AHIP MODULE 2 QUIZ TEST QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Medicare Basics and Fee-Service Eligibility
Medicare Advantage Plan Types and Designs
Eligibility Requirements and Coverage Rules
Medicare Savings Accounts (MSAs)
Fraud, Waste, and Abuse (FWA) Compliance
Nondiscrimination and Marketing Standards
Enrollment Periods and Options
Provider Networks and Benefits
Legal and Regulatory Compliance
Ethics and Professional Standards
,Introduction
This comprehensive assessment evaluates critical knowledge required for AHIP Medicare Training Module 2
certification. The exam assesses understanding of Medicare Advantage plans, eligibility requirements,
enrollment processes, Medicare Savings Accounts, fraud waste and abuse prevention, nondiscrimination
training, and marketing compliance. Through multiple-choice and scenario-based questions, candidates
demonstrate their ability to apply theoretical knowledge to real-world situations involving Medicare
beneficiaries, insurance agents, and healthcare providers. The assessment emphasizes practical decision-
making skills essential for navigating complex Medicare regulations, ensuring compliant marketing
practices, and providing accurate information to beneficiaries about plan benefits and enrollment options.
Success on this exam demonstrates readiness for professional certification in Medicare Advantage plan sales
and administration.
SECTION ONE: QUESTIONS 1–100
Question 1
Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about what
type of plan designs are available through this program. What should you tell him about the types of health
plans available through the Medicare Advantage program?
A. They include only HMOs and PPOs
B. They include HMOs, PPOs, PFFS, and MSAs
C. They include only PPOs and Cost Plans
D. They include only HMOs and SNPs
🟢 Correct answer: B
,🔴 RATIONALE: Medicare Advantage plans include multiple Medicare health plan types such as HMOs
(Health Maintenance Organizations), PPOs (Preferred Provider Organizations), PFFS (Private Fee-for-Service),
and MSAs (Medicare Savings Accounts). This comprehensive answer correctly identifies all major plan designs
available through Medicare Advantage.
Question 2
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What should
you tell her?
A. She must be enrolled in both Medigap and Part A
B. She must be entitled to Part A and enrolled in Part B
C. She must apply for a medical review before acceptance
D. She can enroll in any plan operating in the United States
🟢 Correct answer: B
🔴 RATIONALE: To be eligible to enroll in Medicare Advantage, an individual must be entitled (not merely
enrolled) to Part A benefits and enrolled in Part B. This is the fundamental eligibility requirement for all
Medicare Advantage plans.
Question 3
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but has recently stopped paying his
Part B premium. He is still covered by Part A and wants to enroll in a Medicare Advantage plan. What should
you tell him?
, A. He is not eligible until he re-enrolls in Medicare Part B
B. He can enroll immediately since he has Part A coverage
C. He needs to wait for the next open enrollment period only
D. He must enroll in a Special Needs Plan instead
🟢 Correct answer: A
🔴 RATIONALE: Mr. Castillo is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in
Medicare Part B. Since he stopped paying his Part B premium, his Part B enrollment is terminated, and he must
re-enroll to meet the eligibility requirement of being entitled to Part A and enrolled in Part B.
Question 4
Mrs. Billings enrolled in the ABC Medicare Advantage plan several years ago. Her doctor recently confirmed a
diagnosis of end-stage renal disease (ESRD). What options does she have regarding her MA plan during the
next open enrollment season?
A. She may remain in her ABC MA plan or enroll in a Special Needs Plan for ESRD if available
B. She must immediately disenroll from her MA plan
C. She can only enroll in Original Medicare with no MA options
D. She must switch to a PPO plan regardless of location
🟢 Correct answer: A
🔴 RATIONALE: Individuals with ESRD may remain in their current Medicare Advantage plan or enroll in a
Special Needs Plan (SNP) specifically for individuals suffering from ESRD if one is available in their area. They
are not required to immediately disenroll.
