AHIP Exam Latest (2026/2027)
Complete
Questions and Correct Answers
Complete
GRADED A+
1. Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD
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plan and was disappointed with the service she received from her primary care
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physician because she was told she would have to wait five weeks to get an app
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o
intment when she was feeling ill. She called you to ask what she could do so she
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w
ould not have to put up with such poor access to care. What could you tell her?:
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S
he could file a grievance with her plan to complain about the lack of timeline
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ss in getting an appointment.
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2. Edward IP suffered from serious kidney disease. As a result. Edward be-
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g came eligible for Medicare coverage due to end-
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stage renal disease (ESRD). A close relative donated their kidney and Edward s
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uccessfully underwent transplant surgery 12 months ago. Edward is now age 5
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0 and asks you if his Medicare coverage will continue, what should you say?: In
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dividuals eligible for Medicare based on ESRD generally lose eligibility 36 m
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onths afte g
r the month in which the individual receives a kidney transplant unless they
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are eligible for Medicare
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on another basis such as age or disability. Edward may, however, remain enr
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,olled in Part B but solely for coverage of immunosuppressive drugs if he has
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no other he alth care coverage that would cover the drugs.
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3. Mildred Savage enrolled in Allcare Medicare Advantage plan several years ag
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o. Mildred recently learned that she is suffering from inoperable cancer and has j
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ust a few months to live. She would like to spend these final months in hospice c
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1g/g39
,are. Mildred's family asks you whether hospice benefits will be paid for under th
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e Allcare Medicare Advantage plan. What should you say?: Mildred may remai
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n en g
rolled in Allcare and make a hospice election. Hospice benefits will be paid f
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or by Origi g g
nal Medicare under Part A and Allcare will continue to pay for any non-
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hospice services. g
4. Mr. Diaz continued working with his company and was insured under his emp
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loyer's group plan until he reached age 68. He has heard that there is a premium
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penalty for those who did not sign up for Part B when first eligible and
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wants to kno g g
w how much he will have to pay. What should you tell him?: Mr. Diaz will not pay
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an
y penalty because he had continuous coverage under his employer's plan.
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5. Mr. Moy's wife has a Medicare Advantage plan, but he wants to under-
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g stand what coverage Medicare Supplemental Insurance provides since his he
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alth care needs are different from his wife's needs. What could you tell Mr. Moy?
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: Medicare Supplemental Insurance would help cover his Part A and Part B d
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eductible s or coinsurance in Original Fee-for- g g g g g
Service (FFS) Medicare as well as possibly some services that Medicare doe
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s not co ver.
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6. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been emplo
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yed full time, and paid taxes during that entire period. She is concerned
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, 2g/g39
Complete
Questions and Correct Answers
Complete
GRADED A+
1. Mrs. Burton is a retiree with substantial income. She is enrolled in an MA-PD
g g g g g g g g g g g g g
plan and was disappointed with the service she received from her primary care
g g g g g g g g g g g g g
physician because she was told she would have to wait five weeks to get an app
g g g g g g g g g g g g g g g
o
intment when she was feeling ill. She called you to ask what she could do so she
g g g g g g g g g g g g g g g g g
w
ould not have to put up with such poor access to care. What could you tell her?:
g g g g g g g g g g g g g g g g g
S
he could file a grievance with her plan to complain about the lack of timeline
g g g g g g g g g g g g g g
ss in getting an appointment.
g g g g
2. Edward IP suffered from serious kidney disease. As a result. Edward be-
g g g g g g g g g g g
g came eligible for Medicare coverage due to end-
g g g g g g g
stage renal disease (ESRD). A close relative donated their kidney and Edward s
g g g g g g g g g g g g
uccessfully underwent transplant surgery 12 months ago. Edward is now age 5
g g g g g g g g g g g
0 and asks you if his Medicare coverage will continue, what should you say?: In
g g g g g g g g g g g g g g
dividuals eligible for Medicare based on ESRD generally lose eligibility 36 m
g g g g g g g g g g g
onths afte g
r the month in which the individual receives a kidney transplant unless they
g g g g g g g g g g g g g
are eligible for Medicare
g g g g
on another basis such as age or disability. Edward may, however, remain enr
g g g g g g g g g g g g
,olled in Part B but solely for coverage of immunosuppressive drugs if he has
g g g g g g g g g g g g g g
no other he alth care coverage that would cover the drugs.
g g g g g g g g g
3. Mildred Savage enrolled in Allcare Medicare Advantage plan several years ag
g g g g g g g g g g
o. Mildred recently learned that she is suffering from inoperable cancer and has j
g g g g g g g g g g g g g
ust a few months to live. She would like to spend these final months in hospice c
g g g g g g g g g g g g g g g g
1g/g39
,are. Mildred's family asks you whether hospice benefits will be paid for under th
g g g g g g g g g g g g g
e Allcare Medicare Advantage plan. What should you say?: Mildred may remai
g g g g g g g g g g g
n en g
rolled in Allcare and make a hospice election. Hospice benefits will be paid f
g g g g g g g g g g g g g
or by Origi g g
nal Medicare under Part A and Allcare will continue to pay for any non-
g g g g g g g g g g g g g
hospice services. g
4. Mr. Diaz continued working with his company and was insured under his emp
g g g g g g g g g g g g
loyer's group plan until he reached age 68. He has heard that there is a premium
g g g g g g g g g g g g g g g g
penalty for those who did not sign up for Part B when first eligible and
g g g g g g g g g g g g g g g
wants to kno g g
w how much he will have to pay. What should you tell him?: Mr. Diaz will not pay
g g g g g g g g g g g g g g g g g g
an
y penalty because he had continuous coverage under his employer's plan.
g g g g g g g g g g
5. Mr. Moy's wife has a Medicare Advantage plan, but he wants to under-
g g g g g g g g g g g g
g stand what coverage Medicare Supplemental Insurance provides since his he
g g g g g g g g g
alth care needs are different from his wife's needs. What could you tell Mr. Moy?
g g g g g g g g g g g g g g
: Medicare Supplemental Insurance would help cover his Part A and Part B d
g g g g g g g g g g g g g
eductible s or coinsurance in Original Fee-for- g g g g g
Service (FFS) Medicare as well as possibly some services that Medicare doe
g g g g g g g g g g g
s not co ver.
g g
6. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has been emplo
g g g g g g g g g g g g g g g
yed full time, and paid taxes during that entire period. She is concerned
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, 2g/g39
