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AHIP FINAL EXAM FULL PACKAGE ACTUAL STUDY
GUIDE WITH 100% ACCURATE ANSWERS 2026-27
LATEST UPDATED VERSION
Mr. And Mrs. Nunez attended one of your sales presentations.
They’ve asked you to come to their home to clear up a few questions.
During the presentation, Mrs. Nunez feels tired and tells you that her
husband can finish things up. She goes to bed. At the end of your
discussion, Mr. Nunez says that he wants to enroll both himself and
his wife. What should you do? – Correct Answer As long as she
is able to do so, only Mrs. Nunez can sign her enrollment form. Mrs.
Nunez will have to wake up to sign her form or do so at another time.
Mr. Cole has been a Medicaid beneficiary for some time, and recently
qualified for Medicare as well. He is concerned about changes in his
cost-sharing. What should you tell him? – Correct Answer He
should know that Medicaid will pay cost sharing only for services
provided by Medicaid participating providers.
Mr. Barker enjoys a comfortable retirement income. He recently had
surgery and expected that he would have certain services and items
covered by the plan with minimal out-of-pocket costs because his
MA-PD coverage has been very good. However, when he received the
bill, he was surprised to see large charges in excess of his maximum
out-of-pocket limit that included a number of services and items he
thought would be fully covered. He called you to ask what he could
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do? What could you tell him? – Correct Answer You can offer to
review the plans appeal process to help him ask the plan to review
the coverage decision.
Mr. Zachow has a condition for which three drugs are available. He
has tried two, but had an allergic reaction to them. Only the third
drug works for him and it is not on his Part D plan’s formulary. What
could you tell him to do? – Correct Answer Mr. Zachow has a
right to request a formulary exception to obtain coverage for his Part
D drug. He or his physician could obtain the standardized request
form on the plan’s website, fill it out, and submit it to his plan.
Mr. Patel is in good health and is preparing a budget in anticipation of
his retirement when he turns 66. He wants to understand the health
care costs he might be exposed to under Medicare if he were to
require hospitalization as a result of an illness. In general terms, what
could you tell him about his costs for inpatient hospital services
under Original Medicare? – Correct Answer Under Original
Medicare, there is a single deductible amount due for the first 60
days of any inpatient
Hospital stay, after which it converts into a per-day amount through
day 90. After day 90, he would pay a daily
Amount up to 60 days over his lifetime, after which he would be
responsible for all costs
AHIP MEDICARE ADVANTAGE ENROLLMENT EXAM 2026 | 60
WRITTEN QUESTIONS WITH VERIFIED ACCURATE ANSWERS –
GUARANTEED SUCCESS
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Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and
disagrees with a determination that partially denied one of her
claims for services. What advice would you give her? – Correct
Answer Mrs. Duarte should file and appeal of this initial
determination within 120 days of the date she received the MSN in
the mail
Your friend’s mother just moved to an assisted living facility and he
asked if you could present a program for the residents about the MA-
PD plans you market. What could you tell him? – Correct
Answer You appreciate the opportunity and would be happy to
schedule an appointment with anyone at their request.
Mrs. Andrews asked how a Private Fee-for-Service (PFFS) plan might
affect her access to services since she receives some assistance for
her health care costs from the State. What should you tell her? –
Correct Answer Medicaid may provide additional benefits, but
Medicaid will coordinate benefits only with Medicaid participating
providers.
Mrs. Schmidt is moving and a friend told her she might qualify for a
“Special Election Period” to enroll in a new Medicare Advantage plan.
She contacted you to ask what a Special Election Period is. What
could you tell her? – Correct Answer It is a time period, outside
of the Annual Election Period, when a Medicare beneficiary can
select a new or different Medicare Advantage and/or Part D
prescription drug plan. Typically the Special Election Period is
AHIP FINAL EXAM FULL PACKAGE ACTUAL STUDY
GUIDE WITH 100% ACCURATE ANSWERS 2026-27
LATEST UPDATED VERSION
Mr. And Mrs. Nunez attended one of your sales presentations.
They’ve asked you to come to their home to clear up a few questions.
During the presentation, Mrs. Nunez feels tired and tells you that her
husband can finish things up. She goes to bed. At the end of your
discussion, Mr. Nunez says that he wants to enroll both himself and
his wife. What should you do? – Correct Answer As long as she
is able to do so, only Mrs. Nunez can sign her enrollment form. Mrs.
Nunez will have to wake up to sign her form or do so at another time.
Mr. Cole has been a Medicaid beneficiary for some time, and recently
qualified for Medicare as well. He is concerned about changes in his
cost-sharing. What should you tell him? – Correct Answer He
should know that Medicaid will pay cost sharing only for services
provided by Medicaid participating providers.
Mr. Barker enjoys a comfortable retirement income. He recently had
surgery and expected that he would have certain services and items
covered by the plan with minimal out-of-pocket costs because his
MA-PD coverage has been very good. However, when he received the
bill, he was surprised to see large charges in excess of his maximum
out-of-pocket limit that included a number of services and items he
thought would be fully covered. He called you to ask what he could
,2
do? What could you tell him? – Correct Answer You can offer to
review the plans appeal process to help him ask the plan to review
the coverage decision.
Mr. Zachow has a condition for which three drugs are available. He
has tried two, but had an allergic reaction to them. Only the third
drug works for him and it is not on his Part D plan’s formulary. What
could you tell him to do? – Correct Answer Mr. Zachow has a
right to request a formulary exception to obtain coverage for his Part
D drug. He or his physician could obtain the standardized request
form on the plan’s website, fill it out, and submit it to his plan.
Mr. Patel is in good health and is preparing a budget in anticipation of
his retirement when he turns 66. He wants to understand the health
care costs he might be exposed to under Medicare if he were to
require hospitalization as a result of an illness. In general terms, what
could you tell him about his costs for inpatient hospital services
under Original Medicare? – Correct Answer Under Original
Medicare, there is a single deductible amount due for the first 60
days of any inpatient
Hospital stay, after which it converts into a per-day amount through
day 90. After day 90, he would pay a daily
Amount up to 60 days over his lifetime, after which he would be
responsible for all costs
AHIP MEDICARE ADVANTAGE ENROLLMENT EXAM 2026 | 60
WRITTEN QUESTIONS WITH VERIFIED ACCURATE ANSWERS –
GUARANTEED SUCCESS
, 3
Mrs. Duarte is enrolled in Original Medicare Parts A and B. She has
recently reviewed her Medicare Summary Notice (MSN) and
disagrees with a determination that partially denied one of her
claims for services. What advice would you give her? – Correct
Answer Mrs. Duarte should file and appeal of this initial
determination within 120 days of the date she received the MSN in
the mail
Your friend’s mother just moved to an assisted living facility and he
asked if you could present a program for the residents about the MA-
PD plans you market. What could you tell him? – Correct
Answer You appreciate the opportunity and would be happy to
schedule an appointment with anyone at their request.
Mrs. Andrews asked how a Private Fee-for-Service (PFFS) plan might
affect her access to services since she receives some assistance for
her health care costs from the State. What should you tell her? –
Correct Answer Medicaid may provide additional benefits, but
Medicaid will coordinate benefits only with Medicaid participating
providers.
Mrs. Schmidt is moving and a friend told her she might qualify for a
“Special Election Period” to enroll in a new Medicare Advantage plan.
She contacted you to ask what a Special Election Period is. What
could you tell her? – Correct Answer It is a time period, outside
of the Annual Election Period, when a Medicare beneficiary can
select a new or different Medicare Advantage and/or Part D
prescription drug plan. Typically the Special Election Period is
