AHIP Final Exam Latest (2025/2026) | 50
Verified Questions and Correct Answers |
A+ Graded
.
Question 1
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a Medigap
plan to pick up costs not covered by that plan. What should you tell him?
A) You can sell him a Medigap plan to help with costs not covered under Medicare
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
Rationale: Medigap plans are supplemental policies that fill gaps in Original Medicare
(Parts A and B). Federal law prohibits the sale of a Medigap policy to someone enrolled
in a Medicare Advantage plan, as Medigap cannot pay the cost-sharing of an MA plan.
Question 2
What is the total duration of the Initial Enrollment Period (IEP) for a beneficiary turning
65?
A) 3 months
B) 6 months
,C) 7 months
D) 12 months
Correct Answer: C
Rationale: The Initial Enrollment Period is a 7-month window that includes the 3
months before the individual turns 65, their birth month, and the 3 months immediately
following. This is a fundamental eligibility concept for Medicare enrollment.
Question 3
Which of the following best describes Medicare Part A?
A) It covers outpatient medical services and doctor visits.
B) It covers inpatient hospital care, skilled nursing facility care, hospice, and some home
health services.
C) It covers prescription drugs only.
D) It covers vision, dental, and hearing services exclusively.
Correct Answer: B
Rationale: Medicare Part A is "Hospital Insurance" and covers inpatient hospital stays,
skilled nursing facility care, hospice, and limited home health care. Outpatient services
are covered under Part B, and prescription drugs are covered under Part D.
Question 4
During the Annual Election Period (AEP), which runs from October 15 to December 7,
what change is a Medicare beneficiary legally permitted to make?
A) They can only enroll in a Medigap policy without medical underwriting.
B) They can switch from Original Medicare to a Medicare Advantage plan, or swap
existing MA plans.
C) They can apply for an institutional Special Needs Plan without residing in a care
facility.
D) They can permanently opt out of all future Medicare payroll taxes.
, Correct Answer: B
Rationale: The Annual Election Period allows any Medicare beneficiary to make changes
to their plan choices, including moving from Original Medicare to Medicare Advantage
(MA), switching between separate MA plans, or adding/dropping a Part D prescription
drug plan.
Question 5
What is the primary purpose of the Medicare Advantage (Part C) program?
A) To provide prescription drug coverage only.
B) To offer a private alternative to Original Medicare.
C) To replace Medicaid for low-income beneficiaries.
D) To provide supplemental coverage only.
Correct Answer: B
Rationale: Medicare Advantage plans are private health plan alternatives to Original
Medicare, often including additional benefits like dental, vision, and hearing. Part C is
not solely for drug coverage (that's Part D), does not replace Medicaid, and offers more
than just supplemental coverage.
Question 6
Waste includes any misuse of resources, such as the overuse of services or other
practices that directly or indirectly result in unnecessary costs to the Medicare Program.
A) True
B) False
Correct Answer: A
Rationale: This statement is correct. Waste includes overuse of services or practices that
cause unnecessary costs to Medicare. Unlike fraud (which involves intentional
deception), waste may occur without malicious intent but still results in program costs.
Verified Questions and Correct Answers |
A+ Graded
.
Question 1
Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a Medigap
plan to pick up costs not covered by that plan. What should you tell him?
A) You can sell him a Medigap plan to help with costs not covered under Medicare
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
Rationale: Medigap plans are supplemental policies that fill gaps in Original Medicare
(Parts A and B). Federal law prohibits the sale of a Medigap policy to someone enrolled
in a Medicare Advantage plan, as Medigap cannot pay the cost-sharing of an MA plan.
Question 2
What is the total duration of the Initial Enrollment Period (IEP) for a beneficiary turning
65?
A) 3 months
B) 6 months
,C) 7 months
D) 12 months
Correct Answer: C
Rationale: The Initial Enrollment Period is a 7-month window that includes the 3
months before the individual turns 65, their birth month, and the 3 months immediately
following. This is a fundamental eligibility concept for Medicare enrollment.
Question 3
Which of the following best describes Medicare Part A?
A) It covers outpatient medical services and doctor visits.
B) It covers inpatient hospital care, skilled nursing facility care, hospice, and some home
health services.
C) It covers prescription drugs only.
D) It covers vision, dental, and hearing services exclusively.
Correct Answer: B
Rationale: Medicare Part A is "Hospital Insurance" and covers inpatient hospital stays,
skilled nursing facility care, hospice, and limited home health care. Outpatient services
are covered under Part B, and prescription drugs are covered under Part D.
Question 4
During the Annual Election Period (AEP), which runs from October 15 to December 7,
what change is a Medicare beneficiary legally permitted to make?
A) They can only enroll in a Medigap policy without medical underwriting.
B) They can switch from Original Medicare to a Medicare Advantage plan, or swap
existing MA plans.
C) They can apply for an institutional Special Needs Plan without residing in a care
facility.
D) They can permanently opt out of all future Medicare payroll taxes.
, Correct Answer: B
Rationale: The Annual Election Period allows any Medicare beneficiary to make changes
to their plan choices, including moving from Original Medicare to Medicare Advantage
(MA), switching between separate MA plans, or adding/dropping a Part D prescription
drug plan.
Question 5
What is the primary purpose of the Medicare Advantage (Part C) program?
A) To provide prescription drug coverage only.
B) To offer a private alternative to Original Medicare.
C) To replace Medicaid for low-income beneficiaries.
D) To provide supplemental coverage only.
Correct Answer: B
Rationale: Medicare Advantage plans are private health plan alternatives to Original
Medicare, often including additional benefits like dental, vision, and hearing. Part C is
not solely for drug coverage (that's Part D), does not replace Medicaid, and offers more
than just supplemental coverage.
Question 6
Waste includes any misuse of resources, such as the overuse of services or other
practices that directly or indirectly result in unnecessary costs to the Medicare Program.
A) True
B) False
Correct Answer: A
Rationale: This statement is correct. Waste includes overuse of services or practices that
cause unnecessary costs to Medicare. Unlike fraud (which involves intentional
deception), waste may occur without malicious intent but still results in program costs.
