AHIP 2025/2026 ACTUAL FINAL EXAM
QUESTIONS WITH CORRECT
ANSWERS 100% VERIFIED GRADED
A+
Mr.mArias,mamnaturalizedmcitizen,mpreviouslymenrolledminmMedicaremPartmBmbutmhasmrecentlymstopp
edmpayingmhismPartmBmpremium.mMr.mAriasmismstillmcoveredmbymPartmA.mHemwouldmlikemtomenrollminm
amMedicaremAdvantagem(MA)mplanmandmismstillmcoveredmbymPartmA.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmHemismnotmeligiblemtomenrollminmamMedicaremAdvantagemplanmuntilmhemre-
enrollsminmMedicaremPartmB.
Mrs.mJoy,magem65,mismentitledmtomPartmAmbutmhasmnotmyetmenrolledminmPartmB.mShemismconsideringme
nrollingminmamMedicaremAdvantagemplanm(PartmC).mWhatmshouldmyoumadvisemhermtomdombeforemshe
mcanmenrollminmamMedicaremAdvantagemplan?m-
mCORRECTmANSWERSmTomjoinmamMedicaremAdvantagemplan,mshemalsommustmenrollminmPartmB.
Mr.mKumarmismconsideringmamMedicaremAdvantagemHMOmandmhasmquestionsmaboutmhismabilitymtom
accessmproviders.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmInmmostmMedicaremAdvantagemHMOs,mMr.mKumarmmustmgenerallymobtainmhi
smservicesmonlymfrommprovidersmwithinmthemplan'smnetworkm(exceptminmanmemergencymormwheremc
aremismunavailablemwithinmthemnetwork).
Mrs.mRoblesmismconsideringmamMedicaremAdvantagemPPOmandmhasmquestionsmaboutmwhichmprovid
ersmshemcanmgomtomformhermhealthmcare.mWhatmshouldmyoumtellmher?m-
mCORRECTmANSWERSmMrs.mRoblesmcanmobtainmcaremfrommanymprovidermwhomparticipatesminmOrigi
nalmMedicare,mbutmgenerallymwillmhavemamhighermcost-
sharingmamountmifmshemseesmamprovidermwho/thatmismnotmampartmofmthemPPOmnetwork.
Mrs.mLestermismagem75mandmenjoysmamcomfortablembutmnotmextremelymhigh-
incomemlevel.mShemwishesmtomenrollminmanmMAmMSAmplanmthatmshemheardmaboutmfrommhermneigh
bor.mShemalsomwantsmtomhavemprescriptionmdrugmcoveragemsincemhermdoctormrecentlymprescribedm
, severalmexpensivemmedications.mCurrently,mshemismenrolledminmOriginalmMedicaremandmamstandalo
nemPartmDmplan.mHowmwouldmyoumadvisemMrs.mLester?m-
mCORRECTmANSWERSmMrs.mLestermmaymenrollminmanmMAmMSAmplanmandmremainminmhermcurrentmst
andalonemPartmDmprescriptionmdrugmplan.
Mr.mDaltonmisminmexcellentmhealth,mlivesminmhismownmhome,mandmhasmamsizeablemincomemfrommhismi
nvestments.mHemhasmamfriendmenrolledminmamMedicaremAdvantagemSpecialmNeedsmPlanm(SNP).mHism
friendmhasmmentionedmthatmthemSNPmchargesmverymlowmcost-
sharingmamountsmandmMr.mDaltonmwouldmlikemtomjoinmthatmplan.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmSNPsmlimitmenrollmentmtomcertainmsubpopulationsmofmbeneficiaries.mGivenm
hismcurrentmsituation,mhemismunlikelymtomqualifymandmwouldmnotmbemablemtomenrollminmthemSNP.
