AHIP FINAL EXAM NEWEST 2025-2026 VERSION QUESTIONS WITH GOLD
TIPS SOLUTIONS AND REVEWEIRS
1. Mr. Wu is eligible for Medicare. He has lim- Mr. Wu may still qualify for help in paying
ited financial resources but failed to qualify Part D costs through his State Pharmaceu-
for the Part D low-income subsidy. Where tical Assistance Program.
might he turn for help with his prescription
drug costs?
2. Mr. Bauer is 49 years old, but eighteen After receiving such disability payments for
months ago he was declared disabled by 24 months, he will be automatically en-
the Social Security Administration and has rolled in Medicare, regardless of age.
been receiving disability payments. He is
wondering whether he can obtain cover-
age under Medicare. What should you tell
him?
3. Mildred Savage enrolled in Allcare Mildred may remain enrolled in Allcare and
Medicare Advantage plan several years make a hospice election. Hospice benefits
ago. Mildred recently learned that she is will be paid for by Original Medicare under
suffering from inoperable cancer and has Part A and Allcare will continue to pay for
just a few months to live. She would like any non-hospice services.
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?
4. Mr. Schmidt would like to plan for re- Part A, which covers hospital, skilled nurs-
tirement and has asked you what is cov- ing facility, hospice, and home health ser-
ered under Original Fee-for-Service (FFS) vices and Part B, which covers professional
Medicare. What could you tell him? services such as those provided by a doctor
are covered under Original Medicare.
, AHIP FINAL EXAM NEWEST 2025-2026 VERSION QUESTIONS WITH GOLD
TIPS SOLUTIONS AND REVEWEIRS
5. Agent John Miller is meeting with Jerry Tell prospect Jerry Smith that he should
Smith, a new prospect. Jerry is currently consider adding a standalone Part D pre-
enrolled in Medicare Parts A and B. Jer- scription drug coverage policy to his pre-
ry has also purchased a Medicare Supple- sent coverage.
ment (Medigap) plan which he has had for
several years. However, the plan does not
provide drug benefits. How would you ad-
vise Agent John Miller to proceed?
6. Mr. Davis is 52 years old and has recently He may sign-up for Medicare at any time
been diagnosed with end-stage renal dis- however coverage usually begins on the
ease (ESRD) and will soon begin dialysis. fourth month after dialysis treatments start.
He is wondering if he can obtain coverage
under Medicare. What should you tell him?
7. Mr. Diaz continued working with his com- Mr. Diaz will not pay any penalty because
pany and was insured under his employer's he had continuous coverage under his em-
group plan until he reached age 68. He has ployer's plan.
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?
8. Madeline Martinez was widowed several You should tell Madeline that she will be
years ago. Her husband worked for many able to enroll in Medicare Part A without
years and contributed into the Medicare paying monthly premiums due to her hus-
system. He also left a substantial estate band's long work record and participation
which provides Madeline with an annual in the Medicare system. You should also tell
income of approximately $130,000. Made- Madeline that she will pay Part B premiums
line, who has only worked part-time for the at more than the standard lowest rate but
, AHIP FINAL EXAM NEWEST 2025-2026 VERSION QUESTIONS WITH GOLD
TIPS SOLUTIONS AND REVEWEIRS
last three years, will soon turn age 65 and less than the highest rate due her substan-
hopes to enroll in Original Medicare. She tial income.
comes to you for advice. What should you
tell her?
9. Edward IP suffered from serious kidney dis- Individuals eligible for Medicare based on
ease. As a result. Edward became eligible ESRD generally lose eligibility 36 months
for Medicare coverage due to end-stage after the month in which the individual re-
renal disease (ESRD). A close relative do- ceives a kidney transplant unless they are
nated their kidney and Edward successfully eligible for Medicare on another basis such
underwent transplant surgery 12 months as age or disability. Edward may, however,
ago. Edward is now age 50 and asks you if remain enrolled in Part B but solely for
his Medicare coverage will continue, what coverage of immunosuppressive drugs if
should you say? he has no other health care coverage that
would cover the drugs.
10. Mrs. Peňa is 66 years old, has coverage un- She may enroll at any time while she is cov-
der an employer plan, and will retire next ered under her employer plan, but she will
year. She heard she must enroll in Part B at have a special eight-month enrollment pe-
the beginning of the year to ensure no gap riod after the last month on her employer
in coverage. What can you tell her? plan that ditters from the standard general
enrollment period, during which she may
enroll in Medicare Part B.
11. Mr. Capadona would like to purchase a It is illegal for you to sell Mr. Capadona
Medicare Advantage (MA) plan and a Medi- a Medigap plan if he is enrolled in an
gap plan to pick up costs not covered by MA plan, and besides, Medigap only works
that plan. What should you tell him? with Original Medicare.
12. Ms. Henderson believes that she will qual- To obtain Part B coverage, she must pay
ify for Medicare Coverage when she turns a standard monthly premium, though it is
65, without paying any premiums, because higher for individuals with higher incomes.
