AHIP - 2026 - MODULES 1-5 LATEST
ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED
GRADED A+
Mr.mCapadonamwouldmlikemtompurchasemamMedicaremAdvantagem(MA)mplanmandmamMedigapmplanmt
ompickmupmcostsmnotmcoveredmbymthatmplan.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmItmismillegalmformyoumtomsellmMr.mCapadonamamMedigapmplanmifmhemismenrolled
minmanmMAmplan,mandmbesides,mMedigapmonlymworksmwithmOriginalmMedicare.
AgentmJohnmMillermismmeetingmwithmJerrymSmith,mamnewmprospect.mJerrymismcurrentlymenrolledminm
MedicaremPartsmAmandmB.mJerrymhasmalsompurchasedmamMedicaremSupplementm(Medigap)mplanmw
hichmhemhasmhadmformseveralmyears.mHowever,mthemplanmdoesmnotmprovidemdrugmbenefits.mHowmw
ouldmyoumadvisemAgentmJohnmMillermtomproceed?m-
mCORRECTmANSWERSmTellmprospectmJerrymSmithmthatmhemshouldmconsidermaddingmamstandalonemP
artmDmprescriptionmdrugmcoveragempolicymtomhismpresentmcoverage.
Mr.mWumismeligiblemformMedicare.mHemhasmlimitedmfinancialmresourcesmbutmfailedmtomqualifymformth
emPartmDmlow-
incomemsubsidy.mWheremmightmhemturnmformhelpmwithmhismprescriptionmdrugmcosts?m-
mCORRECTmANSWERSmMr.mWummaymstillmqualifymformhelpminmpayingmPartmDmcostsmthroughmhismStat
emPharmaceuticalmAssistancemProgramm(SPAP).
Mr.mVasquezmisminmgoodmhealthmandmismpreparingmambudgetminmanticipationmofmhismretirementmwh
enmhemturnsm66.mHemwantsmtomunderstandmthemhealthmcaremcostsmhemmightmbemexposedmtomunder
mMedicaremifmhemweremtomrequiremhospitalizationmbecausemofmanmillness.mInmgeneralmterms,mwhatm
couldmyoumtellmhimmaboutmhismcostsmforminpatientmhospitalmservicesmundermOriginalmMedicare?m-
mCORRECTmANSWERSmUndermOriginalmMedicare,mtheremismamsinglemdeductiblemamountmduemformth
emfirstm60mdaysmofmanyminpatientmhospitalmstay,maftermwhichmitmconvertsmintomamper-
daymcoinsurancemamountmthroughmdaym90.mAftermdaym90,mhemwouldmpaymamdailymamountmupmtom6
0mdaysmovermhismlifetime,maftermwhichmhemwouldmbemresponsiblemformallmcosts.
,Mr.mMoymwillmsoonmturnmagem65.mHemismslightlymyoungermthanmhismwife.mMr.mMoy'smwifemhasmamMe
dicaremAdvantagemplan,mbutmhemwantsmtomunderstandmwhatmcoveragemMedicaremSupplementalmI
nsurancemprovidesmsincemhismhealthmcaremneedsmaremdifferentmfrommhismwife'smneeds.mWhatmcoul
dmyoumtellmMr.mMoy?m-
mCORRECTmANSWERSmMedicaremSupplementalmInsurancemwouldmhelpmcovermhismPartmAmdeductibl
emandmPartmBmcoinsurancemormcopaymentsminmOriginalmFee-for-
Servicem(FFS)mMedicaremasmwellmasmpossiblymsomemservicesmthatmMedicaremdoesmnotmcover.
JuanmPerez,mwhomismturningmagem65mnextmmonth,mintendsmtomworkmformseveralmmoremyearsmatmSm
allcap,mIncorporated.mSmallcapmhasmamworkforcemofm15memployeesmandmoffersmemployer-
sponsoredmhealthcaremcoverage.mJuanmismamnaturalizedmcitizenmandmhasmcontributedmtomthemMedi
caremsystemmformoverm20myears.mJuanmasksmyoumifmhemwillmbementitledmtomMedicaremandmifmhemenr
ollsmhowmthatmwillmimpactmhismemployer-
msponsoredmhealthcaremcoverage.mHowmwouldmyoumrespond?m-
mCORRECTmANSWERSmJuanmismlikelymtombemeligiblemformMedicaremoncemhemturnsmagem65mandmifmhe
menrolls,mMedicaremwouldmbecomemthemprimarympayormofmhismhealthcaremclaimsmandmSmallcapmd
oesmnotmhavemtomcontinuemtomoffermhimmcoveragemcomparablemtomthosemundermagem65mundermitsm
employer-
sponsoredmgroupmhealthmplan.mJuanmismlikelymtombemeligiblemformMedicaremoncemhemturnsmagem65m
andmifmhemenrolls,mMedicaremwouldmbecomemthemprimarympayormofmhismhealthcaremclaimsmbutmS
mallcapmmustmcontinuemtomoffermhimmcoveragemundermitsmemployer-
sponsoredmgroupmhealthmplanmandmwouldmbecomemamsecondarympayor.