Mr.mAndersonmwantsmtomknowmwhethermhemismeligiblemtomsignmupmformamPrivatemfee-for-
servicem(PFFS)mplan.mWhatmquestionsmwouldmyoumneedmtomaskmtomdeterminemhismeligibility?m-
mCORRECTmANSWERSmYoumwouldmneedmtomaskmMr.mAndersonmifmhemismentitledmtomPartmA,menrolled
minmPartmB,mandmifmhemlivesminmthemPFFSmplan'smservicemarea.
HerbermNoblemismturningm65mnextmmonth,mHerbermlegallymenteredmthemUnitedmStatesmovermtwent
ymyearsmagombutmismnotmamcitizen.mSincemhismentrymintomthemcountry,mHerbermhasmworkedmatmSmall
capmIncorporatedmandmcontributedmtomthemMedicaremsystem.mHerbermsuffersmfrommdiabetes.mHem
willmsoonmretiremandmasksmyoumifmhemcanmenrollminmamMedicaremAdvantagemplanmthatmyoumreprese
nt.mHowmwouldmyoumrespond?m-
mCORRECTmANSWERSmHerbermismeligiblemtomenrollminmMedicaremAdvantagemasmlongmasmhemismentitl
edmtomPartmAmandmenrolledminmPartmB.mHerbermshouldmgomtomthemSocialmSecuritymwebsitemtomenroll
minmMedicaremPartmAmandmBmifmhemhasmnotmdonemsomalready.mOncemhemismenrolled,mhemcanmchoose
mamMedicaremAdvantagemplan.
WhichmofmthemfollowingmindividualsmismmostmlikelymtombemeligiblemtomenrollminmamPartmDmPlan?m-
mCORRECTmANSWERSmJose,mamgrandfathermwhomwasmgrantedmasylummandmhasmworkedminmthemUni
tedmStatesmformmanymyears.
Mrs.mCastromhasmjustmturnedm65,misminmexcellentmhealthmandmhasmamrelativelymhighmincome.mShemu
sesmnommedicationsmandmseesmnomreasonmtomspendmmoneymonmamMedicaremprescriptionmdrugmpla
QUESTIONS WITH CORRECT
ANSWERS 100% VERIFIED GRADED
A+
Mr.mArias,mamnaturalizedmcitizen,mpreviouslymenrolledminmMedicaremPartmBmbutmhasmrecentlymstopp
edmpayingmhismPartmBmpremium.mMr.mAriasmismstillmcoveredmbymPartmA.mHemwouldmlikemtomenrollminm
amMedicaremAdvantagem(MA)mplanmandmismstillmcoveredmbymPartmA.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmHemismnotmeligiblemtomenrollminmamMedicaremAdvantagemplanmuntilmhemre-
enrollsminmMedicaremPartmB.
Mrs.mJoy,magem65,mismentitledmtomPartmAmbutmhasmnotmyetmenrolledminmPartmB.mShemismconsideringme
nrollingminmamMedicaremAdvantagemplanm(PartmC).mWhatmshouldmyoumadvisemhermtomdombeforemshe
mcanmenrollminmamMedicaremAdvantagemplan?m-
mCORRECTmANSWERSmTomjoinmamMedicaremAdvantagemplan,mshemalsommustmenrollminmPartmB.
Mr.mKumarmismconsideringmamMedicaremAdvantagemHMOmandmhasmquestionsmaboutmhismabilitymtom
accessmproviders.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmInmmostmMedicaremAdvantagemHMOs,mMr.mKumarmmustmgenerallymobtainmhi
smservicesmonlymfrommprovidersmwithinmthemplan'smnetworkm(exceptminmanmemergencymormwheremc
aremismunavailablemwithinmthemnetwork).
Mrs.mRoblesmismconsideringmamMedicaremAdvantagemPPOmandmhasmquestionsmaboutmwhichmprovid
ersmshemcanmgomtomformhermhealthmcare.mWhatmshouldmyoumtellmher?m-
mCORRECTmANSWERSmMrs.mRoblesmcanmobtainmcaremfrommanymprovidermwhomparticipatesminmOrigi
nalmMedicare,mbutmgenerallymwillmhavemamhighermcost-
sharingmamountmifmshemseesmamprovidermwho/thatmismnotmampartmofmthemPPOmnetwork.
