[
2026 AHIP
FINAL EXAM
Actual Questions and Answers
What’s Inside?
Actual AHIP 2026 Final Exam
questions with verified and explained
answers
Fully aligned with the latest CMS &
AHIP training modules
Detailed coverage of all exam sections,
Each question includes rationales and key references to
reinforce understanding
Content designed to mirror the official AHIP testing
environment
,**1.[Mr.[Capadona[would[like[to[purchase[a[Medicare[Advantage[(MA)[pl
an[and[a[Medigap[plan[to[pick[up[costs[not[covered[by[that[plan.[What[s
hould[you[tell[him?**
A)[You[can[sell[him[a[Medigap[plan[to[help[with[costs[not[covered[under[Medic
are[Advantage.[[
B)[It[is[illegal[for[you[to[sell[Mr.[Capadona[a[Medigap[plan[if[he[is[enrolled[in[an[
MA[plan,[and[besides,[Medigap[only[works[with[Original[Medicare.[[
C)[Medigap[plans[are[designed[to[work[alongside[Medicare[Advantage[plans.[
[
D)[He[must[disenroll[from[his[MA[plan[before[buying[a[Medigap[plan.
**Correct[Answer:**[[
B)[It[is[illegal[for[you[to[sell[Mr.[Capadona[a[Medigap[plan[if[he[is[enrolled[in[an[
MA[plan,[and[besides,[Medigap[only[works[with[Original[Medicare.
**Expert[Rationale:**[[
Medigap[plans[are[supplemental[policies[that[fill[gaps[in[Original[Medicare[(Pa
rts[A[and[B)[coverage.[Federal[law[prohibits[issuance[of[a[Medigap[policy[to[an
yone[currently[enrolled[in[a[Medicare[Advantage[plan;[Medigap[cannot[pay[co
sts[associated[with[MA.[This[ensures[coordination[of[benefits[and[prevents[du
plicate[coverage.
---
**2.[Agent[John[Miller[is[meeting[with[Jerry[Smith,[a[new[prospect.[Jerry
[is[currently[enrolled[in[Medicare[Parts[A[and[B.[Jerry[has[also[purchase
,d[a[Medicare[Supplement[(Medigap)[plan[which[he[has[had[for[several[y
ears.[However,[the[plan[does[not[provide[drug[benefits.[How[would[you[
advise[Agent[John[Miller[to[proceed?**
A)[Advise[Jerry[to[switch[to[a[Medicare[Advantage[plan[for[drug[coverage.[[
B)[Tell[prospect[Jerry[Smith[that[he[should[consider[adding[a[standalone[Part[
D[prescription[drug[coverage[policy[to[his[present[coverage.[[
C)[Inform[Jerry[that[Medigap[automatically[covers[prescription[drugs.[[
D)[Recommend[canceling[the[Medigap[plan.
**Correct[Answer:**[[
B)[Tell[prospect[Jerry[Smith[that[he[should[consider[adding[a[standalone[Part[
D[prescription[drug[coverage[policy[to[his[present[coverage.
**Expert[Rationale:**[[
Medigap[plans[sold[after[2006[do[not[include[prescription[drug[coverage.[Ben
eficiaries[needing[drug[coverage[must[enroll[in[a[standalone[Medicare[Part[D[
plan.[This[allows[individuals[to[retain[their[Medigap[coverage[while[accessing[
necessary[medications[through[an[appropriate[channel.
---
**3.[Mr.[Wu[is[eligible[for[Medicare.[He[has[limited[financial[resources[bu
t[failed[to[qualify[for[the[Part[D[low-
income[subsidy.[Where[might[he[turn[for[help[with[his[prescription[drug
[costs?**
, A)[Apply[for[Medicaid[to[cover[prescription[costs.[[
B)[Seek[assistance[from[pharmaceutical[company[discount[programs.[[
C)[Mr.[Wu[may[still[qualify[for[help[in[paying[Part[D[costs[through[his[State[Pha
rmaceutical[Assistance[Program[(SPAP).[[
D)[Try[to[enroll[in[a[Medigap[plan[with[drug[coverage.
**Correct[Answer:**[[
C)[Mr.[Wu[may[still[qualify[for[help[in[paying[Part[D[costs[through[his[State[Pha
rmaceutical[Assistance[Program[(SPAP).
**Expert[Rationale:**[[
States[may[offer[SPAPs[to[assist[residents[who[do[not[qualify[for[the[federal[Lo
w[Income[Subsidy[but[still[need[help[with[Part[D[drug[costs.[Eligibility[and[ben
efits[vary[by[state,[but[these[programs[can[provide[meaningful[financial[suppo
rt[when[other[federal[options[aren’t[available.
---
**4.[Mr.[Vasquez[is[in[good[health[and[wants[to[understand[the[health[ca
re[costs[for[inpatient[hospital[services[under[Original[Medicare.[What[c
ould[you[tell[him?**
A)[He[pays[no[deductible[if[admitted[to[a[hospital.[[
B)[He[is[responsible[for[a[copayment[every[day[in[the[hospital.[[
C)[Under[Original[Medicare,[there[is[a[single[deductible[amount[due[for[the[firs
t[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[am
2026 AHIP
FINAL EXAM
Actual Questions and Answers
What’s Inside?
