AHIP FINAL EXAM NEWEST 2025-2026
VERSION QUESTIONS WITH GOLDEN
TIPS SOLUTIONS AND REVEWEIRS
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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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.
11. Mr. Capadona would like to purchase a Medicare Advantage (MA)
plan and a Medigap plan to pick up costs not covered by that plan.
What should you tell him? - ANSWER-It is illegal for you to sell Mr.
Capadona a Medigap plan if he is enrolled in an MA plan, and besides,
Medigap only works with Original Medicare.
12. 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? - ANSWER-To obtain Part B coverage, she must
pay a standard monthly premium, though it is higher for individuals
with higher incomes.
VERSION QUESTIONS WITH GOLDEN
TIPS SOLUTIONS AND REVEWEIRS
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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-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.
11. Mr. Capadona would like to purchase a Medicare Advantage (MA)
plan and a Medigap plan to pick up costs not covered by that plan.
What should you tell him? - ANSWER-It is illegal for you to sell Mr.
Capadona a Medigap plan if he is enrolled in an MA plan, and besides,
Medigap only works with Original Medicare.
12. 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? - ANSWER-To obtain Part B coverage, she must
pay a standard monthly premium, though it is higher for individuals
with higher incomes.
