AHIP FINAL EXAM (ACTUAL
TEST) GRADED A 2026/2027
Update Complete Review
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?
Correct Ans - He may sign-up for
Medicare at any time however coverage usually begins
on the fourth month after dialysis treatments start.
Juan Perez, who is turning age 65 next month, intends
to work for several more years at Smallcap,
Incorporated. Smallcap has a workforce of15 employees
and offers employer-sponsored healthcare coverage.
Juan is a naturalized citizen and has contributed to the
Medicare system for over 20 years. Juan asks you if he
will be entitled to Medicare and if he enrolls how that
will impact his employer-sponsored healthcare
coverage. How would you respond? Correct Ans -Juan
is likely to be eligible for Medicare once he turns age 65
and if he enrolls Medicare would become the primary
payor of his healthcare claims and Smallcap does not
have to continue to offer him coverage comparable to
those under age 65 under its employer-sponsored group
health plan.
Mr. Moy's wife has a Medicare Advantage plan, but he
wants to understand what coverage Medicare
Supplemental Insurance provides since his health care
needs are different from his wife's needs. What could
you tell Mr. Moy? Correct Ans -
Medicare
Supplemental Insurance would help cover his Part A
and Part B deductibles or coinsurance in Original Fee-
,for-Service (FFS) Medicare as well as possibly some
services that Medicare does not cover.
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?Correct 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 month on her employer plan that differs from the standard general
enrollment period, during
,which she may enroll in Medicare Part B.
Mrs. Chen will be 65 soon, has been a citizen for twelve
years, has been employed full time, and paid taxes
during that entire period. She is concerned that she will
not qualify for coverage under part A because she was
not born in the United States. What should you tell her?
Correct Ans - Most individuals who are citizens
and age 65
, or over are covered under Part A by virtue of having
paid Medicare taxes while working, though some may
be covered as a result of paying monthly premiums.
Mrs. Gonzalez is enrolled in Original Medicare and has
a Medigap policy as well, but it provides no drug
coverage. She would like to keep the coverage she has
but replace her existing Medigap plan with one that
providesAns
Correct drug coverage.
- Mrs. What
Gonzalez should
cannot you tell aher?
purchase Medigap
plan that covers drugs, but she could keep her Medigap
policy and enroll in a Part D prescription drug plan.
Mrs. West wears glasses and dentures and has enjoyed
considerable pain relief from arthritis through massage
therapy. She is concerned about whether or not
Medicare will cover these items and services. What
should you tell her? Correct Ans - Medicare does not
cover massage therapy, or, in general, glasses or
dentures.
Mr. Patel is in good health and is preparing a budget in
anticipation of his retirement when he turns 66. He
wants to understand the health care costs he might be
exposed to under Medicare if he were to require
hospitalization as a result of an illness. In general
terms, what could you tell him about his costs for
inpatient hospital services
under Original Medicare? Correct Ans -
Under Original Medicare, there is
a single deductible amount due for the first 60 days of
any inpatient hospital stay, after which it converts into
a per-day coinsurance amount through day 90. After
day 90, he would pay a daily amount up to 60 days
over his lifetime, after which he would be responsible
for all costs.
Ms. Henderson believes that she will qualify for
Medicare Coverage when she turns 65, without paying
any premiums, because she has been working for 40
years and paying Medicare taxes. What should you tell
her? Correct Ans - To obtain Part B coverage,
she must pay a standard monthly premium, though it is
higher for individuals with higher incomes.
Mr. Alonso receives some help paying for his two
generic prescription drugs from his employer's retiree
coverage, but he wants to compare it to a Part D
prescription drug plan. He asks you what costs he
would generally expect to encounter when enrolling
into a standard MedicarePart D prescription drug plan.