Ms.mKumarmplansmtomretiremwhenmshemturnsm65minmamfewmmonths.mShemisminmexcellentmhealthmand
mwillmhavemconsiderablemincomemwhenmshemretires.mShemismconcernedmthatmhermincomemwillmmak
emitmimpossiblemformhermtomqualifymformMedicare.mWhatmcouldmyoumtellmhermtomaddressmhermconce
rn?m-
mCORRECTmANSWERSmMedicaremismamprogrammformpeoplemagem65mormoldermandmthosemundermagem
65mwithmcertainmdisabilities,mend-
stagemrenalmdisease,mandmLoumGehrig'smdiseasemsomshemwillmbemeligiblemformMedicare.
Mrs.mEllismrecentlymturnedm66mandmdecidedmaftermmanymyearsmofmworkmtomretiremandmbeginmreceiv
ingmSocialmSecuritymbenefits.mShortlymthereaftermMrs.mEllismreceivedmamletterminformingmhermthatms
hemhadmbeenmautomaticallymenrolledminmMedicaremPartmB.mShemwantsmtomunderstandmwhatmthism
means.mWhatmshouldmyoumtellmMrs.mEllis?m-
, mCORRECTmANSWERSmPartmBmprimarilymcoversmphysicianmservices.mShemwillmbempayingmammonthlym
premiummand,mexceptmformmanympreventivemandmscreeningmtests,mgenerallymwillmhavem20%mco-
paymentsmformthesemservices,minmadditionmtomanmannualmdeductible.
Mr.mSinghmwouldmlikemdrugmcoveragembutmdoesmnotmwantmtombemenrolledminmamMedicaremAdvanta
gemplan.mWhatmshouldmyoumtellmhim?m-mCORRECTmANSWERSmMr.mSinghmcanmenrollminmamstand-
alonemprescriptionmdrugmplanmandmcontinuemtombemcoveredmformPartmAmandmPartmBmservicesmthrou
ghmOriginalmFee-for-ServicemMedicare.
Mrs.mCookmismanmelderlymretiree.mMrs.mCookmhasmamlowmfixedmincome.mWhatmcouldmyoumtellmMrs.m
Cookmthatmmightmbemofmassistance?m-
mCORRECTmANSWERSmShemshouldmcontactmhermstatemMedicaidmagencymtomseemifmshemqualifiesmfor
monemofmseveralmprogramsmthatmcanmhelpmwithmMedicaremcostsmformwhichmshemismresponsible.
Ms.mHendersonmbelievesmthatmshemwillmqualifymformMedicaremCoveragemwhenmshemturnsm65,mwith
outmpayingmanympremiums,mbecausemshemhasmbeenmworkingmform40myearsmandmpayingmMedicaremt
axes.mWhatmshouldmyoumtellmher?m-
mCORRECTmANSWERSmTomobtainmPartmBmcoverage,mshemmustmpaymamstandardmmonthlympremium,m
thoughmitmismhighermformindividualsmwithmhighermincomes.
Mr.mBauermism49myearsmold,mbutmeighteenmmonthsmagomhemwasmdeclaredmdisabledmbymthemSocialmS
ecuritymAdministrationmandmhasmbeenmreceivingmdisabilitympayments.mHemismwonderingmwhetherm
hemcanmobtainmcoveragemundermMedicare.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmAftermreceivingmsuchmdisabilitympaymentsmform24mmonths,mhemwillmbemauto
maticallymenrolledminmMedicare,mregardlessmofmage.
Mr.mSchmidtmwouldmlikemtomplanmformretirementmandmhasmaskedmyoumwhatmismcoveredmundermOrig
inalmFee-for-Servicem(FFS)mMedicare.mWhatmcouldmyoumtellmhim?m-
mCORRECTmANSWERSmPartmA,mwhichmcoversmhospital,mskilledmnursingmfacility,mhospice,mandmhome
mhealthmservicesmandmPartmB,mwhichmcoversmprofessionalmservicesmsuchmasmthosemprovidedmbymamd
octormaremcoveredmundermOriginalmMedicare.
