AHIP Medicare Sales Practice
Examination Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download
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1. Which statement best describes the primary role of an agent selling
Medicare Advantage products?
A. To enroll every eligible beneficiary who requests information
B. To promote the plan with the highest commission
C. To provide accurate information that helps a beneficiary make an
informed enrollment decision
D. To determine which Medicare plan CMS requires the beneficiary to
select
Answer: C. To provide accurate information that helps a beneficiary
make an informed enrollment decision
Rationale: An agent's sales role involves explaining available plan
features accurately and helping beneficiaries understand their options.
The agent should not pressure the beneficiary, steer the person toward
a plan solely because of compensation, or make the enrollment
decision for the beneficiary. Medicare sales activities must be
conducted in accordance with applicable federal requirements, CMS
guidance, and state licensing requirements.
2. Which individual generally has primary responsibility for
establishing whether an agent is properly licensed to sell insurance
in a particular state?
,A. The applicable state insurance regulator
B. The beneficiary's primary care physician
C. The Social Security Administration
D. The local Medicare Administrative Contractor
Answer: A. The applicable state insurance regulator
Rationale: State insurance departments establish and enforce
insurance producer licensing requirements within their jurisdictions.
Medicare agents must comply with applicable state licensing and
appointment requirements in addition to federal Medicare
requirements. An agent should never assume that being licensed in
one state automatically authorizes sales activities in another state.
3. What is an important distinction between Medicare Advantage and
Original Medicare?
A. Medicare Advantage is administered only by Social Security
B. Medicare Advantage is offered through Medicare-approved private
health plans
C. Medicare Advantage eliminates all Medicare Part B obligations
D. Medicare Advantage is available only to people receiving Medicaid
Answer: B. Medicare Advantage is offered through Medicare-
approved private health plans
Rationale: Medicare Advantage, also called Medicare Part C, is
offered by Medicare-approved private organizations. These plans
provide Medicare-covered Part A and Part B services and may provide
additional benefits. Beneficiaries who enroll in Medicare Advantage
generally receive their Medicare-covered health services through the
plan rather than through Original Medicare.
4. Which statement about Original Medicare is correct?
,A. It is always administered by private Medicare Advantage
organizations
B. It requires enrollment in a Medicare Advantage plan
C. It automatically includes comprehensive prescription drug coverage
D. It consists primarily of Medicare Part A and Part B coverage
Answer: D. It consists primarily of Medicare Part A and Part B
coverage
Rationale: Original Medicare consists of Part A hospital insurance
and Part B medical insurance. Beneficiaries may make additional
choices, such as obtaining Part D prescription drug coverage or
Medicare Supplement insurance, depending on their circumstances.
Original Medicare differs from Medicare Advantage because
beneficiaries generally receive covered services directly through the
Medicare program.
5. A beneficiary asks an agent whether a particular doctor participates
in a Medicare Advantage plan. What should the agent do?
A. Tell the beneficiary that all Medicare doctors participate
B. Verify the provider's status using current plan information before
giving a definitive answer
C. Tell the beneficiary that provider participation never matters
D. Advise the beneficiary to enroll first and check afterward
Answer: B. Verify the provider's status using current plan
information before giving a definitive answer
Rationale: Provider participation can materially affect a beneficiary's
access and costs under Medicare Advantage. An agent should use
current, reliable plan information and avoid guessing. Beneficiaries
should be encouraged to confirm important provider information
, before enrollment because provider networks can differ among plans
and may change over time.
6. What is the Annual Election Period for Medicare Advantage and
Part D generally associated with?
A. October 15 through December 7
B. January 1 through January 31
C. February 1 through March 31
D. July 1 through August 31
Answer: A. October 15 through December 7
Rationale: The Annual Election Period, commonly called AEP,
generally runs from October 15 through December 7 each year.
Elections made during this period generally take effect January 1 of
the following year. Agents should distinguish AEP from other election
periods because eligibility, effective dates, and permissible enrollment
actions differ.
7. What is the primary purpose of an enrollment period?
A. To permit agents to change plan benefits
B. To determine agent compensation
C. To establish when eligible beneficiaries may make specified
enrollment elections
D. To replace state insurance licensing requirements
Answer: C. To establish when eligible beneficiaries may make
specified enrollment elections
Rationale: Medicare enrollment periods establish specific windows
during which beneficiaries can make particular types of elections.
