AHIP 2026 Final Exam
Actual Questions and Verified Answers
With 106 verified questions and
answers
1) 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 still qualify for help in paying Part D costs through his
State Pharmaceutical Assistance Program.
2) Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled
by the Social Security Administration and has been receiving disability
payments. He is wondering whether he can obtain coverage under Medicare.
What should you tell him?
- Ans>> After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
,3) Mildred Savage enrolled in Allcare Medicare Advantage plan several years
ago. Mildred recently learned that she is suffering from inoperable cancer
and has just a few months to live. She would like to spend these final months
in hospice care. Mildred's family asks you whether hospice benefits will be
paid for under the Allcare Medicare Advantage plan. What should you say?
- Ans>> Mildred may remain enrolled in Allcare and make a hospice election.
Hospice benefits will be paid for by Original Medicare under Part A and
Allcare will continue to pay for any non-hospice services.
4) Mr. Schmidt would like to plan for retirement and has asked you what is
covered under Original Fee-for-Service (FFS) Medicare. What could you tell
him?
- Ans>> Part A, which covers hospital, skilled nursing facility, hospice, and
home health services and Part B, which covers professional services such as
those provided by a doctor are covered under Original Medicare.
5) Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is
currently enrolled in Medicare Parts A and B. Jerry has also purchased a
Medicare Supplement (Medigap) plan which he has had for several years.
However, the plan does not provide drug benefits. How would you advise
Agent John Miller to proceed?
- Ans>> Tell prospect Jerry Smith that he should consider adding a
, standalone Part D prescription drug coverage policy to his present coverage.
6) Mr. Davis is 52 years old and has recently been diagnosed with end-stage
renal disease (ESRD) and will soon begin dialysis. He is wondering if he can
obtain coverage under Medicare. What should you tell him?
- Ans>> He may sign-up for Medicare at any time however coverage usually
begins on the fourth month after dialysis treatments start.
7) Mr. Diaz continued working with his company and was insured under his
employer's group plan until he reached age 68. He has heard that there is a
premium penalty for those who did not sign up for Part B when first eligible
and wants to know how much he will have to pay. What should you tell him?
- Ans>> Mr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
8) Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a
substantial estate which provides Madeline with an annual income of
approximately $130,000. Madeline, who has only worked part-time for the
last three years, will soon turn age 65 and hopes to enroll in Original
Medicare. She comes to you for advice. What should you tell her?
- Ans>> You should tell Madeline that she will be able to enroll in Medicare
, Part A without paying monthly premiums due to her husband's long work
record and participation in the Medicare system. You should also tell
Madeline that she will pay Part B premiums at more than the standard lowest
rate but less than the highest rate due her substantial income.
9) Edward IP suffered from serious kidney disease. As a result. Edward became
eligible for Medicare coverage due to end-stage renal disease (ESRD). A
close relative donated their kidney and Edward successfully underwent
transplant surgery 12 months ago. Edward is now age 50 and asks you if his
Medicare coverage will continue, what should you say?
- Ans>> Individuals eligible for Medicare based on ESRD generally lose
eligibility 36 months after the month in which the individual receives a
kidney transplant unless they are eligible for Medicare on another basis such
as age or disability. Edward may, however, remain enrolled in Part B but
solely for coverage of immunosuppressive drugs if he has no other health
care coverage that would cover the drugs.
10) Mrs. Peňa is 66 years old, has coverage under an employer plan, and will
retire next year. She heard 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 a special eight-month enrollment period after the last
Actual Questions and Verified Answers
With 106 verified questions and
answers
1) 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 still qualify for help in paying Part D costs through his
State Pharmaceutical Assistance Program.
2) Mr. Bauer is 49 years old, but eighteen months ago he was declared disabled
by the Social Security Administration and has been receiving disability
payments. He is wondering whether he can obtain coverage under Medicare.
What should you tell him?
- Ans>> After receiving such disability payments for 24 months, he will be
automatically enrolled in Medicare, regardless of age.
,3) Mildred Savage enrolled in Allcare Medicare Advantage plan several years
ago. Mildred recently learned that she is suffering from inoperable cancer
and has just a few months to live. She would like to spend these final months
in hospice care. Mildred's family asks you whether hospice benefits will be
paid for under the Allcare Medicare Advantage plan. What should you say?
- Ans>> Mildred may remain enrolled in Allcare and make a hospice election.
Hospice benefits will be paid for by Original Medicare under Part A and
Allcare will continue to pay for any non-hospice services.
4) Mr. Schmidt would like to plan for retirement and has asked you what is
covered under Original Fee-for-Service (FFS) Medicare. What could you tell
him?
- Ans>> Part A, which covers hospital, skilled nursing facility, hospice, and
home health services and Part B, which covers professional services such as
those provided by a doctor are covered under Original Medicare.
5) Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is
currently enrolled in Medicare Parts A and B. Jerry has also purchased a
Medicare Supplement (Medigap) plan which he has had for several years.
However, the plan does not provide drug benefits. How would you advise
Agent John Miller to proceed?
- Ans>> Tell prospect Jerry Smith that he should consider adding a
, standalone Part D prescription drug coverage policy to his present coverage.
6) Mr. Davis is 52 years old and has recently been diagnosed with end-stage
renal disease (ESRD) and will soon begin dialysis. He is wondering if he can
obtain coverage under Medicare. What should you tell him?
- Ans>> He may sign-up for Medicare at any time however coverage usually
begins on the fourth month after dialysis treatments start.
7) Mr. Diaz continued working with his company and was insured under his
employer's group plan until he reached age 68. He has heard that there is a
premium penalty for those who did not sign up for Part B when first eligible
and wants to know how much he will have to pay. What should you tell him?
- Ans>> Mr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
8) Madeline Martinez was widowed several years ago. Her husband worked for
many years and contributed into the Medicare system. He also left a
substantial estate which provides Madeline with an annual income of
approximately $130,000. Madeline, who has only worked part-time for the
last three years, will soon turn age 65 and hopes to enroll in Original
Medicare. She comes to you for advice. What should you tell her?
- Ans>> You should tell Madeline that she will be able to enroll in Medicare
, Part A without paying monthly premiums due to her husband's long work
record and participation in the Medicare system. You should also tell
Madeline that she will pay Part B premiums at more than the standard lowest
rate but less than the highest rate due her substantial income.
9) Edward IP suffered from serious kidney disease. As a result. Edward became
eligible for Medicare coverage due to end-stage renal disease (ESRD). A
close relative donated their kidney and Edward successfully underwent
transplant surgery 12 months ago. Edward is now age 50 and asks you if his
Medicare coverage will continue, what should you say?
- Ans>> Individuals eligible for Medicare based on ESRD generally lose
eligibility 36 months after the month in which the individual receives a
kidney transplant unless they are eligible for Medicare on another basis such
as age or disability. Edward may, however, remain enrolled in Part B but
solely for coverage of immunosuppressive drugs if he has no other health
care coverage that would cover the drugs.
10) Mrs. Peňa is 66 years old, has coverage under an employer plan, and will
retire next year. She heard 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 a special eight-month enrollment period after the last
