AHIP FINAL EXAM
2026/2027
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
Which individual is eligible to enroll in a Medicare Advantage plan?
A. A 60-year-old with private insurance
B. A 65-year-old enrolled in Medicare Part A and Part B
C. A 67-year-old with employer-only coverage
D. A 70-year-old enrolled only in Medicare Part D
Correct Answer: B
Rationale:
To enroll in a Medicare Advantage plan, an individual must be entitled to
Medicare Part A and enrolled in Medicare Part B and live within the plan’s service
area. Part D alone or private insurance does not meet eligibility requirements.
,Question 2
A beneficiary enrolls in a Medicare Advantage Prescription Drug (MAPD) plan.
What happens to their Original Medicare coverage?
A. Original Medicare becomes secondary
B. Original Medicare remains primary
C. Original Medicare is replaced by the MA plan
D. The beneficiary must keep Part D separately
Correct Answer: C
Rationale:
When a beneficiary enrolls in a Medicare Advantage plan, the MA plan replaces
Original Medicare as the primary source of coverage while still providing
Medicare benefits.
Question 3
Which service must all Medicare Advantage plans cover?
A. Routine dental services
B. Hospice care
C. Vision exams
D. Hearing aids
Correct Answer: B
Rationale:
Hospice care remains covered under Original Medicare even for beneficiaries
enrolled in Medicare Advantage plans. Dental, vision, and hearing are optional
supplemental benefits.
,Question 4
An agent advertises a Medicare Advantage plan as “the best plan available.” Is this
compliant?
A. Yes, if the plan has a 5-star rating
B. Yes, if beneficiaries agree
C. No, it is considered misleading
D. No, unless CMS approves the statement
Correct Answer: C
Rationale:
CMS marketing guidelines prohibit superlative or unsubstantiated claims such as
“best” or “most comprehensive,” as they can mislead beneficiaries.
Question 5
Which enrollment period allows beneficiaries to switch from one Medicare
Advantage plan to another?
A. Initial Enrollment Period
B. Annual Election Period
C. Guaranteed Issue Period
D. Medicaid Enrollment Period
Correct Answer: B
Rationale:
The Annual Election Period (October 15–December 7) allows beneficiaries to
enroll in, disenroll from, or switch Medicare Advantage and Part D plans.
Question 6
A beneficiary enrolls in a Part D plan and does not take any medications. What is
the primary benefit of enrolling?
A. Lower Part B premiums
B. Protection against future late enrollment penalties
, C. Free preventive services
D. Automatic enrollment in Medicaid
Correct Answer: B
Rationale:
Enrolling in Part D when first eligible helps beneficiaries avoid the permanent late
enrollment penalty should they need prescription coverage later.
Question 7
Which action by an agent would be considered marketing misconduct?
A. Explaining plan costs accurately
B. Conducting a health risk assessment after enrollment
C. Offering a gift card worth $50 for enrollment
D. Providing CMS-approved marketing materials
Correct Answer: C
Rationale:
CMS prohibits offering cash or cash-equivalent inducements exceeding nominal
value to influence enrollment decisions.
Question 8
A beneficiary wants to enroll in a Special Needs Plan (SNP). What must be
verified?
A. Their employment status
B. Their income only
C. Their eligibility for the specific SNP category
D. Their prescription drug history
Correct Answer: C
Rationale:
SNPs are designed for specific populations (e.g., dual-eligible, institutionalized, or
chronic condition beneficiaries), and eligibility must be confirmed.
2026/2027
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
Which individual is eligible to enroll in a Medicare Advantage plan?
A. A 60-year-old with private insurance
B. A 65-year-old enrolled in Medicare Part A and Part B
C. A 67-year-old with employer-only coverage
D. A 70-year-old enrolled only in Medicare Part D
Correct Answer: B
Rationale:
To enroll in a Medicare Advantage plan, an individual must be entitled to
Medicare Part A and enrolled in Medicare Part B and live within the plan’s service
area. Part D alone or private insurance does not meet eligibility requirements.
,Question 2
A beneficiary enrolls in a Medicare Advantage Prescription Drug (MAPD) plan.
What happens to their Original Medicare coverage?
A. Original Medicare becomes secondary
B. Original Medicare remains primary
C. Original Medicare is replaced by the MA plan
D. The beneficiary must keep Part D separately
Correct Answer: C
Rationale:
When a beneficiary enrolls in a Medicare Advantage plan, the MA plan replaces
Original Medicare as the primary source of coverage while still providing
Medicare benefits.
Question 3
Which service must all Medicare Advantage plans cover?
A. Routine dental services
B. Hospice care
C. Vision exams
D. Hearing aids
Correct Answer: B
Rationale:
Hospice care remains covered under Original Medicare even for beneficiaries
enrolled in Medicare Advantage plans. Dental, vision, and hearing are optional
supplemental benefits.
,Question 4
An agent advertises a Medicare Advantage plan as “the best plan available.” Is this
compliant?
A. Yes, if the plan has a 5-star rating
B. Yes, if beneficiaries agree
C. No, it is considered misleading
D. No, unless CMS approves the statement
Correct Answer: C
Rationale:
CMS marketing guidelines prohibit superlative or unsubstantiated claims such as
“best” or “most comprehensive,” as they can mislead beneficiaries.
Question 5
Which enrollment period allows beneficiaries to switch from one Medicare
Advantage plan to another?
A. Initial Enrollment Period
B. Annual Election Period
C. Guaranteed Issue Period
D. Medicaid Enrollment Period
Correct Answer: B
Rationale:
The Annual Election Period (October 15–December 7) allows beneficiaries to
enroll in, disenroll from, or switch Medicare Advantage and Part D plans.
Question 6
A beneficiary enrolls in a Part D plan and does not take any medications. What is
the primary benefit of enrolling?
A. Lower Part B premiums
B. Protection against future late enrollment penalties
, C. Free preventive services
D. Automatic enrollment in Medicaid
Correct Answer: B
Rationale:
Enrolling in Part D when first eligible helps beneficiaries avoid the permanent late
enrollment penalty should they need prescription coverage later.
Question 7
Which action by an agent would be considered marketing misconduct?
A. Explaining plan costs accurately
B. Conducting a health risk assessment after enrollment
C. Offering a gift card worth $50 for enrollment
D. Providing CMS-approved marketing materials
Correct Answer: C
Rationale:
CMS prohibits offering cash or cash-equivalent inducements exceeding nominal
value to influence enrollment decisions.
Question 8
A beneficiary wants to enroll in a Special Needs Plan (SNP). What must be
verified?
A. Their employment status
B. Their income only
C. Their eligibility for the specific SNP category
D. Their prescription drug history
Correct Answer: C
Rationale:
SNPs are designed for specific populations (e.g., dual-eligible, institutionalized, or
chronic condition beneficiaries), and eligibility must be confirmed.
