AHIP Final Exam 2026/2027 – Questions With
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Terms in this set (63)
Mr. Garcia was told he qualifies for a If the SEP is for MA coverage, he will generally have
Special Enrollment Period (SEP), but one opportunity to change his MA coverage.
he lost the paper that explains what he 3 multiple choice options
could do during the SEP. What can you
tell him?
Mrs. Walters is entitled to Part A and Yes. Mrs. Walters must be entitled to Part A or
has medical coverage without drug enrolled in Part B to be eligible for coverage under
coverage through an employer retiree the Medicare prescription drug program.
plan. She is not enrolled in Part B.
3 multiple choice options
Since the employer plan does not
cover prescription drugs, she wants to
enroll in a Medicare prescription drug
plan. Will she be able to?
,Mrs. Goodman enrolled in an MA-PD During the MA Open Enrollment Period, from January
plan during the Annual Election Period. 1 - March 31, she may disenroll from the MA-PD plan
In mid-January of the following year, into Original Medicare and also may add a stand-
she wants to switch back to Original alone prescription drug plan.
Medicare and enroll in a stand-alone
3 multiple choice options
prescription drug plan. What should
you tell her?
Mrs. Berkowitz wants to enroll in a If the Medicare Advantage plan is a Private Fee-for-
Medicare Advantage plan that does Service (PFFS) plan that does not offer drug coverage
not include drug coverage and also or a Medical Savings Account plan, Mrs. Berkowitz
enroll in a stand-alone Medicare can do this.
prescription drug plan. Under what
3 multiple choice options
circumstances can she do this?
Ms. Lee is enrolled in an MA-PD plan She is eligible for a Special Election Period that
but will be moving out of the plan's begins either the month before her permanent move,
service area next month. She is if the plan is notified in advance, or the month she
worried that she will not be able to provides notice of the move, and this period typically
enroll in another plan available in her lasts an additional two months.
new residence until the Annual
3 multiple choice options
Election Period. What should you tell
her?
You are doing a sales presentation for "If you're not in very good health, you will probably
Mrs. Pearson. You know that Medicare do better with a different product."
marketing guidelines prohibit certain
3 multiple choice options
types of statements. Apply those
guidelines to the following statements
and identify which would be
prohibited.
, Mr. Anderson is a very organized Tell Mr. Anderson that you cannot accept any
individual and has filled out and enrollment forms until the annual election period
brought to you an enrollment form on begins.
October 10 for a new plan available
3 multiple choice options
January 1 next year. He is currently
enrolled in Original Medicare. What
should you do?
You are visiting with Mr. Tully and his Mr. Tully's daughter can do so only, if she is authorized
daughter at her request. He has under state law as a court-appointed legal guardian,
advanced Alzheimer's and is incapable has a durable power of attorney for health care
of understanding the implications of decisions, or is authorized under state surrogate
choosing a Medicare Advantage or consent laws to make health decisions.
prescription drug plan. Can his
3 multiple choice options
daughter fill out the enrollment form
and sign it for him?
Ms. Gonzales decided to remain in There is a MA Open Enrollment Period (OEP) that
Original Medicare (Parts A and B) and takes place between January 1 and March 31, but Ms.
Part D during the Annual Enrollment Gonzales cannot use it because eligibility to use the
Period (AEP). At the beginning of OEP is available only to MA enrollees.
January, her neighbor told her about 3 multiple choice options
the Medicare Advantage (MA) plan he
selected. He also told her there was an
open enrollment period that she might
be able to use to enroll in a MA plan.
Ms. Gonzales comes to you for advice
shortly after speaking to her neighbor.
What should you tell her?
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Terms in this set (63)
Mr. Garcia was told he qualifies for a If the SEP is for MA coverage, he will generally have
Special Enrollment Period (SEP), but one opportunity to change his MA coverage.
he lost the paper that explains what he 3 multiple choice options
could do during the SEP. What can you
tell him?
Mrs. Walters is entitled to Part A and Yes. Mrs. Walters must be entitled to Part A or
has medical coverage without drug enrolled in Part B to be eligible for coverage under
coverage through an employer retiree the Medicare prescription drug program.
plan. She is not enrolled in Part B.
3 multiple choice options
Since the employer plan does not
cover prescription drugs, she wants to
enroll in a Medicare prescription drug
plan. Will she be able to?
,Mrs. Goodman enrolled in an MA-PD During the MA Open Enrollment Period, from January
plan during the Annual Election Period. 1 - March 31, she may disenroll from the MA-PD plan
In mid-January of the following year, into Original Medicare and also may add a stand-
she wants to switch back to Original alone prescription drug plan.
Medicare and enroll in a stand-alone
3 multiple choice options
prescription drug plan. What should
you tell her?
Mrs. Berkowitz wants to enroll in a If the Medicare Advantage plan is a Private Fee-for-
Medicare Advantage plan that does Service (PFFS) plan that does not offer drug coverage
not include drug coverage and also or a Medical Savings Account plan, Mrs. Berkowitz
enroll in a stand-alone Medicare can do this.
prescription drug plan. Under what
3 multiple choice options
circumstances can she do this?
Ms. Lee is enrolled in an MA-PD plan She is eligible for a Special Election Period that
but will be moving out of the plan's begins either the month before her permanent move,
service area next month. She is if the plan is notified in advance, or the month she
worried that she will not be able to provides notice of the move, and this period typically
enroll in another plan available in her lasts an additional two months.
new residence until the Annual
3 multiple choice options
Election Period. What should you tell
her?
You are doing a sales presentation for "If you're not in very good health, you will probably
Mrs. Pearson. You know that Medicare do better with a different product."
marketing guidelines prohibit certain
3 multiple choice options
types of statements. Apply those
guidelines to the following statements
and identify which would be
prohibited.
, Mr. Anderson is a very organized Tell Mr. Anderson that you cannot accept any
individual and has filled out and enrollment forms until the annual election period
brought to you an enrollment form on begins.
October 10 for a new plan available
3 multiple choice options
January 1 next year. He is currently
enrolled in Original Medicare. What
should you do?
You are visiting with Mr. Tully and his Mr. Tully's daughter can do so only, if she is authorized
daughter at her request. He has under state law as a court-appointed legal guardian,
advanced Alzheimer's and is incapable has a durable power of attorney for health care
of understanding the implications of decisions, or is authorized under state surrogate
choosing a Medicare Advantage or consent laws to make health decisions.
prescription drug plan. Can his
3 multiple choice options
daughter fill out the enrollment form
and sign it for him?
Ms. Gonzales decided to remain in There is a MA Open Enrollment Period (OEP) that
Original Medicare (Parts A and B) and takes place between January 1 and March 31, but Ms.
Part D during the Annual Enrollment Gonzales cannot use it because eligibility to use the
Period (AEP). At the beginning of OEP is available only to MA enrollees.
January, her neighbor told her about 3 multiple choice options
the Medicare Advantage (MA) plan he
selected. He also told her there was an
open enrollment period that she might
be able to use to enroll in a MA plan.
Ms. Gonzales comes to you for advice
shortly after speaking to her neighbor.
What should you tell her?
