AHIP 2025/2026 ACTUAL FINAL EXAM QUESTIONS WITH CORRECT ANSWERS 100% VERIFIED GRADED A+

AHIP 2025/2026 ACTUAL FINAL EXAM
QUESTIONS WITH CORRECT
ANSWERS 100% VERIFIED GRADED
A+
Mr.mArias,mamnaturalizedmcitizen,mpreviouslymenrolledminmMedicaremPartmBmbutmhasmrecentlymstopp
edmpayingmhismPartmBmpremium.mMr.mAriasmismstillmcoveredmbymPartmA.mHemwouldmlikemtomenrollminm
amMedicaremAdvantagem(MA)mplanmandmismstillmcoveredmbymPartmA.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmHemismnotmeligiblemtomenrollminmamMedicaremAdvantagemplanmuntilmhemre-


enrollsminmMedicaremPartmB.



Mrs.mJoy,magem65,mismentitledmtomPartmAmbutmhasmnotmyetmenrolledminmPartmB.mShemismconsideringme
nrollingminmamMedicaremAdvantagemplanm(PartmC).mWhatmshouldmyoumadvisemhermtomdombeforemshe
mcanmenrollminmamMedicaremAdvantagemplan?m-


mCORRECTmANSWERSmTomjoinmamMedicaremAdvantagemplan,mshemalsommustmenrollminmPartmB.




Mr.mKumarmismconsideringmamMedicaremAdvantagemHMOmandmhasmquestionsmaboutmhismabilitymtom
accessmproviders.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmInmmostmMedicaremAdvantagemHMOs,mMr.mKumarmmustmgenerallymobtainmhi


smservicesmonlymfrommprovidersmwithinmthemplan'smnetworkm(exceptminmanmemergencymormwheremc
aremismunavailablemwithinmthemnetwork).



Mrs.mRoblesmismconsideringmamMedicaremAdvantagemPPOmandmhasmquestionsmaboutmwhichmprovid
ersmshemcanmgomtomformhermhealthmcare.mWhatmshouldmyoumtellmher?m-
mCORRECTmANSWERSmMrs.mRoblesmcanmobtainmcaremfrommanymprovidermwhomparticipatesminmOrigi


nalmMedicare,mbutmgenerallymwillmhavemamhighermcost-
sharingmamountmifmshemseesmamprovidermwho/thatmismnotmampartmofmthemPPOmnetwork.



Mrs.mLestermismagem75mandmenjoysmamcomfortablembutmnotmextremelymhigh-
incomemlevel.mShemwishesmtomenrollminmanmMAmMSAmplanmthatmshemheardmaboutmfrommhermneigh
bor.mShemalsomwantsmtomhavemprescriptionmdrugmcoveragemsincemhermdoctormrecentlymprescribedm

, severalmexpensivemmedications.mCurrently,mshemismenrolledminmOriginalmMedicaremandmamstandalo
nemPartmDmplan.mHowmwouldmyoumadvisemMrs.mLester?m-
mCORRECTmANSWERSmMrs.mLestermmaymenrollminmanmMAmMSAmplanmandmremainminmhermcurrentmst


andalonemPartmDmprescriptionmdrugmplan.



Mr.mDaltonmisminmexcellentmhealth,mlivesminmhismownmhome,mandmhasmamsizeablemincomemfrommhismi
nvestments.mHemhasmamfriendmenrolledminmamMedicaremAdvantagemSpecialmNeedsmPlanm(SNP).mHism
friendmhasmmentionedmthatmthemSNPmchargesmverymlowmcost-
sharingmamountsmandmMr.mDaltonmwouldmlikemtomjoinmthatmplan.mWhatmshouldmyoumtellmhim?m-
mCORRECTmANSWERSmSNPsmlimitmenrollmentmtomcertainmsubpopulationsmofmbeneficiaries.mGivenm


hismcurrentmsituation,mhemismunlikelymtomqualifymandmwouldmnotmbemablemtomenrollminmthemSNP.



Mr.mAndersonmwantsmtomknowmwhethermhemismeligiblemtomsignmupmformamPrivatemfee-for-
servicem(PFFS)mplan.mWhatmquestionsmwouldmyoumneedmtomaskmtomdeterminemhismeligibility?m-
mCORRECTmANSWERSmYoumwouldmneedmtomaskmMr.mAndersonmifmhemismentitledmtomPartmA,menrolled


minmPartmB,mandmifmhemlivesminmthemPFFSmplan'smservicemarea.




HerbermNoblemismturningm65mnextmmonth,mHerbermlegallymenteredmthemUnitedmStatesmovermtwent
ymyearsmagombutmismnotmamcitizen.mSincemhismentrymintomthemcountry,mHerbermhasmworkedmatmSmall
capmIncorporatedmandmcontributedmtomthemMedicaremsystem.mHerbermsuffersmfrommdiabetes.mHem
willmsoonmretiremandmasksmyoumifmhemcanmenrollminmamMedicaremAdvantagemplanmthatmyoumreprese
nt.mHowmwouldmyoumrespond?m-
mCORRECTmANSWERSmHerbermismeligiblemtomenrollminmMedicaremAdvantagemasmlongmasmhemismentitl


edmtomPartmAmandmenrolledminmPartmB.mHerbermshouldmgomtomthemSocialmSecuritymwebsitemtomenroll
minmMedicaremPartmAmandmBmifmhemhasmnotmdonemsomalready.mOncemhemismenrolled,mhemcanmchoose


mamMedicaremAdvantagemplan.




WhichmofmthemfollowingmindividualsmismmostmlikelymtombemeligiblemtomenrollminmamPartmDmPlan?m-
mCORRECTmANSWERSmJose,mamgrandfathermwhomwasmgrantedmasylummandmhasmworkedminmthemUni


tedmStatesmformmanymyears.



Mrs.mCastromhasmjustmturnedm65,misminmexcellentmhealthmandmhasmamrelativelymhighmincome.mShemu
sesmnommedicationsmandmseesmnomreasonmtomspendmmoneymonmamMedicaremprescriptionmdrugmpla