AHIP 2025 FINAL EXAM — 250-QUESTION PRACTICE EXAM
Medicare, Medicare Advantage, Part D, Medigap, Enrollment & Compliance
Important: These are original exam-style practice questions based on publicly available Medicare/AHIP-related guidance. They
are not claimed to be leaked, verbatim, or proprietary AHIP exam questions.
1. Which Medicare part primarily covers inpatient hospital services?
• Part D
■ Part A
• Part B
• Part C
Answer: Part A | Topic: Medicare fundamentals
2. Which Medicare part primarily covers physician and outpatient medical services?
• Part C
• Part D
■ Part B
• Part A
Answer: Part B | Topic: Medicare fundamentals
3. Which Medicare part provides prescription drug coverage?
• Part A
• Part B
• Part C
■ Part D
Answer: Part D | Topic: Medicare fundamentals
4. What is Medicare Advantage also known as?
■ Part C
• Part A
• Part B
• Part D
Answer: Part C | Topic: Medicare fundamentals
5. Medicare is primarily a federal health insurance program for people age 65 and older and certain younger people
with disabilities or conditions.
• Only for veterans
■ True
• False
• Only for low-income adults
Answer: True | Topic: Medicare fundamentals
6. The Initial Enrollment Period for someone turning 65 generally begins how many months before the month of the
65th birthday?
• 6 months
• 12 months
■ 3 months
, • 1 month
Answer: 3 months | Topic: Enrollment
7. The Initial Enrollment Period generally includes the birthday month and ends how many months after it?
• 1 month
• 6 months
• 12 months
■ 3 months
Answer: 3 months | Topic: Enrollment
8. A person who delays Part B because they have qualifying active employer coverage may generally use which later
enrollment opportunity?
■ Special Enrollment Period
• General Election only
• Annual Election Period only
• Open Enrollment for Medigap only
Answer: Special Enrollment Period | Topic: Enrollment
9. Medigap policies are designed primarily to supplement which type of Medicare coverage?
• Part D only
■ Original Medicare
• Medicare Advantage
• Medicaid only
Answer: Original Medicare | Topic: Medigap
10. A Medigap policy generally cannot be used with which arrangement?
• Part A
• Part B
■ Medicare Advantage plan
• Original Medicare
Answer: Medicare Advantage plan | Topic: Medigap
11. A Medicare Advantage plan is offered by a private Medicare-approved organization and provides Medicare-covered
benefits.
• False
• Only if Medicaid pays all costs
• Only for people under 65
■ True
Answer: True | Topic: Medicare Advantage
12. Which period is commonly used by Medicare beneficiaries to make an annual change among Medicare health and
drug coverage?
■ Annual Election Period
• Initial Enrollment Period only
• Medigap Open Enrollment only
• General Enrollment Period only
Answer: Annual Election Period | Topic: Medicare Advantage
13. Part D is primarily intended to help pay for what?
, • Long-term custodial care
■ Prescription drugs
• Inpatient room and board
• Routine dental care only
Answer: Prescription drugs | Topic: Part D
14. When Medicare is secondary to an employer group health plan, what concept determines which payer pays first?
• Risk adjustment only
• Coinsurance
■ Coordination of benefits
• Underwriting
Answer: Coordination of benefits | Topic: Coordination
15. Fraud involves intentionally obtaining money or a benefit through deception.
• False
• Only accidental billing
• Only administrative mistakes
■ True
Answer: True | Topic: Compliance
16. Waste generally refers to unnecessary overuse or misuse of services or resources without necessarily involving
intentional deception.
■ True
• False
• Only identity theft
• Only premium collection
Answer: True | Topic: Compliance
17. Abuse can include practices that are inconsistent with accepted sound business or medical practices and may lead
to unnecessary costs.
• Only marketing
■ True
• False
• Only criminal convictions
Answer: True | Topic: Compliance
18. What is the safest approach when a beneficiary asks a question outside an agent's authorized scope?
• Promise coverage
• Tell the beneficiary the answer is guaranteed
■ Refer to an appropriate licensed/authorized resource
• Guess the answer
Answer: Refer to an appropriate licensed/authorized resource | Topic: Ethics
19. An agent should present plan information accurately and avoid misleading statements.
• False
• Only during enrollment
• Only after enrollment
■ True
, Answer: True | Topic: Consumer protection
20. Which action is most appropriate when comparing plans?
■ Explain premiums, benefits, cost-sharing, network and limitations accurately
• Discuss only the premium
• Ignore formularies
• Guarantee a claim will be paid
Answer: Explain premiums, benefits, cost-sharing, network and limitations accurately | Topic: Consumer protection
21. Which Medicare part primarily covers inpatient hospital services?
• Part D
■ Part A
• Part B
• Part C
Answer: Part A | Topic: Medicare fundamentals
22. Which Medicare part primarily covers physician and outpatient medical services?
• Part C
• Part D
■ Part B
• Part A
Answer: Part B | Topic: Medicare fundamentals
23. What Medicare part provides prescription drug coverage?
• Part A
• Part B
• Part C
■ Part D
Answer: Part D | Topic: Medicare fundamentals
24. Which is Medicare Advantage also known as?
■ Part C
• Part A
• Part B
• Part D
Answer: Part C | Topic: Medicare fundamentals
25. Medicare is primarily a federal health insurance program for people age 65 and older and certain younger people
with disabilities or conditions.
