AHIP Final Exam Certification Review (Latest 2026–2027) | Study Guide, Practice Questions, Verified Answers, Module Updates, Costs, Compliance Tips & Exam Prep

AHIP FINAL EXAM
Certification Review (Latest 2026–2027) | Study Guide,
Practice Questions, Verified Answers, Module Updates,
Costs, Compliance Tips & Exam Prep


THIS EXAM INCLUDES:
• ✅ Latest AHIP Certification Updates
• ✅ Comprehensive Study Guide
• ✅ Practice Questions with Verified Answers
• ✅ Detailed Answer Explanations
• ✅ Medicare Parts A, B, C & D Review
• ✅ CMS Compliance & FWA Coverage
• ✅ Module Summaries & Review Notes
• ✅ Exam Preparation Strategies
• ✅ Annual Certification & Recertification Review
• ✅ Instant Digital PDF Study Resource
• ✅ A+ Exam Prep Guide

, AHIP Final Exam Certification Review (Latest 2026–2027)
x x x x x x




| Study Guide, Practice Questions, Verified Answers,
x x x x x x x




x Module Updates, Costs, Compliance Tips & Exam Prep x x x x x x x




Question 1 xx




Mr. Arias, a naturalized citizen, previously enrolled in Medicare Part B
x x x x x x x x x x




x but has recently stopped paying his Part B premium. Mr. Arias is still
x x x x x x x x x x x x




x covered by Part A. He would like to enroll in a Medicare Advantage
x x x x x x x x x x x x




x (MA) plan and is still covered by Part A. What should you tell him?
x x x x x x x x x x x x x




A) He can enroll in a Medicare Advantage plan as long as he has Part A
x x x x x x x x x x x x x x x




coverage
x




B) He is not eligible to enroll in a Medicare Advantage plan until he re-enrolls
x x x x x x x x x x x x x x




in Medicare Part B
x x x x




C) He can enroll in a Medicare Advantage plan but must pay higher
x x x x x x x x x x x x




premiums
x




D) He should enroll in a Medicare Supplement plan instead
x x x x x x x x x




Correct Answer: B x x




Explanation: To enroll in a Medicare Advantage (MA) plan, a beneficiary
x x x x x x x x x x




must be entitled to both Medicare Part A and Part B. Since Mr. Arias stopped
x x x x x x x x x x x x x x x




paying his Part B premium, he is no longer enrolled in Part B, making him
x x x x x x x x x x x x x x x




ineligible for MA plan enrollment until he re-enrolls in Part B.
x x x x x x x x x x x

,Question 2 x




Mrs. Joy, age 65, is entitled to Part A but has not yet enrolled in Part B.
x x x x x x x x x x x x x x x x




x She is considering enrolling in a Medicare Advantage plan (Part C).
x x x x x x x x x x




x What should you advise her to do before she can enroll in a Medicare
x x x x x x x x x x x x x




x Advantage plan? x




A) She can enroll in a Medicare Advantage plan with just Part A coverage
x x x x x x x x x x x x x




B) She must first enroll in Original Medicare fee-for-service
x x x x x x x x




C) To join a Medicare Advantage plan, she also must enroll in Part B
x x x x x x x x x x x x x




D) She should wait until the Annual Election Period
x x x x x x x x




Correct Answer: C x x




Explanation: Medicare Advantage enrollment requires simultaneous x x x x x




enrollment in both Medicare Part A and Part B. Mrs. Joy must first enroll in
x x x x x x x x x x x x x x x




Part B before she can join any Medicare Advantage plan. Part B enrollment is
x x x x x x x x x x x x x x




a prerequisite for MA plan participation.
x x x x x x




Question 3 x




Mr. Kumar is considering a Medicare Advantage HMO and has
x x x x x x x x x




x questions about his ability to access providers. What should you tell
x x x x x x x x x x




x him?

A) He can see any provider who accepts Medicare
x x x x x x x x




B) He must get a referral from his primary care physician for all services
x x x x x x x x x x x x x




C) In most Medicare Advantage HMOs, Mr. Kumar must generally obtain his
x x x x x x x x x x x




services only from providers within the plan's network (except in an
x x x x x x x x x x x

, emergency or where care is unavailable within the network)
x x x x x x x x x




D) He can see out-of-network providers at the same cost-sharing level
x x x x x x x x x x




Correct Answer: C x x




Explanation: Medicare Advantage HMO plans typically have restricted
x x x x x x x




provider networks. Members must generally receive care from in-network
x x x x x x x x x




providers to have services covered, with exceptions for emergencies or when
x x x x x x x x x x x




care is unavailable within the network. Out-of-network care may not be
x x x x x x x x x x x




covered or may have significantly higher costs.
x x x x x x x




Question 4 x




Mrs. Robles is considering a Medicare Advantage PPO and has
x x x x x x x x x




x questions about which providers she can go to for her health care.
x x x x x x x x x x x




x What should you tell her?
x x x x




A) She can only see providers within the PPO network
x x x x x x x x x




B) She must obtain a referral before seeing any specialist
x x x x x x x x x




C) Mrs. Robles can obtain care from any provider who participates in Original
x x x x x x x x x x x x




Medicare, but generally will have a higher cost-sharing amount if she sees a
x x x x x x x x x x x x x




provider who is not a part of the PPO network
x x x x x x x x x x




D) She cannot see out-of-network providers under any circumstances
x x x x x x x x




Correct Answer: C x x




Explanation: PPO (Preferred Provider Organization) plans offer more
x x x x x x x




flexibility than HMOs. Members can see any provider who participates in
x x x x x x x x x x x




Original Medicare, but they will generally pay higher cost-sharing amounts
x x x x x x x x x x