2026 AHIP Final Exam Practice Exam – Actual Questions
and Correct Detailed Answers and Medicare Training
Preparation| Latest Version!!!|Already Graded A+
Alice is enrolled in a MA-PD plan. She makes a permanent move
across the country and wonders what her options are for continuing
MA-PD coverage. What would you say to her in regard to a special
enrollment period (SEP)?
She is likely to qualify for a SEP. She can choose an effective date of
up to three months after the month in which the enrollment form is
received by the new plan, but the effective date may not be earlier
than the date of her permanent move.
Which of the following individuals is most likely to be eligible to
enroll in a part d plan?
Jose, a grandfather who was granted asylum and has worked in the
United States for many years.
Mrs. West wears glasses and dentures and has enjoyed considerable
pain relief from arthritis through acupuncture. She is concerned about
whether or not Medicare will cover these items and services. What
should you tell her?
Medicare does not cover acupuncture, or, in general, glasses or
dentures.
Mr. Bickford did not quite qualify for the extra help low-income
subsidy under the Medicare Part D Prescription Drug program and he
is wondering if there is any other option he has for obtaining help
with his considerable drug costs. What should you tell him?
He could check with the manufacturers of his medications to see if
they offer an assistance program to help people with limited means
pg. 1
,obtain the medications they need. Alternatively, he could check to see
whether his state has a pharmacy assistance program to help him with
his expenses.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan
that you represent. It is one of three plans operated by the same
organization in Mr. Lombardi's area. The MA PPO plan does not
include drug coverage, but the other two plans do. Mr. Lombardi likes
the PPO plan that does not include drug coverage and intends to
obtain his drug coverage through a stand-alone Medicare prescription
drug plan. What should you tell him about this situation?
He could enroll in one of the MA plans that include prescription drug
coverage or a Medigap plan and a stand-alone prescription drug plan,
but he cannot enroll in the MA-only PPO plan and a stand-alone
prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his
monthly Part D premiums with an automatic monthly withdrawal
from his savings account until it is exhausted, and then have his
premiums withheld from his Social Security check. What should you
tell him?
In general, he must select a single Part D premium payment
mechanism that will be used throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an
educational event. Agent Jennings distributes materials that are solely
educational in nature. However, she gives a brief presentation that
mentions plan-specific premiums. Is this a prohibited activity at an
event that has been advertised as educational?
Yes. When an event has been advertised as "educational," discussing
plan-specific premiums is impermissible.
pg. 2
,Mrs. Mulcahy is concerned that she may not qualify for enrollment in
a Medicare prescription drug plan because, although she is entitled to
Part A, she is not enrolled under Medicare Part B. What should you
tell her?
Everyone who is entitled to Part A or enrolled under Part B is eligible
to enroll in a Medicare prescription drug plan. As long as Mrs.
Mulcahy is entitled to Part A, she does not need to enroll under Part B
before enrolling in a prescription drug plan.
Mr. Jacob understands that there is a standard Medicare Part D
prescription drug benefit, but when he looks at information on various
plans available in his area, he sees a wide range in what they charge
for deductibles, premiums and cost sharing. How can you explain this
to him?
Medicare Part D drug plans may have different benefit structures, but
on average, they must all be at least as good as the standard model
established by the government.
Ms. Moore plans to retire when she turns 65 in a few months. She is
in excellent health and will have considerable income when she
retires. She is concerned that her income will make it impossible for
her to qualify for Medicare. What could you tell her to address her
concern?
Medicare is a program for people age 65 or older and those under age
65 with certain disabilities, end stage renal disease or Lou Gehrig's
disease, so she will be eligible for Medicare.
You have come to Mrs. Midler's home for a sales presentation. At the
beginning of the presentation, Mrs. Midler tells you that she has a
copy of her medical record available because she thinks this will help
you understand her needs. She suggests that you will know which
pg. 3
, questions to ask her about her health status in order to best assist her
in selecting a plan. What should you do?
You can only ask Mrs. Midler questions about conditions that affect
eligibility, specifically, whether she has end stage renal disease or one
of the conditions that would qualify her for a special needs plan.
Mrs. Reeves is newly eligible to enrol in a Medicare Advantage plan
and her MA Initial Coverage Election Period (ICEP) has just begun.
Which of the following can she not do during the ICEP?
She can enrol in a Medigap plan to supplement the benefits of the MA
plan that she's also enrolling in.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-
income level. She wishes to enroll in a MA MSA plan that she heard
about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive
medications. Currently, she is enrolled in Original Medicare and a
standalone Part D plan. How would you advise Mrs. Chi?
Mrs. Chi may enroll in a MS MSA plan and remain in her current
standalone Part D prescription drug plan.
Agent Armstrong is employed by XYZ Agency, which is under
contract with ABC Health Plan, a Medicare Advantage (MA) plan that
offers plans in multiple states. XYZ Agency maintains a website
marketing the MA plans with which it has contracts. Agent Armstrong
follows up with individuals who request more information about ABC
MA plans via the website and tries to persuade them to enroll in ABC
plans. What statement best describes the marketing and compliance
rules that apply to Agent Armstrong?