Mrs.mLestermismagem75mandmenjoysmamcomfortablembutmnotmextremelymhigh-
incomemlevel.mShemwishesmtomenrollminmanmMAmMSAmplanmthatmshemheardmaboutmfrommhermneigh
bor.mShemalsomwantsmtomhavemprescriptionmdrugmcoveragemsincemhermdoctormrecentlymprescribedm
, severalmexpensivemmedications.mCurrently,mshemismenrolledminmOriginalmMedicaremandmamstandalo
nemPartmDmplan.mHowmwouldmyoumadvisemMrs.mLester?m-
mCORRECTmANSWERSmMrs.mLestermmaymenrollminmanmMAmMSAmplanmandmremainminmhermcurrentmst
andalonemPartmDmprescriptionmdrugmplan.
Mr.mDaltonmisminmexcellentmhealth,mlivesminmhismownmhome,mandmhasmamsizeablemincomemfrommhismi
nvestments.mHemhasmamfriendmenrolledminmamMedicaremAdvantagemSpecialmNeedsmPlanm(SNP).mHism
friendmhasmmentionedmthatmthemSNPmchargesmverymlowmcost-
sharingmamountsmandmMr.mDaltonmwouldmlikemtomjoinmthatmplan.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmSNPsmlimitmenrollmentmtomcertainmsubpopulationsmofmbeneficiaries.mGivenm
hismcurrentmsituation,mhemismunlikelymtomqualifymandmwouldmnotmbemablemtomenrollminmthemSNP.
Mr.mAndersonmwantsmtomknowmwhethermhemismeligiblemtomsignmupmformamPrivatemfee-for-
servicem(PFFS)mplan.mWhatmquestionsmwouldmyoumneedmtomaskmtomdeterminemhismeligibility?m-
mCORRECTmANSWERSmYoumwouldmneedmtomaskmMr.mAndersonmifmhemismentitledmtomPartmA,menrolled
minmPartmB,mandmifmhemlivesminmthemPFFSmplan'smservicemarea.
HerbermNoblemismturningm65mnextmmonth,mHerbermlegallymenteredmthemUnitedmStatesmovermtwent
ymyearsmagombutmismnotmamcitizen.mSincemhismentrymintomthemcountry,mHerbermhasmworkedmatmSmall
capmIncorporatedmandmcontributedmtomthemMedicaremsystem.mHerbermsuffersmfrommdiabetes.mHem
willmsoonmretiremandmasksmyoumifmhemcanmenrollminmamMedicaremAdvantagemplanmthatmyoumreprese
nt.mHowmwouldmyoumrespond?m-
mCORRECTmANSWERSmHerbermismeligiblemtomenrollminmMedicaremAdvantagemasmlongmasmhemismentitl
edmtomPartmAmandmenrolledminmPartmB.mHerbermshouldmgomtomthemSocialmSecuritymwebsitemtomenroll
minmMedicaremPartmAmandmBmifmhemhasmnotmdonemsomalready.mOncemhemismenrolled,mhemcanmchoose
mamMedicaremAdvantagemplan.
WhichmofmthemfollowingmindividualsmismmostmlikelymtombemeligiblemtomenrollminmamPartmDmPlan?m-
mCORRECTmANSWERSmJose,mamgrandfathermwhomwasmgrantedmasylummandmhasmworkedminmthemUni
tedmStatesmformmanymyears.
Mrs.mCastromhasmjustmturnedm65,misminmexcellentmhealthmandmhasmamrelativelymhighmincome.mShemu
sesmnommedicationsmandmseesmnomreasonmtomspendmmoneymonmamMedicaremprescriptionmdrugmpla