ACTUAL EXAM 135 QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED
GRADED A+
Mr.mCapadonamwouldmlikemtompurchasemamMedicaremAdvantagem(MA)mplanmandmamMedigapmplanmt
ompickmupmcostsmnotmcoveredmbymthatmplan.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmItmismillegalmformyoumtomsellmMr.mCapadonamamMedigapmplanmifmhemismenrolled
minmanmMAmplan,mandmbesides,mMedigapmonlymworksmwithmOriginalmMedicare.
AgentmJohnmMillermismmeetingmwithmJerrymSmith,mamnewmprospect.mJerrymismcurrentlymenrolledminm
MedicaremPartsmAmandmB.mJerrymhasmalsompurchasedmamMedicaremSupplementm(Medigap)mplanmw
hichmhemhasmhadmformseveralmyears.mHowever,mthemplanmdoesmnotmprovidemdrugmbenefits.mHowmw
ouldmyoumadvisemAgentmJohnmMillermtomproceed?m-
mCORRECTmANSWERSmTellmprospectmJerrymSmithmthatmhemshouldmconsidermaddingmamstandalonemP
artmDmprescriptionmdrugmcoveragempolicymtomhismpresentmcoverage.
Mr.mWumismeligiblemformMedicare.mHemhasmlimitedmfinancialmresourcesmbutmfailedmtomqualifymformth
emPartmDmlow-
incomemsubsidy.mWheremmightmhemturnmformhelpmwithmhismprescriptionmdrugmcosts?m-
mCORRECTmANSWERSmMr.mWummaymstillmqualifymformhelpminmpayingmPartmDmcostsmthroughmhismStat
emPharmaceuticalmAssistancemProgramm(SPAP).
Mr.mVasquezmisminmgoodmhealthmandmismpreparingmambudgetminmanticipationmofmhismretirementmwh
enmhemturnsm66.mHemwantsmtomunderstandmthemhealthmcaremcostsmhemmightmbemexposedmtomunder
mMedicaremifmhemweremtomrequiremhospitalizationmbecausemofmanmillness.mInmgeneralmterms,mwhatm
couldmyoumtellmhimmaboutmhismcostsmforminpatientmhospitalmservicesmundermOriginalmMedicare?m-
mCORRECTmANSWERSmUndermOriginalmMedicare,mtheremismamsinglemdeductiblemamountmduemformth
emfirstm60mdaysmofmanyminpatientmhospitalmstay,maftermwhichmitmconvertsmintomamper-
daymcoinsurancemamountmthroughmdaym90.mAftermdaym90,mhemwouldmpaymamdailymamountmupmtom6
0mdaysmovermhismlifetime,maftermwhichmhemwouldmbemresponsiblemformallmcosts.
,Mr.mMoymwillmsoonmturnmagem65.mHemismslightlymyoungermthanmhismwife.mMr.mMoy'smwifemhasmamMe
dicaremAdvantagemplan,mbutmhemwantsmtomunderstandmwhatmcoveragemMedicaremSupplementalmI
nsurancemprovidesmsincemhismhealthmcaremneedsmaremdifferentmfrommhismwife'smneeds.mWhatmcoul
dmyoumtellmMr.mMoy?m-
mCORRECTmANSWERSmMedicaremSupplementalmInsurancemwouldmhelpmcovermhismPartmAmdeductibl
emandmPartmBmcoinsurancemormcopaymentsminmOriginalmFee-for-
Servicem(FFS)mMedicaremasmwellmasmpossiblymsomemservicesmthatmMedicaremdoesmnotmcover.
JuanmPerez,mwhomismturningmagem65mnextmmonth,mintendsmtomworkmformseveralmmoremyearsmatmSm
allcap,mIncorporated.mSmallcapmhasmamworkforcemofm15memployeesmandmoffersmemployer-
sponsoredmhealthcaremcoverage.mJuanmismamnaturalizedmcitizenmandmhasmcontributedmtomthemMedi
caremsystemmformoverm20myears.mJuanmasksmyoumifmhemwillmbementitledmtomMedicaremandmifmhemenr
ollsmhowmthatmwillmimpactmhismemployer-
msponsoredmhealthcaremcoverage.mHowmwouldmyoumrespond?m-
mCORRECTmANSWERSmJuanmismlikelymtombemeligiblemformMedicaremoncemhemturnsmagem65mandmifmhe
menrolls,mMedicaremwouldmbecomemthemprimarympayormofmhismhealthcaremclaimsmandmSmallcapmd
oesmnotmhavemtomcontinuemtomoffermhimmcoveragemcomparablemtomthosemundermagem65mundermitsm
employer-
sponsoredmgroupmhealthmplan.mJuanmismlikelymtombemeligiblemformMedicaremoncemhemturnsmagem65m
andmifmhemenrolls,mMedicaremwouldmbecomemthemprimarympayormofmhismhealthcaremclaimsmbutmS
mallcapmmustmcontinuemtomoffermhimmcoveragemundermitsmemployer-
sponsoredmgroupmhealthmplanmandmwouldmbecomemamsecondarympayor.