Agent Armstrong needs to be licensed and appointed in every state in
which beneficiaries to whom he markets ABC MA plans are located.
pg. 4
and Correct Detailed Answers and Medicare Training
Preparation| Latest Version!!!|Already Graded A+
Alice is enrolled in a MA-PD plan. She makes a permanent move
across the country and wonders what her options are for continuing
MA-PD coverage. What would you say to her in regard to a special
enrollment period (SEP)?
She is likely to qualify for a SEP. She can choose an effective date of
up to three months after the month in which the enrollment form is
received by the new plan, but the effective date may not be earlier
than the date of her permanent move.
Which of the following individuals is most likely to be eligible to
enroll in a part d plan?
Jose, a grandfather who was granted asylum and has worked in the
United States for many years.
Mrs. West wears glasses and dentures and has enjoyed considerable
pain relief from arthritis through acupuncture. She is concerned about
whether or not Medicare will cover these items and services. What
should you tell her?
Medicare does not cover acupuncture, or, in general, glasses or
dentures.
Mr. Bickford did not quite qualify for the extra help low-income
subsidy under the Medicare Part D Prescription Drug program and he
is wondering if there is any other option he has for obtaining help
with his considerable drug costs. What should you tell him?
He could check with the manufacturers of his medications to see if
they offer an assistance program to help people with limited means
pg. 1
,obtain the medications they need. Alternatively, he could check to see
whether his state has a pharmacy assistance program to help him with
his expenses.
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan
that you represent. It is one of three plans operated by the same
organization in Mr. Lombardi's area. The MA PPO plan does not
include drug coverage, but the other two plans do. Mr. Lombardi likes
the PPO plan that does not include drug coverage and intends to
obtain his drug coverage through a stand-alone Medicare prescription
drug plan. What should you tell him about this situation?
He could enroll in one of the MA plans that include prescription drug
coverage or a Medigap plan and a stand-alone prescription drug plan,
but he cannot enroll in the MA-only PPO plan and a stand-alone
prescription drug plan.
Mr. Torres has a small savings account. He would like to pay for his
monthly Part D premiums with an automatic monthly withdrawal
from his savings account until it is exhausted, and then have his
premiums withheld from his Social Security check. What should you
tell him?
In general, he must select a single Part D premium payment
mechanism that will be used throughout the year.
Agent Jennings makes a presentation on Medicare advertised as an
educational event. Agent Jennings distributes materials that are solely
educational in nature. However, she gives a brief presentation that
mentions plan-specific premiums. Is this a prohibited activity at an
event that has been advertised as educational?
Yes. When an event has been advertised as "educational," discussing
plan-specific premiums is impermissible.
pg. 2
,Mrs. Mulcahy is concerned that she may not qualify for enrollment in
a Medicare prescription drug plan because, although she is entitled to
Part A, she is not enrolled under Medicare Part B. What should you
tell her?
Everyone who is entitled to Part A or enrolled under Part B is eligible
to enroll in a Medicare prescription drug plan. As long as Mrs.
Mulcahy is entitled to Part A, she does not need to enroll under Part B
before enrolling in a prescription drug plan.
Mr. Jacob understands that there is a standard Medicare Part D
prescription drug benefit, but when he looks at information on various
plans available in his area, he sees a wide range in what they charge
for deductibles, premiums and cost sharing. How can you explain this
to him?
Medicare Part D drug plans may have different benefit structures, but
on average, they must all be at least as good as the standard model
established by the government.
Ms. Moore plans to retire when she turns 65 in a few months. She is
in excellent health and will have considerable income when she
retires. She is concerned that her income will make it impossible for
her to qualify for Medicare. What could you tell her to address her
concern?
Medicare is a program for people age 65 or older and those under age
65 with certain disabilities, end stage renal disease or Lou Gehrig's
disease, so she will be eligible for Medicare.
You have come to Mrs. Midler's home for a sales presentation. At the
beginning of the presentation, Mrs. Midler tells you that she has a
copy of her medical record available because she thinks this will help
you understand her needs. She suggests that you will know which
pg. 3
, questions to ask her about her health status in order to best assist her
in selecting a plan. What should you do?
You can only ask Mrs. Midler questions about conditions that affect
eligibility, specifically, whether she has end stage renal disease or one
of the conditions that would qualify her for a special needs plan.
Mrs. Reeves is newly eligible to enrol in a Medicare Advantage plan
and her MA Initial Coverage Election Period (ICEP) has just begun.
Which of the following can she not do during the ICEP?
She can enrol in a Medigap plan to supplement the benefits of the MA
plan that she's also enrolling in.
Mrs. Chi is age 75 and enjoys a comfortable but not extremely high-
income level. She wishes to enroll in a MA MSA plan that she heard
about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive
medications. Currently, she is enrolled in Original Medicare and a
standalone Part D plan. How would you advise Mrs. Chi?
Mrs. Chi may enroll in a MS MSA plan and remain in her current
standalone Part D prescription drug plan.
Agent Armstrong is employed by XYZ Agency, which is under
contract with ABC Health Plan, a Medicare Advantage (MA) plan that
offers plans in multiple states. XYZ Agency maintains a website
marketing the MA plans with which it has contracts. Agent Armstrong
follows up with individuals who request more information about ABC
MA plans via the website and tries to persuade them to enroll in ABC
plans. What statement best describes the marketing and compliance
rules that apply to Agent Armstrong?
Agent Armstrong needs to be licensed and appointed in every state in
which beneficiaries to whom he markets ABC MA plans are located.
pg. 4