Actual AHIP 2026 Final Exam
questions with verified and explained
answers
Fully aligned with the latest CMS &
AHIP training modules
Detailed coverage of all exam sections,
Each question includes rationales and key references to
reinforce understanding
Content designed to mirror the official AHIP testing
environment
,**1.[Mr.[Capadona[would[like[to[purchase[a[Medicare[Advantage[(MA)[pl
an[and[a[Medigap[plan[to[pick[up[costs[not[covered[by[that[plan.[What[s
hould[you[tell[him?**
A)[You[can[sell[him[a[Medigap[plan[to[help[with[costs[not[covered[under[Medic
are[Advantage.[[
B)[It[is[illegal[for[you[to[sell[Mr.[Capadona[a[Medigap[plan[if[he[is[enrolled[in[an[
MA[plan,[and[besides,[Medigap[only[works[with[Original[Medicare.[[
C)[Medigap[plans[are[designed[to[work[alongside[Medicare[Advantage[plans.[
[
D)[He[must[disenroll[from[his[MA[plan[before[buying[a[Medigap[plan.
**Correct[Answer:**[[
B)[It[is[illegal[for[you[to[sell[Mr.[Capadona[a[Medigap[plan[if[he[is[enrolled[in[an[
MA[plan,[and[besides,[Medigap[only[works[with[Original[Medicare.
**Expert[Rationale:**[[
Medigap[plans[are[supplemental[policies[that[fill[gaps[in[Original[Medicare[(Pa
rts[A[and[B)[coverage.[Federal[law[prohibits[issuance[of[a[Medigap[policy[to[an
yone[currently[enrolled[in[a[Medicare[Advantage[plan;[Medigap[cannot[pay[co
sts[associated[with[MA.[This[ensures[coordination[of[benefits[and[prevents[du
plicate[coverage.
---
**2.[Agent[John[Miller[is[meeting[with[Jerry[Smith,[a[new[prospect.[Jerry
[is[currently[enrolled[in[Medicare[Parts[A[and[B.[Jerry[has[also[purchase
,d[a[Medicare[Supplement[(Medigap)[plan[which[he[has[had[for[several[y
ears.[However,[the[plan[does[not[provide[drug[benefits.[How[would[you[
advise[Agent[John[Miller[to[proceed?**
A)[Advise[Jerry[to[switch[to[a[Medicare[Advantage[plan[for[drug[coverage.[[
B)[Tell[prospect[Jerry[Smith[that[he[should[consider[adding[a[standalone[Part[
D[prescription[drug[coverage[policy[to[his[present[coverage.[[
C)[Inform[Jerry[that[Medigap[automatically[covers[prescription[drugs.[[
D)[Recommend[canceling[the[Medigap[plan.
**Correct[Answer:**[[
B)[Tell[prospect[Jerry[Smith[that[he[should[consider[adding[a[standalone[Part[
D[prescription[drug[coverage[policy[to[his[present[coverage.
**Expert[Rationale:**[[
Medigap[plans[sold[after[2006[do[not[include[prescription[drug[coverage.[Ben
eficiaries[needing[drug[coverage[must[enroll[in[a[standalone[Medicare[Part[D[
plan.[This[allows[individuals[to[retain[their[Medigap[coverage[while[accessing[
necessary[medications[through[an[appropriate[channel.
---
**3.[Mr.[Wu[is[eligible[for[Medicare.[He[has[limited[financial[resources[bu
t[failed[to[qualify[for[the[Part[D[low-
income[subsidy.[Where[might[he[turn[for[help[with[his[prescription[drug
[costs?**
, A)[Apply[for[Medicaid[to[cover[prescription[costs.[[
B)[Seek[assistance[from[pharmaceutical[company[discount[programs.[[
C)[Mr.[Wu[may[still[qualify[for[help[in[paying[Part[D[costs[through[his[State[Pha
rmaceutical[Assistance[Program[(SPAP).[[
D)[Try[to[enroll[in[a[Medigap[plan[with[drug[coverage.
**Correct[Answer:**[[
C)[Mr.[Wu[may[still[qualify[for[help[in[paying[Part[D[costs[through[his[State[Pha
rmaceutical[Assistance[Program[(SPAP).
**Expert[Rationale:**[[
States[may[offer[SPAPs[to[assist[residents[who[do[not[qualify[for[the[federal[Lo
w[Income[Subsidy[but[still[need[help[with[Part[D[drug[costs.[Eligibility[and[ben
efits[vary[by[state,[but[these[programs[can[provide[meaningful[financial[suppo
rt[when[other[federal[options[aren’t[available.
---
**4.[Mr.[Vasquez[is[in[good[health[and[wants[to[understand[the[health[ca
re[costs[for[inpatient[hospital[services[under[Original[Medicare.[What[c
ould[you[tell[him?**
A)[He[pays[no[deductible[if[admitted[to[a[hospital.[[
B)[He[is[responsible[for[a[copayment[every[day[in[the[hospital.[[
C)[Under[Original[Medicare,[there[is[a[single[deductible[amount[due[for[the[firs
t[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[am