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Medicare Basics and Fee-Service Eligibility
Medicare Advantage Plan Types and Designs
Eligibility Requirements and Coverage Rules
Medicare Savings Accounts (MSAs)
Fraud, Waste, and Abuse (FWA) Compliance
Nondiscrimination and Marketing Standards
Enrollment Periods and Options
Provider Networks and Benefits
Legal and Regulatory Compliance
Ethics and Professional Standards
,Introduction
This comprehensive assessment evaluates critical knowledge required for AHIP Medicare Training Module 2
certification. The exam assesses understanding of Medicare Advantage plans, eligibility requirements,
enrollment processes, Medicare Savings Accounts, fraud waste and abuse prevention, nondiscrimination
training, and marketing compliance. Through multiple-choice and scenario-based questions, candidates
demonstrate their ability to apply theoretical knowledge to real-world situations involving Medicare
beneficiaries, insurance agents, and healthcare providers. The assessment emphasizes practical decision-
making skills essential for navigating complex Medicare regulations, ensuring compliant marketing
practices, and providing accurate information to beneficiaries about plan benefits and enrollment options.
Success on this exam demonstrates readiness for professional certification in Medicare Advantage plan sales
and administration.
SECTION ONE: QUESTIONS 1–100
Question 1
Mr. Lopez has heard that he can sign up for a product called "Medicare Advantage" but is not sure about what
type of plan designs are available through this program. What should you tell him about the types of health
plans available through the Medicare Advantage program?
A. They include only HMOs and PPOs
B. They include HMOs, PPOs, PFFS, and MSAs
C. They include only PPOs and Cost Plans
D. They include only HMOs and SNPs
🟢 Correct answer: B
,🔴 RATIONALE: Medicare Advantage plans include multiple Medicare health plan types such as HMOs
(Health Maintenance Organizations), PPOs (Preferred Provider Organizations), PFFS (Private Fee-for-Service),
and MSAs (Medicare Savings Accounts). This comprehensive answer correctly identifies all major plan designs
available through Medicare Advantage.
Question 2
Mrs. Radford asks whether there are any special eligibility requirements for Medicare Advantage. What should
you tell her?
A. She must be enrolled in both Medigap and Part A
B. She must be entitled to Part A and enrolled in Part B
C. She must apply for a medical review before acceptance
D. She can enroll in any plan operating in the United States
🟢 Correct answer: B
🔴 RATIONALE: To be eligible to enroll in Medicare Advantage, an individual must be entitled (not merely
enrolled) to Part A benefits and enrolled in Part B. This is the fundamental eligibility requirement for all
Medicare Advantage plans.
Question 3
Mr. Castillo, a naturalized citizen, previously enrolled in Medicare Part B but has recently stopped paying his
Part B premium. He is still covered by Part A and wants to enroll in a Medicare Advantage plan. What should
you tell him?
, A. He is not eligible until he re-enrolls in Medicare Part B
B. He can enroll immediately since he has Part A coverage
C. He needs to wait for the next open enrollment period only
D. He must enroll in a Special Needs Plan instead
🟢 Correct answer: A
🔴 RATIONALE: Mr. Castillo is not eligible to enroll in a Medicare Advantage plan until he re-enrolls in
Medicare Part B. Since he stopped paying his Part B premium, his Part B enrollment is terminated, and he must
re-enroll to meet the eligibility requirement of being entitled to Part A and enrolled in Part B.
Question 4
Mrs. Billings enrolled in the ABC Medicare Advantage plan several years ago. Her doctor recently confirmed a
diagnosis of end-stage renal disease (ESRD). What options does she have regarding her MA plan during the
next open enrollment season?
A. She may remain in her ABC MA plan or enroll in a Special Needs Plan for ESRD if available
B. She must immediately disenroll from her MA plan
C. She can only enroll in Original Medicare with no MA options
D. She must switch to a PPO plan regardless of location
🟢 Correct answer: A
🔴 RATIONALE: Individuals with ESRD may remain in their current Medicare Advantage plan or enroll in a
Special Needs Plan (SNP) specifically for individuals suffering from ESRD if one is available in their area. They
are not required to immediately disenroll.