Examples include the Initial Enrollment Period, Annual Election
Period, Medicare Advantage Open Enrollment Period, and Special
Examination Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant Download
1. Which statement best describes the primary role of an agent selling
Medicare Advantage products?
A. To enroll every eligible beneficiary who requests information
B. To promote the plan with the highest commission
C. To provide accurate information that helps a beneficiary make an
informed enrollment decision
D. To determine which Medicare plan CMS requires the beneficiary to
select
Answer: C. To provide accurate information that helps a beneficiary
make an informed enrollment decision
Rationale: An agent's sales role involves explaining available plan
features accurately and helping beneficiaries understand their options.
The agent should not pressure the beneficiary, steer the person toward
a plan solely because of compensation, or make the enrollment
decision for the beneficiary. Medicare sales activities must be
conducted in accordance with applicable federal requirements, CMS
guidance, and state licensing requirements.
2. Which individual generally has primary responsibility for
establishing whether an agent is properly licensed to sell insurance
in a particular state?
,A. The applicable state insurance regulator
B. The beneficiary's primary care physician
C. The Social Security Administration
D. The local Medicare Administrative Contractor
Answer: A. The applicable state insurance regulator
Rationale: State insurance departments establish and enforce
insurance producer licensing requirements within their jurisdictions.
Medicare agents must comply with applicable state licensing and
appointment requirements in addition to federal Medicare
requirements. An agent should never assume that being licensed in
one state automatically authorizes sales activities in another state.
3. What is an important distinction between Medicare Advantage and
Original Medicare?
A. Medicare Advantage is administered only by Social Security
B. Medicare Advantage is offered through Medicare-approved private
health plans
C. Medicare Advantage eliminates all Medicare Part B obligations
D. Medicare Advantage is available only to people receiving Medicaid
Answer: B. Medicare Advantage is offered through Medicare-
approved private health plans
Rationale: Medicare Advantage, also called Medicare Part C, is
offered by Medicare-approved private organizations. These plans
provide Medicare-covered Part A and Part B services and may provide
additional benefits. Beneficiaries who enroll in Medicare Advantage
generally receive their Medicare-covered health services through the
plan rather than through Original Medicare.
4. Which statement about Original Medicare is correct?
,A. It is always administered by private Medicare Advantage
organizations
B. It requires enrollment in a Medicare Advantage plan
C. It automatically includes comprehensive prescription drug coverage
D. It consists primarily of Medicare Part A and Part B coverage
Answer: D. It consists primarily of Medicare Part A and Part B
coverage
Rationale: Original Medicare consists of Part A hospital insurance
and Part B medical insurance. Beneficiaries may make additional
choices, such as obtaining Part D prescription drug coverage or
Medicare Supplement insurance, depending on their circumstances.
Original Medicare differs from Medicare Advantage because
beneficiaries generally receive covered services directly through the
Medicare program.
5. A beneficiary asks an agent whether a particular doctor participates
in a Medicare Advantage plan. What should the agent do?
A. Tell the beneficiary that all Medicare doctors participate
B. Verify the provider's status using current plan information before
giving a definitive answer
C. Tell the beneficiary that provider participation never matters
D. Advise the beneficiary to enroll first and check afterward
Answer: B. Verify the provider's status using current plan
information before giving a definitive answer
Rationale: Provider participation can materially affect a beneficiary's
access and costs under Medicare Advantage. An agent should use
current, reliable plan information and avoid guessing. Beneficiaries
should be encouraged to confirm important provider information
, before enrollment because provider networks can differ among plans
and may change over time.
6. What is the Annual Election Period for Medicare Advantage and
Part D generally associated with?
A. October 15 through December 7
B. January 1 through January 31
C. February 1 through March 31
D. July 1 through August 31
Answer: A. October 15 through December 7
Rationale: The Annual Election Period, commonly called AEP,
generally runs from October 15 through December 7 each year.
Elections made during this period generally take effect January 1 of
the following year. Agents should distinguish AEP from other election
periods because eligibility, effective dates, and permissible enrollment
actions differ.
7. What is the primary purpose of an enrollment period?
A. To permit agents to change plan benefits
B. To determine agent compensation
C. To establish when eligible beneficiaries may make specified
enrollment elections
D. To replace state insurance licensing requirements
Answer: C. To establish when eligible beneficiaries may make
specified enrollment elections
Rationale: Medicare enrollment periods establish specific windows
during which beneficiaries can make particular types of elections.
Examples include the Initial Enrollment Period, Annual Election
Period, Medicare Advantage Open Enrollment Period, and Special