• Only for veterans
■ True
• False
• Only for low-income adults
Answer: True | Topic: Medicare fundamentals
Medicare, Medicare Advantage, Part D, Medigap, Enrollment & Compliance
Important: These are original exam-style practice questions based on publicly available Medicare/AHIP-related guidance. They
are not claimed to be leaked, verbatim, or proprietary AHIP exam questions.
1. Which Medicare part primarily covers inpatient hospital services?
• Part D
■ Part A
• Part B
• Part C
Answer: Part A | Topic: Medicare fundamentals
2. Which Medicare part primarily covers physician and outpatient medical services?
• Part C
• Part D
■ Part B
• Part A
Answer: Part B | Topic: Medicare fundamentals
3. Which Medicare part provides prescription drug coverage?
• Part A
• Part B
• Part C
■ Part D
Answer: Part D | Topic: Medicare fundamentals
4. What is Medicare Advantage also known as?
■ Part C
• Part A
• Part B
• Part D
Answer: Part C | Topic: Medicare fundamentals
5. Medicare is primarily a federal health insurance program for people age 65 and older and certain younger people
with disabilities or conditions.
• Only for veterans
■ True
• False
• Only for low-income adults
Answer: True | Topic: Medicare fundamentals
6. The Initial Enrollment Period for someone turning 65 generally begins how many months before the month of the
65th birthday?
• 6 months
• 12 months
■ 3 months
, • 1 month
Answer: 3 months | Topic: Enrollment
7. The Initial Enrollment Period generally includes the birthday month and ends how many months after it?
• 1 month
• 6 months
• 12 months
■ 3 months
Answer: 3 months | Topic: Enrollment
8. A person who delays Part B because they have qualifying active employer coverage may generally use which later
enrollment opportunity?
■ Special Enrollment Period
• General Election only
• Annual Election Period only
• Open Enrollment for Medigap only
Answer: Special Enrollment Period | Topic: Enrollment
9. Medigap policies are designed primarily to supplement which type of Medicare coverage?
• Part D only
■ Original Medicare
• Medicare Advantage
• Medicaid only
Answer: Original Medicare | Topic: Medigap
10. A Medigap policy generally cannot be used with which arrangement?
• Part A
• Part B
■ Medicare Advantage plan
• Original Medicare
Answer: Medicare Advantage plan | Topic: Medigap
11. A Medicare Advantage plan is offered by a private Medicare-approved organization and provides Medicare-covered
benefits.
• False
• Only if Medicaid pays all costs
• Only for people under 65
■ True
Answer: True | Topic: Medicare Advantage
12. Which period is commonly used by Medicare beneficiaries to make an annual change among Medicare health and
drug coverage?
■ Annual Election Period
• Initial Enrollment Period only
• Medigap Open Enrollment only
• General Enrollment Period only
Answer: Annual Election Period | Topic: Medicare Advantage
13. Part D is primarily intended to help pay for what?
, • Long-term custodial care
■ Prescription drugs
• Inpatient room and board
• Routine dental care only
Answer: Prescription drugs | Topic: Part D
14. When Medicare is secondary to an employer group health plan, what concept determines which payer pays first?
• Risk adjustment only
• Coinsurance
■ Coordination of benefits
• Underwriting
Answer: Coordination of benefits | Topic: Coordination
15. Fraud involves intentionally obtaining money or a benefit through deception.
• False
• Only accidental billing
• Only administrative mistakes
■ True
Answer: True | Topic: Compliance
16. Waste generally refers to unnecessary overuse or misuse of services or resources without necessarily involving
intentional deception.
■ True
• False
• Only identity theft
• Only premium collection
Answer: True | Topic: Compliance
17. Abuse can include practices that are inconsistent with accepted sound business or medical practices and may lead
to unnecessary costs.
• Only marketing
■ True
• False
• Only criminal convictions
Answer: True | Topic: Compliance
18. What is the safest approach when a beneficiary asks a question outside an agent's authorized scope?
• Promise coverage
• Tell the beneficiary the answer is guaranteed
■ Refer to an appropriate licensed/authorized resource
• Guess the answer
Answer: Refer to an appropriate licensed/authorized resource | Topic: Ethics
19. An agent should present plan information accurately and avoid misleading statements.
• False
• Only during enrollment
• Only after enrollment
■ True
, Answer: True | Topic: Consumer protection
20. Which action is most appropriate when comparing plans?
■ Explain premiums, benefits, cost-sharing, network and limitations accurately
• Discuss only the premium
• Ignore formularies
• Guarantee a claim will be paid
Answer: Explain premiums, benefits, cost-sharing, network and limitations accurately | Topic: Consumer protection
21. Which Medicare part primarily covers inpatient hospital services?
• Part D
■ Part A
• Part B
• Part C
Answer: Part A | Topic: Medicare fundamentals
22. Which Medicare part primarily covers physician and outpatient medical services?
• Part C
• Part D
■ Part B
• Part A
Answer: Part B | Topic: Medicare fundamentals
23. What Medicare part provides prescription drug coverage?
• Part A
• Part B
• Part C
■ Part D
Answer: Part D | Topic: Medicare fundamentals
24. Which is Medicare Advantage also known as?
■ Part C
• Part A
• Part B
• Part D
Answer: Part C | Topic: Medicare fundamentals
25. Medicare is primarily a federal health insurance program for people age 65 and older and certain younger people
with disabilities or conditions.
• Only for veterans
■ True
• False
• Only for low-income adults
Answer: True | Topic: Medicare fundamentals
