AHIP 2026 Final Exam Questions with Correct Accurate Graded A+
and Passing Marks Answers
1. Mr. Pham is a Qualified Medicare Beneficiary (QMB). He enrolls in a
Medicare Advantage HMO. Shortly thereafter, Mr. Pham visits his primary
care provider (PCP), Dr. Maria Sanchez. Mr. Pham complains of a bad cold
and receives care - a Medicare-covered service. The normal copayment is
$40. How much may Dr. Sanchez collects? - Answer-The minimal
copayment that would apply under Medicaid, regardless of what the plan
requires of other enrollees.
1. Mr. Vasquez is in good health and is preparing a budget in anticipation
of his retirement when he turns 66. He wants to understand the health
care costs he might be exposed to under Medicare if he were to require
hospitalization because of an illness. In general terms, what could you tell
him about his costs for inpatient hospital services under Original
Medicare? - Answer-Under Original Medicare, there is a single deductible
amount due for the first 60 days of any inpatient hospital stay, after which
it converts into a per-day coinsurance amount through day 90. After day
90, he would pay a daily amount up to 60 days over his lifetime, after
which he would be responsible for all costs.
1. Mrs. Thomas 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.
1. 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.
