AHIP MODULE 1 | MOST RECENT
VERSION| 2025/ 2026 QUESTIONS WITH
VERIFIED ANSWERS
Mr. Kelly has substantial financial means. He enrolled in Original Medicare and purchased a
Medigap policy many years ago that offered prescription drug coverage. The prescription drug
coverage has not been comparable to that offered by Medicare Part D for several years and
despite notification, Mr. Kelly took no action. Which of the following statements best describes
what will occur if Mr. Kelly now decides to enroll in Medicare Part D? - correct answer -a. He will
incur a late enrollment penalty. Correct
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? - correct answer -b. 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. Correct
What impact, if any, will the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
have upon Medigap plans? - correct answer -d. The Part B deductible will no longer be covered
for individuals newly eligible for Medicare starting January 1, 2020. Correct
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? - correct answer -d. 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. Correct
, Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan
may, at some time in the future, reduce his benefits below what is available in Original
Medicare. What should you tell him about his concern? - correct answer -a. Medicare health
plans must cover all benefits available under Medicare Part A and Part B. Many also cover Part D
prescription drugs. Correct
Mrs. Willard wants to know generally how the benefits under Original Medicare might compare
to the benefit package of a Medicare Health Plan before she starts looking at specific plans.
What could you tell her? - correct answer -a. Medicare Health Plans may offer extra benefits
that Original Medicare does not offer such as vision, hearing, and dental services and must
include a maximum out-of-pocket limit on Part A and Part B services. Correct
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own
home. She is attracted by the idea of maintaining control over a Medical Savings Account (MSA),
but is not sure if the plan associated with the account will fit her needs. What specific piece of
information about a Medicare MSA plan would it be important for her to know, prior to
enrolling in such a plan? - correct answer -a. All MSAs cover Part A and Part B benefits, but not
Part D prescription drug benefits, which could be obtained by also enrolling in a separate
prescription drug plan. Correct
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?
Choose one answer.
a. Most individuals who are citizens and over age 65 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.
VERSION| 2025/ 2026 QUESTIONS WITH
VERIFIED ANSWERS
Mr. Kelly has substantial financial means. He enrolled in Original Medicare and purchased a
Medigap policy many years ago that offered prescription drug coverage. The prescription drug
coverage has not been comparable to that offered by Medicare Part D for several years and
despite notification, Mr. Kelly took no action. Which of the following statements best describes
what will occur if Mr. Kelly now decides to enroll in Medicare Part D? - correct answer -a. He will
incur a late enrollment penalty. Correct
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? - correct answer -b. 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. Correct
What impact, if any, will the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
have upon Medigap plans? - correct answer -d. The Part B deductible will no longer be covered
for individuals newly eligible for Medicare starting January 1, 2020. Correct
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? - correct answer -d. 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. Correct
, Mr. Hernandez is concerned that if he signs up for a Medicare Advantage plan, the health plan
may, at some time in the future, reduce his benefits below what is available in Original
Medicare. What should you tell him about his concern? - correct answer -a. Medicare health
plans must cover all benefits available under Medicare Part A and Part B. Many also cover Part D
prescription drugs. Correct
Mrs. Willard wants to know generally how the benefits under Original Medicare might compare
to the benefit package of a Medicare Health Plan before she starts looking at specific plans.
What could you tell her? - correct answer -a. Medicare Health Plans may offer extra benefits
that Original Medicare does not offer such as vision, hearing, and dental services and must
include a maximum out-of-pocket limit on Part A and Part B services. Correct
Mrs. Lyons is in good health, uses a single prescription, and lives independently in her own
home. She is attracted by the idea of maintaining control over a Medical Savings Account (MSA),
but is not sure if the plan associated with the account will fit her needs. What specific piece of
information about a Medicare MSA plan would it be important for her to know, prior to
enrolling in such a plan? - correct answer -a. All MSAs cover Part A and Part B benefits, but not
Part D prescription drug benefits, which could be obtained by also enrolling in a separate
prescription drug plan. Correct
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?
Choose one answer.
a. Most individuals who are citizens and over age 65 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.
