, and paid taxes
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during that entire period. She is concerned that she will not qualify for coverage under part A because she was
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not born in the United States. What should you tell her?
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