AHIP 2026 Final Exam WITH CORRECT
SOLUTIONS /GRADED A+/JUST RELEASED!!!
1. Mr. Arias, a naturalized citizen, previously enrolled in Medicare Part B but has
recently stopped paying his Part B premium. Mr. Arias is still covered by Part A. He
would like to enroll in a Medicare Advantage (MA) plan and is still covered by Part A.
What should you tell him? - ANSWER-He is not eligible to enroll in a Medicare
Advantage plan until he re-enrolls in Medicare Part B.
2. Mrs. Joy, age 65, is entitled to Part A but has not yet enrolled in Part B. She is
considering enrolling in a Medicare Advantage plan (Part C). What should you advise
her to do before she can enroll in a Medicare Advantage plan? - ANSWER-To join a
Medicare Advantage plan, she also must enroll in Part B.
3. Mr. Kumar is considering a Medicare Advantage HMO and has questions about his
ability to access providers. What should you tell him? - ANSWER-In most Medicare
Advantage HMOs, Mr. Kumar must generally obtain his services only from providers
within the plan's network (except in an emergency or where care is unavailable
within the network).
4. Mrs. Robles is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care. What should you tell her? - ANSWER-Mrs.
Robles can obtain care from any provider who participates in Original Medicare, but
generally will have a higher cost-sharing amount if she sees a provider who/that is
not a part of the PPO network.
5. Mrs. Lester is age 75 and enjoys a comfortable but not extremely high-income level.
She wishes to enroll in an MA MSA plan that she heard about from her neighbor. She
also wants to have prescription drug coverage since her doctor recently prescribed
several expensive medications. Currently, she is enrolled in Original Medicare and a
standalone Part D plan. How would you advise Mrs. Lester? - ANSWER-Mrs. Lester
, may enroll in an MA MSA plan and remain in her current standalone Part D
prescription drug plan.
6. Mr. Dalton is in excellent health, lives in his own home, and has a sizeable income
from his investments. He has a friend enrolled in a Medicare Advantage Special Needs
Plan (SNP). His friend has mentioned that the SNP charges very low cost-sharing
amounts and Mr. Dalton would like to join that plan. What should you tell him? -
ANSWER-SNPs limit enrollment to certain subpopulations of beneficiaries. Given his
current situation, he is unlikely to qualify and would not be able to enroll in the SNP.
7. Mr. Anderson wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility? - ANSWER-You would need to ask Mr. Anderson if he is entitled to Part A,
enrolled in Part B, and if he lives in the PFFS plan's service area.
8. Herber Noble is turning 65 next month, Herber legally entered the United States over
twenty years ago but is not a citizen. Since his entry into the country, Herber has
worked at Smallcap Incorporated and contributed to the Medicare system. Herber
suffers from diabetes. He will soon retire and asks you if he can enroll in a Medicare
Advantage plan that you represent. How would you respond? - ANSWER-Herber is
eligible to enroll in Medicare Advantage as long as he is entitled to Part A and
enrolled in Part B. Herber should go to the Social Security website to enroll in
Medicare Part A and B if he has not done so already. Once he is enrolled, he can
choose a Medicare Advantage plan.
9. Which of the following individuals is most likely to be eligible to enroll in a Part D
Plan? - ANSWER-Jose, a grandfather who was granted asylum and has worked in the
United States for many years.
10. Mrs. Castro has just turned 65, is in excellent health and has a relatively high income.
She uses no medications and sees no reason to spend money on a Medicare
prescription drug plan if she does not need the coverage. She currently does not have
creditable coverage. What could you tell her about the implications of such a
SOLUTIONS /GRADED A+/JUST RELEASED!!!
1. Mr. Arias, a naturalized citizen, previously enrolled in Medicare Part B but has
recently stopped paying his Part B premium. Mr. Arias is still covered by Part A. He
would like to enroll in a Medicare Advantage (MA) plan and is still covered by Part A.
What should you tell him? - ANSWER-He is not eligible to enroll in a Medicare
Advantage plan until he re-enrolls in Medicare Part B.
2. Mrs. Joy, age 65, is entitled to Part A but has not yet enrolled in Part B. She is
considering enrolling in a Medicare Advantage plan (Part C). What should you advise
her to do before she can enroll in a Medicare Advantage plan? - ANSWER-To join a
Medicare Advantage plan, she also must enroll in Part B.
3. Mr. Kumar is considering a Medicare Advantage HMO and has questions about his
ability to access providers. What should you tell him? - ANSWER-In most Medicare
Advantage HMOs, Mr. Kumar must generally obtain his services only from providers
within the plan's network (except in an emergency or where care is unavailable
within the network).
4. Mrs. Robles is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care. What should you tell her? - ANSWER-Mrs.
Robles can obtain care from any provider who participates in Original Medicare, but
generally will have a higher cost-sharing amount if she sees a provider who/that is
not a part of the PPO network.
5. Mrs. Lester is age 75 and enjoys a comfortable but not extremely high-income level.
She wishes to enroll in an MA MSA plan that she heard about from her neighbor. She
also wants to have prescription drug coverage since her doctor recently prescribed
several expensive medications. Currently, she is enrolled in Original Medicare and a
standalone Part D plan. How would you advise Mrs. Lester? - ANSWER-Mrs. Lester
, may enroll in an MA MSA plan and remain in her current standalone Part D
prescription drug plan.
6. Mr. Dalton is in excellent health, lives in his own home, and has a sizeable income
from his investments. He has a friend enrolled in a Medicare Advantage Special Needs
Plan (SNP). His friend has mentioned that the SNP charges very low cost-sharing
amounts and Mr. Dalton would like to join that plan. What should you tell him? -
ANSWER-SNPs limit enrollment to certain subpopulations of beneficiaries. Given his
current situation, he is unlikely to qualify and would not be able to enroll in the SNP.
7. Mr. Anderson wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility? - ANSWER-You would need to ask Mr. Anderson if he is entitled to Part A,
enrolled in Part B, and if he lives in the PFFS plan's service area.
8. Herber Noble is turning 65 next month, Herber legally entered the United States over
twenty years ago but is not a citizen. Since his entry into the country, Herber has
worked at Smallcap Incorporated and contributed to the Medicare system. Herber
suffers from diabetes. He will soon retire and asks you if he can enroll in a Medicare
Advantage plan that you represent. How would you respond? - ANSWER-Herber is
eligible to enroll in Medicare Advantage as long as he is entitled to Part A and
enrolled in Part B. Herber should go to the Social Security website to enroll in
Medicare Part A and B if he has not done so already. Once he is enrolled, he can
choose a Medicare Advantage plan.
9. Which of the following individuals is most likely to be eligible to enroll in a Part D
Plan? - ANSWER-Jose, a grandfather who was granted asylum and has worked in the
United States for many years.
10. Mrs. Castro has just turned 65, is in excellent health and has a relatively high income.
She uses no medications and sees no reason to spend money on a Medicare
prescription drug plan if she does not need the coverage. She currently does not have
creditable coverage. What could you tell her about the implications of such a
