AHIP 2027 FINAL EXAM – MEDICARE
CERTIFICATION EXAM QUESTIONS
AND ANSWERS. A+
1. Under the 2027 CMS regulations, what is the mandatory minimum timeframe for obtaining
a Scope of Appointment (SOA) prior to a personal marketing appointment, unless an
exception applies?
A. 24 hours
B. 48 hours
C. 72 hours
D. None, as long as it is completed before the presentation starts
Answer: B
Conceptual Explanation: CMS requires a Scope of Appointment (SOA) to be documented
at least 48 hours prior to the scheduled personal marketing appointment, with limited
exceptions such as walk-ins or end-of-enrollment periods.
2. Which of the following is true regarding the Part B Late Enrollment Penalty (LEP)?
A. It is a 1% penalty for every month the individual was eligible but not enrolled.
B. The penalty is waived if the individual has COBRA coverage.
,C. It is a lifelong 10% penalty for each full 12-month period an individual could have had
Part B but didn’t.
D. It is a one-time flat fee assessed during the first year of enrollment.
Answer: C
Conceptual Explanation: The Part B LEP is a permanent 10% increase in the premium for
each full 12-month period that the beneficiary was eligible for Part B but did not enroll and
did not have creditable coverage. COBRA is not considered creditable coverage for avoiding
this penalty.
3. An agent is hosting an ‘Educational Event.’ Which of the following activities is permitted
under CMS Marketing Guidelines?
A. Setting up a lead card collection box for future contact.
B. Distributing and collecting enrollment applications.
C. Providing a meal to attendees.
D. Answering specific questions about a plan’s premium or benefits.
Answer: A
Conceptual Explanation: At educational events, agents may distribute business cards and
lead cards. They may not distribute applications, offer meals (only light snacks), or discuss
specific plan benefits.
, 4. A beneficiary is in the ‘Coverage Gap’ phase of Part D. In 2027, what percentage of the cost
of generic drugs do they typically pay?
A. 5%
B. 25%
C. 35%
D. 100%
Answer: B
Conceptual Explanation: Since the implementation of the Bipartisan Budget Act and
subsequent updates, the beneficiary’s responsibility in the Coverage Gap for both brand-
name and generic drugs has been standardized at 25%.
5. Which Medicare Part C plan type requires a member to use a network of providers but
generally does not require a primary care physician (PCP) or referrals for specialists?
A. PPO
B. HMO
C. SNP
D. PFFS
Answer: A
CERTIFICATION EXAM QUESTIONS
AND ANSWERS. A+
1. Under the 2027 CMS regulations, what is the mandatory minimum timeframe for obtaining
a Scope of Appointment (SOA) prior to a personal marketing appointment, unless an
exception applies?
A. 24 hours
B. 48 hours
C. 72 hours
D. None, as long as it is completed before the presentation starts
Answer: B
Conceptual Explanation: CMS requires a Scope of Appointment (SOA) to be documented
at least 48 hours prior to the scheduled personal marketing appointment, with limited
exceptions such as walk-ins or end-of-enrollment periods.
2. Which of the following is true regarding the Part B Late Enrollment Penalty (LEP)?
A. It is a 1% penalty for every month the individual was eligible but not enrolled.
B. The penalty is waived if the individual has COBRA coverage.
,C. It is a lifelong 10% penalty for each full 12-month period an individual could have had
Part B but didn’t.
D. It is a one-time flat fee assessed during the first year of enrollment.
Answer: C
Conceptual Explanation: The Part B LEP is a permanent 10% increase in the premium for
each full 12-month period that the beneficiary was eligible for Part B but did not enroll and
did not have creditable coverage. COBRA is not considered creditable coverage for avoiding
this penalty.
3. An agent is hosting an ‘Educational Event.’ Which of the following activities is permitted
under CMS Marketing Guidelines?
A. Setting up a lead card collection box for future contact.
B. Distributing and collecting enrollment applications.
C. Providing a meal to attendees.
D. Answering specific questions about a plan’s premium or benefits.
Answer: A
Conceptual Explanation: At educational events, agents may distribute business cards and
lead cards. They may not distribute applications, offer meals (only light snacks), or discuss
specific plan benefits.
, 4. A beneficiary is in the ‘Coverage Gap’ phase of Part D. In 2027, what percentage of the cost
of generic drugs do they typically pay?
A. 5%
B. 25%
C. 35%
D. 100%
Answer: B
Conceptual Explanation: Since the implementation of the Bipartisan Budget Act and
subsequent updates, the beneficiary’s responsibility in the Coverage Gap for both brand-
name and generic drugs has been standardized at 25%.
5. Which Medicare Part C plan type requires a member to use a network of providers but
generally does not require a primary care physician (PCP) or referrals for specialists?
A. PPO
B. HMO
C. SNP
D. PFFS
Answer: A