TIPS SOLUTIONS AND REVEWEIRS
1. Mr. Wu is eligible for Medicare. He has lim- Mr. Wu may still qualify for help in paying
ited financial resources but failed to qualify Part D costs through his State Pharmaceu-
for the Part D low-income subsidy. Where tical Assistance Program.
might he turn for help with his prescription
drug costs?
2. Mr. Bauer is 49 years old, but eighteen After receiving such disability payments for
months ago he was declared disabled by 24 months, he will be automatically en-
the Social Security Administration and has rolled in Medicare, regardless of age.
been receiving disability payments. He is
wondering whether he can obtain cover-
age under Medicare. What should you tell
him?
3. Mildred Savage enrolled in Allcare Mildred may remain enrolled in Allcare and
Medicare Advantage plan several years make a hospice election. Hospice benefits
ago. Mildred recently learned that she is will be paid for by Original Medicare under
suffering from inoperable cancer and has Part A and Allcare will continue to pay for
just a few months to live. She would like any non-hospice services.
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?
4. Mr. Schmidt would like to plan for re- Part A, which covers hospital, skilled nurs-
tirement and has asked you what is cov- ing facility, hospice, and home health ser-
ered under Original Fee-for-Service (FFS) vices and Part B, which covers professional
Medicare. What could you tell him? services such as those provided by a doctor
are covered under Original Medicare.
, AHIP FINAL EXAM NEWEST 2025-2026 VERSION QUESTIONS WITH GOLD
TIPS SOLUTIONS AND REVEWEIRS
5. Agent John Miller is meeting with Jerry Tell prospect Jerry Smith that he should
Smith, a new prospect. Jerry is currently consider adding a standalone Part D pre-
enrolled in Medicare Parts A and B. Jer- scription drug coverage policy to his pre-
ry has also purchased a Medicare Supple- sent coverage.
ment (Medigap) plan which he has had for
several years. However, the plan does not
provide drug benefits. How would you ad-
vise Agent John Miller to proceed?
6. Mr. Davis is 52 years old and has recently He may sign-up for Medicare at any time
been diagnosed with end-stage renal dis- however coverage usually begins on the
ease (ESRD) and will soon begin dialysis. fourth month after dialysis treatments start.
He is wondering if he can obtain coverage
under Medicare. What should you tell him?
7. Mr. Diaz continued working with his com- Mr. Diaz will not pay any penalty because
pany and was insured under his employer's he had continuous coverage under his em-
group plan until he reached age 68. He has ployer's plan.
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?
8. Madeline Martinez was widowed several You should tell Madeline that she will be
years ago. Her husband worked for many able to enroll in Medicare Part A without
years and contributed into the Medicare paying monthly premiums due to her hus-
system. He also left a substantial estate band's long work record and participation
which provides Madeline with an annual in the Medicare system. You should also tell
income of approximately $130,000. Made- Madeline that she will pay Part B premiums
line, who has only worked part-time for the at more than the standard lowest rate but
, AHIP FINAL EXAM NEWEST 2025-2026 VERSION QUESTIONS WITH GOLD
TIPS SOLUTIONS AND REVEWEIRS
last three years, will soon turn age 65 and less than the highest rate due her substan-
hopes to enroll in Original Medicare. She tial income.
comes to you for advice. What should you
tell her?
9. Edward IP suffered from serious kidney dis- Individuals eligible for Medicare based on
ease. As a result. Edward became eligible ESRD generally lose eligibility 36 months
for Medicare coverage due to end-stage after the month in which the individual re-
renal disease (ESRD). A close relative do- ceives a kidney transplant unless they are
nated their kidney and Edward successfully eligible for Medicare on another basis such
underwent transplant surgery 12 months as age or disability. Edward may, however,
ago. Edward is now age 50 and asks you if remain enrolled in Part B but solely for
his Medicare coverage will continue, what coverage of immunosuppressive drugs if
should you say? he has no other health care coverage that
would cover the drugs.
10. Mrs. Peňa is 66 years old, has coverage un- She may enroll at any time while she is cov-
der an employer plan, and will retire next ered under her employer plan, but she will
year. She heard she must enroll in Part B at have a special eight-month enrollment pe-
the beginning of the year to ensure no gap riod after the last month on her employer
in coverage. What can you tell her? plan that ditters from the standard general
enrollment period, during which she may
enroll in Medicare Part B.
11. Mr. Capadona would like to purchase a It is illegal for you to sell Mr. Capadona
Medicare Advantage (MA) plan and a Medi- a Medigap plan if he is enrolled in an
gap plan to pick up costs not covered by MA plan, and besides, Medigap only works
that plan. What should you tell him? with Original Medicare.
12. Ms. Henderson believes that she will qual- To obtain Part B coverage, she must pay
ify for Medicare Coverage when she turns a standard monthly premium, though it is
65, without paying any premiums, because higher for individuals with higher incomes.