Ms.mKumarmplansmtomretiremwhenmshemturnsm65minmamfewmmonths.mShemisminmexcellentmhealthmand
mwillmhavemconsiderablemincomemwhenmshemretires.mShemismconcernedmthatmhermincomemwillmmak
emitmimpossiblemformhermtomqualifymformMedicare.mWhatmcouldmyoumtellmhermtomaddressmhermconce
rn?m-
mCORRECTmANSWERSmMedicaremismamprogrammformpeoplemagem65mormoldermandmthosemundermagem
65mwithmcertainmdisabilities,mend-
stagemrenalmdisease,mandmLoumGehrig'smdiseasemsomshemwillmbemeligiblemformMedicare.
Mrs.mEllismrecentlymturnedm66mandmdecidedmaftermmanymyearsmofmworkmtomretiremandmbeginmreceiv
ingmSocialmSecuritymbenefits.mShortlymthereaftermMrs.mEllismreceivedmamletterminformingmhermthatms
hemhadmbeenmautomaticallymenrolledminmMedicaremPartmB.mShemwantsmtomunderstandmwhatmthism
means.mWhatmshouldmyoumtellmMrs.mEllis?m-
, mCORRECTmANSWERSmPartmBmprimarilymcoversmphysicianmservices.mShemwillmbempayingmammonthlym
premiummand,mexceptmformmanympreventivemandmscreeningmtests,mgenerallymwillmhavem20%mco-
paymentsmformthesemservices,minmadditionmtomanmannualmdeductible.
Mr.mSinghmwouldmlikemdrugmcoveragembutmdoesmnotmwantmtombemenrolledminmamMedicaremAdvanta
gemplan.mWhatmshouldmyoumtellmhim?m-mCORRECTmANSWERSmMr.mSinghmcanmenrollminmamstand-
alonemprescriptionmdrugmplanmandmcontinuemtombemcoveredmformPartmAmandmPartmBmservicesmthrou
ghmOriginalmFee-for-ServicemMedicare.
Mrs.mCookmismanmelderlymretiree.mMrs.mCookmhasmamlowmfixedmincome.mWhatmcouldmyoumtellmMrs.m
Cookmthatmmightmbemofmassistance?m-
mCORRECTmANSWERSmShemshouldmcontactmhermstatemMedicaidmagencymtomseemifmshemqualifiesmfor
monemofmseveralmprogramsmthatmcanmhelpmwithmMedicaremcostsmformwhichmshemismresponsible.
Ms.mHendersonmbelievesmthatmshemwillmqualifymformMedicaremCoveragemwhenmshemturnsm65,mwith
outmpayingmanympremiums,mbecausemshemhasmbeenmworkingmform40myearsmandmpayingmMedicaremt
axes.mWhatmshouldmyoumtellmher?m-
mCORRECTmANSWERSmTomobtainmPartmBmcoverage,mshemmustmpaymamstandardmmonthlympremium,m
thoughmitmismhighermformindividualsmwithmhighermincomes.
Mr.mBauermism49myearsmold,mbutmeighteenmmonthsmagomhemwasmdeclaredmdisabledmbymthemSocialmS
ecuritymAdministrationmandmhasmbeenmreceivingmdisabilitympayments.mHemismwonderingmwhetherm
hemcanmobtainmcoveragemundermMedicare.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmAftermreceivingmsuchmdisabilitympaymentsmform24mmonths,mhemwillmbemauto
maticallymenrolledminmMedicare,mregardlessmofmage.
Mr.mSchmidtmwouldmlikemtomplanmformretirementmandmhasmaskedmyoumwhatmismcoveredmundermOrig
inalmFee-for-Servicem(FFS)mMedicare.mWhatmcouldmyoumtellmhim?m-
mCORRECTmANSWERSmPartmA,mwhichmcoversmhospital,mskilledmnursingmfacility,mhospice,mandmhome
mhealthmservicesmandmPartmB,mwhichmcoversmprofessionalmservicesmsuchmasmthosemprovidedmbymamd
octormaremcoveredmundermOriginalmMedicare.
