AHIP Final Exam with Questions and Answers 2025/2026 new update
**Question 1:** Mrs. Burton is a retiree with substantial income. She is enrolled in an MAPD plan and was disappointed with the service she received from her primary care physician
because she was told she would have to wait five weeks to get an appointment when she was
feeling ill. She called you to ask what she could do so she would not have to put up with such
poor access to care. What could you tell her?
**Answer 1:** She could file a grievance with her plan to complain about the lack of
timeliness in getting an appointment.
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**Question 2:** 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 2:** 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.
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**Question 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?