AHIP TEST ACTUAL EXAM 2026 2027
VERIFIED ANSWERS ACTUAL UPDATED
PRACTICE QUESTIONS HIGH YIELD
STUDY GUIDE EXAM PREP MATERIAL
LATEST VERSION REAL EXAM QUESTIONS
AND ANSWERS GRADED A+ SUCCESS
PACK REVIEW EDITION
• 1. What impact, if any, will the Medicare Access and CHIP Reauthorization Act of
2015 (MACRA) have upon Medigap plans?
a. The Part A deductible will no longer be covered for individuals newly
eligible for Medicare starting January 1, 2020.
b. The Part B deductible will no longer be covered for individuals newly eligible
for Medicare starting January 1, 2020.
c. The Part A deductible is no longer covered under Medigap plans for all
enrollees staring January 1, 2020.
d. MACRA provides funding to help individuals age 59 and above enroll in
Medigap plans.
• 2.Able, Baker, and Charles are engaged in the marketing to and enrollment of
beneficiaries into Medicare health plans. Mr. Able is an independent agent paid
directly by a health plan. Ms. Baker is an independent agent paid through a field
marketing organization (FMO). Mr. Charles is an independent agent paid for his
work by a third-party marketing organization (TMO). How do the CMS
compensation rules apply to these three agents?
,
, a. All three are treated as independent agents under CMS compensation
rules.
b. Baker and Charles are subject to CMS compensation rules because they
are paid by third parties. Able is not bec he is paid directly by a health
plan.
c. Able is subject to CMS compensation rules because he is paid directly by
a hea
plan. Agents Baker and Charle not because they are paid by third parties.
d. Charles is subject to CMS compliance rules because he works for a TMO
and CMS applies an extra layer of scru such organizations. Able and
Baker are not.
• 3.Mrs. Paterson is concerned about the deductibles and co-payments associated with
Original Medicare. What can you tell her about Medigap as an option to address this
concern?
a. Medigap plans are not sold by private companies and are a government
insurance product.
b. All costs not covered by Medicare are covered by some Medigap plans.
c. If Mrs. Paterson applies during the Medigap open enrollment period,
she will have to undergo a medical review to determine if she has a pre-
existing condition that would increase the premium for a Medigap policy.
d. Medigap plans help beneficiaries cover coinsurance, copayments,
and/or deductibles for medically necessary services.
• 4.Mr Valesquez asked if the Private Fee-for-Service plan you have discussed is like
Original Medicare or a Medigap supplement plan. What should you say about a
Private Fee-for-Service (PFFS) plan to explain it to Mr. Valesquez?
,
, ,
a. It is a type of Medicare Advantage plan that allows
you to go to any doctor anywhere.
c. It is the same as Original Medicare, but offered by a private company.
d. It is not Original Medicare and it works differently than a
,
, ,
Medicare supplement plan.
• 5.Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of
health status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy
network but may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may
only obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a
standalone PDP or through their plan.
a. I and II only
b. I only
d. I, II, III, and IV
c. I, II, and III only
• 6. You are completing a PFFS plan sale to Mr. West who is new to Medicare and
prefers to be contacted by telephone. As you are finishing up, what should you tell
him about next steps in the enrollment process?
a. You need to ask Mr. West a few final questions to ensure he
understands the nature of the plan and really wants to enroll. You also
should tell Mr. Schmidt that after you leave, he should not answer any
questions about his enrollment in the plan because it could result in a
disenrollment.
b. You need to get Mr. West’s phone number and include it on the
enrollment form because the PFFS plan will contact him once the
,
VERIFIED ANSWERS ACTUAL UPDATED
PRACTICE QUESTIONS HIGH YIELD
STUDY GUIDE EXAM PREP MATERIAL
LATEST VERSION REAL EXAM QUESTIONS
AND ANSWERS GRADED A+ SUCCESS
PACK REVIEW EDITION
• 1. What impact, if any, will the Medicare Access and CHIP Reauthorization Act of
2015 (MACRA) have upon Medigap plans?
a. The Part A deductible will no longer be covered for individuals newly
eligible for Medicare starting January 1, 2020.
b. The Part B deductible will no longer be covered for individuals newly eligible
for Medicare starting January 1, 2020.
c. The Part A deductible is no longer covered under Medigap plans for all
enrollees staring January 1, 2020.
d. MACRA provides funding to help individuals age 59 and above enroll in
Medigap plans.
• 2.Able, Baker, and Charles are engaged in the marketing to and enrollment of
beneficiaries into Medicare health plans. Mr. Able is an independent agent paid
directly by a health plan. Ms. Baker is an independent agent paid through a field
marketing organization (FMO). Mr. Charles is an independent agent paid for his
work by a third-party marketing organization (TMO). How do the CMS
compensation rules apply to these three agents?
,
, a. All three are treated as independent agents under CMS compensation
rules.
b. Baker and Charles are subject to CMS compensation rules because they
are paid by third parties. Able is not bec he is paid directly by a health
plan.
c. Able is subject to CMS compensation rules because he is paid directly by
a hea
plan. Agents Baker and Charle not because they are paid by third parties.
d. Charles is subject to CMS compliance rules because he works for a TMO
and CMS applies an extra layer of scru such organizations. Able and
Baker are not.
• 3.Mrs. Paterson is concerned about the deductibles and co-payments associated with
Original Medicare. What can you tell her about Medigap as an option to address this
concern?
a. Medigap plans are not sold by private companies and are a government
insurance product.
b. All costs not covered by Medicare are covered by some Medigap plans.
c. If Mrs. Paterson applies during the Medigap open enrollment period,
she will have to undergo a medical review to determine if she has a pre-
existing condition that would increase the premium for a Medigap policy.
d. Medigap plans help beneficiaries cover coinsurance, copayments,
and/or deductibles for medically necessary services.
• 4.Mr Valesquez asked if the Private Fee-for-Service plan you have discussed is like
Original Medicare or a Medigap supplement plan. What should you say about a
Private Fee-for-Service (PFFS) plan to explain it to Mr. Valesquez?
,
, ,
a. It is a type of Medicare Advantage plan that allows
you to go to any doctor anywhere.
c. It is the same as Original Medicare, but offered by a private company.
d. It is not Original Medicare and it works differently than a
,
, ,
Medicare supplement plan.
• 5.Which of the following statements about Medicare Part D are correct?
I. Part D plans must enroll any eligible beneficiary who applies regardless of
health status except in limited circumstances.
II. Private fee-for-service (PFFS) plans are not required to use a pharmacy
network but may choose to have one.
III. Beneficiaries enrolled in a MA-Medical Savings Account (MSA) plan may
only obtain Part D benefits through a standalone PDP.
IV. Beneficiaries enrolled in a MA-PPO may obtain Part D benefits through a
standalone PDP or through their plan.
a. I and II only
b. I only
d. I, II, III, and IV
c. I, II, and III only
• 6. You are completing a PFFS plan sale to Mr. West who is new to Medicare and
prefers to be contacted by telephone. As you are finishing up, what should you tell
him about next steps in the enrollment process?
a. You need to ask Mr. West a few final questions to ensure he
understands the nature of the plan and really wants to enroll. You also
should tell Mr. Schmidt that after you leave, he should not answer any
questions about his enrollment in the plan because it could result in a
disenrollment.
b. You need to get Mr. West’s phone number and include it on the
enrollment form because the PFFS plan will contact him once the
,
