2026 AHIP Final Exam – Exam-Style Practice Questions with Answers & Rationales

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,100 VERIFIED QUESTIONS ,ANSWERS AND RATIONALES
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CONTENTS

1. Mr. Capadona would like to purchase a Medicare Advantage (MA) plan and a Medigap pla
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n to pick up costs not covered by that plan. What should you tell him?
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A) You can sell him a Medigap plan to help with costs not covered under Medicare Advantage.
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B) It is illegal for you to sell Mr. Capadona a Medigap plan if he is enrolled in an MA plan, and
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besides, Medigap only works with Original Medicare.
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C) Medigap plans are designed to work alongside Medicare Advantage plans.
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D) He must disenroll from his MA plan before buying a Medigap plan.
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Correct Answer: B) It is illegal for you to sell Mr. Capadona a Medigap plan if he is enrolled in a
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n MA plan, and besides, Medigap only works with Original Medicare.
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Expert Rationale: Medicare Supplement (Medigap) policies are strictly designed to supplement
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Original Medicare (Parts A and B). Federal law makes it illegal for anyone to sell a Medigap pol
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icy to a beneficiary who is actively enrolled in a Medicare Advantage plan, unless the beneficia
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ry is already in the process of returning to Original Medicare.
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2. Agent John Miller is meeting with Jerry Smith, a new prospect. Jerry is currently enrolled i
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n Medicare Parts A and B. Jerry has also purchased a Medicare Supplement (Medigap) plan
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which he has had for several years. However, the plan does not provide drug benefits. How
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would you advise Agent John Miller to proceed?
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A) Advise Jerry to switch to a Medicare Advantage plan for drug coverage.
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B) Tell prospect Jerry Smith that he should consider adding a standalone Part D prescription dr
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ug coverage policy to his present coverage.
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C) Inform Jerry that Medigap automatically covers prescription drugs.
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D) Recommend canceling the Medigap plan.
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Correct Answer: B) Tell prospect Jerry Smith that he should consider adding a standalone Part
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D prescription drug coverage policy to his present coverage.
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Expert Rationale: Medigap plans sold after 2006 do not include prescription drug coverage. Be
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neficiaries needing drug coverage must enroll in a standalone Medicare Part D plan. This allow
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s individuals to retain their Medigap coverage while accessing necessary medications.
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,3. Mr. Wu is eligible for Medicare. He has limited financial resources but failed to qualify for
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the Part D low income subsidy. Where might he turn for help with his prescription drug costs
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?

A) Apply for Medicaid to cover prescription costs.
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B) Seek assistance from pharmaceutical company discount programs.
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C) Mr. Wu may still qualify for help in paying Part D costs through his State Pharmaceutical Assi
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stance Program (SPAP). uo uo




D) Try to enroll in a Medigap plan with drug coverage.
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Correct Answer: C) Mr. Wu may still qualify for help in paying Part D costs through his State Ph
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armaceutical Assistance Program (SPAP). uo uo uo




Expert Rationale: States may offer SPAPs to assist residents who do not qualify for the federal
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Low Income Subsidy but still need help with Part D drug costs. Eligibility and benefits vary by st
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ate, but these programs can provide meaningful financial support when other federal options a
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ren't available. uo




4. Mrs. Davis is turning 65 next month and has been receiving Social Security retirement ben
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efits for the past year. She is wondering what she needs to do to enroll in Original Medicare.
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How should you advise her?
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A) She must visit her local Social Security office to manually enroll in both Part A and Part B.
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B) She will be automatically enrolled in Part A and Part B and will receive her Medicare card in
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the mail. uo




C) She is automatically enrolled in Part A only and must actively sign up for Part B to avoid a la
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te enrollment penalty.
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D) She needs to enroll through the CMS website during her Initial Coverage Election Period (IC
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EP).

Correct Answer: B) She will be automatically enrolled in Part A and Part B and will receive her
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Medicare card in the mail. uo uo uo uo




Expert Rationale: Individuals who have been receiving Social Security or Railroad Retirement B
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oard (RRB) benefits for at least four months prior to turning 65 are automatically enrolled in b
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oth Medicare Part A and Part B. Their Medicare card is typically mailed to them about three m
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, onths before their 65th birthday, and no manual enrollment action is required unless they cho
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ose to decline Part B.
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5. Mr. Henderson is enrolled in a Medicare Advantage (MA) plan. He recently moved to a ne
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w state to be closer to his family, which is entirely outside of his current MA plan's service ar
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ea. What options does he have regarding his Medicare coverage?
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A) He must remain in his current MA plan until the next Annual Election Period (AEP).
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B) His current MA plan is required by CMS to continue providing his network coverage in the n
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ew state. uo




C) He qualifies for a Special Enrollment Period (SEP) to join a new MA plan or return to Origina
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l Medicare.
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D) He loses his Medicare eligibility temporarily and must reapply after establishing residency.
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Correct Answer: C) He qualifies for a Special Enrollment Period (SEP) to join a new MA plan or
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return to Original Medicare. uo uo uo




Expert Rationale: Moving permanently outside of a Medicare Advantage plan's service area is
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a qualifying life event that triggers a Special Enrollment Period (SEP). During this SEP, the benef
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iciary can select a new Medicare Advantage plan available in their new location or choose to re
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turn to Original Medicare, along with the opportunity to purchase a standalone Part D prescrip
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tion drug plan. uo uo




6. Agent Sarah is reviewing marketing guidelines. She wants to know if she can leave busines
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s cards or flyers at a residence where she was not invited. What does CMS state regarding th
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is practice?
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A) She may leave flyers but not business cards on the doorstep. B) She is permitted to leave inf
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ormation at a residence only if she previously spoke to the beneficiary on the phone. C) Unsoli
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cited door-to- uo




door marketing, including leaving flyers or business cards at a residence without a prior appoin
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tment, is strictly prohibited. D) She may leave marketing materials as long as she does not kno
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ck on the door or ring the doorbell.
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Correct Answer: C) Unsolicited door-to- uo uo uo uo




door marketing, including leaving flyers or business cards at a residence without a prior appoin
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tment, is strictly prohibited. uo uo uo