[STUDY GUIDE] • HIGH-YIELD PRACTICE & REVIEW EDITION
AHIP Final Exam Test Questions
2026/2027 Updated Exam Prep
Questions with Verified Answers
Comprehensive Examination Question Bank • Concept Mapping
TOTAL QUESTIONS EXAM TOPICS ANSWERS
50 Questions 12 Modules 100% Verified
DOCUMENT OVERVIEW
This document contains 50 verified questions with correct answers related to Medicare Advantage, Special
Election Periods, and prescription drug plans. Each question is designed to enhance understanding of
Medicare policies and practices, making it suitable for exam preparation and certification review in health
insurance.
EXAM BLUEPRINT & TOPIC DISTRIBUTION
Systematic breakdown of subject domains and exam coverage.
Topic Module Scope & Core Focus Questions Share (%)
Explores the structure, benefits, and enrollment criteria of
Medicare Advantage Plans Medicare Advantage plans. 5 Qs 10.0%
Medicare Part D Prescription Covers the details of Medicare Part D, including eligibility and
Drug Coverage enrollment processes. 5 Qs 10.0%
Examines the conditions and eligibility for Special Enrollment
Special Enrollment Periods Periods under Medicare. 4 Qs 8.0%
Medical Savings Accounts Discusses the features and benefits of Medical Savings
(MSA) Accounts in relation to Medicare. 4 Qs 8.0%
Clarifies the coverage offered under Original Medicare,
Original Medicare Coverage including Parts A and B. 4 Qs 8.0%
Agent Responsibilities and Outlines the ethical and legal responsibilities of agents in
Regulations selling Medicare products. 5 Qs 10.0%
Confidential • Student Study Edition • Practice & Review Guide Page 1 of 17
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
Eligibility Requirements for Focuses on the basic eligibility criteria for individuals seeking
Medicare Medicare coverage. 5 Qs 10.0%
Medicare and Medicaid Explores the relationship between Medicare and Medicaid
Interactions benefits for dual-eligible individuals. 4 Qs 8.0%
Examines the process for appealing Medicare decisions
Medicare Appeals Process regarding coverage and services. 3 Qs 6.0%
Marketing and Sales Strategies Discusses effective methods for marketing Medicare plans
for Medicare Products while adhering to regulations. 4 Qs 8.0%
Prescription Drug Plan Covers strategies for managing and navigating Medicare
Management prescription drug plans. 3 Qs 6.0%
Consumer Rights and Addresses the rights of consumers enrolled in Medicare and
Protections protections available to them. 4 Qs 8.0%
Total Exam Coverage 12 Integrated Topic Modules 50 Qs 100.0%
TOPIC 1: MEDICARE ADVANTAGE PLANS
5 Questions • 10.0% of Exam • Explores the structure, benefits, and enrollment criteria of Medicare Advantage plans.
QUESTION 1
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent.
It is one of three plans operated by the same organization in Mr. Lombardi's area. The
MA PPO plan does not include drug coverage, but the other two plans do. Mr.
Lombardi likes the PPO plan that does not include drug coverage and intends to obtain
his drug coverage through a stand-alone Medicare prescription drug plan. What should
you tell him about this situation?
Answer: He could enroll in one of the MA plans that include prescription drug coverage or a Medigap plan
and a stand-alone prescription drug plan, but he cannot enroll in the MA-only PPO plan and a stand-alone
prescription drug plan.
QUESTION 2
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health
Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency
maintains a website marketing the MA plans with which it has contracts. Agent
Armstrong follows up with individuals who request more information about ABC MA
plans via the website and tries to persuade them to enroll in ABC plans. What statement
best describes the marketing and compliance rules that apply to Agent Armstrong?
Answer: Agent Armstrong needs to be licensed and appointed in every state in which beneficiaries to whom
he markets ABC MA plans are located.
Confidential • Student Study Edition • Practice & Review Guide Page 2 of 17
, STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
QUESTION 3
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial
Coverage Election Period (ICEP) has just
begun. Which of the following can she not do during the ICEP?
Answer: She can enroll in a Medigap plan to supplement the benefits of the MA plan that she's also enrolling
in.
QUESTION 4
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and
wonders what her options are for continuing MA-PD coverage. What would you say to
her in regard to a special enrollment period (SEP)?
Answer: She is likely to qualify for a SEP. She can choose an effective date of up to three months after the
month in which the enrollment form is received by the new plan, but the effective date may not be earlier than
the date of her permanent move.
QUESTION 5
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care.
What should you tell her?
Answer: Mrs. Ramos can obtain care from any provider who participates in Original Medicare, but generally
will have a higher costsharing amount if she sees a provider who/that is not part of the PPO network.
TOPIC 2: MEDICARE PART D PRESCRIPTION DRUG COVERAGE
5 Questions • 10.0% of Exam • Covers the details of Medicare Part D, including eligibility and enrollment processes.
Confidential • Student Study Edition • Practice & Review Guide Page 3 of 17
AHIP Final Exam Test Questions
2026/2027 Updated Exam Prep
Questions with Verified Answers
Comprehensive Examination Question Bank • Concept Mapping
TOTAL QUESTIONS EXAM TOPICS ANSWERS
50 Questions 12 Modules 100% Verified
DOCUMENT OVERVIEW
This document contains 50 verified questions with correct answers related to Medicare Advantage, Special
Election Periods, and prescription drug plans. Each question is designed to enhance understanding of
Medicare policies and practices, making it suitable for exam preparation and certification review in health
insurance.
EXAM BLUEPRINT & TOPIC DISTRIBUTION
Systematic breakdown of subject domains and exam coverage.
Topic Module Scope & Core Focus Questions Share (%)
Explores the structure, benefits, and enrollment criteria of
Medicare Advantage Plans Medicare Advantage plans. 5 Qs 10.0%
Medicare Part D Prescription Covers the details of Medicare Part D, including eligibility and
Drug Coverage enrollment processes. 5 Qs 10.0%
Examines the conditions and eligibility for Special Enrollment
Special Enrollment Periods Periods under Medicare. 4 Qs 8.0%
Medical Savings Accounts Discusses the features and benefits of Medical Savings
(MSA) Accounts in relation to Medicare. 4 Qs 8.0%
Clarifies the coverage offered under Original Medicare,
Original Medicare Coverage including Parts A and B. 4 Qs 8.0%
Agent Responsibilities and Outlines the ethical and legal responsibilities of agents in
Regulations selling Medicare products. 5 Qs 10.0%
Confidential • Student Study Edition • Practice & Review Guide Page 1 of 17
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
Eligibility Requirements for Focuses on the basic eligibility criteria for individuals seeking
Medicare Medicare coverage. 5 Qs 10.0%
Medicare and Medicaid Explores the relationship between Medicare and Medicaid
Interactions benefits for dual-eligible individuals. 4 Qs 8.0%
Examines the process for appealing Medicare decisions
Medicare Appeals Process regarding coverage and services. 3 Qs 6.0%
Marketing and Sales Strategies Discusses effective methods for marketing Medicare plans
for Medicare Products while adhering to regulations. 4 Qs 8.0%
Prescription Drug Plan Covers strategies for managing and navigating Medicare
Management prescription drug plans. 3 Qs 6.0%
Consumer Rights and Addresses the rights of consumers enrolled in Medicare and
Protections protections available to them. 4 Qs 8.0%
Total Exam Coverage 12 Integrated Topic Modules 50 Qs 100.0%
TOPIC 1: MEDICARE ADVANTAGE PLANS
5 Questions • 10.0% of Exam • Explores the structure, benefits, and enrollment criteria of Medicare Advantage plans.
QUESTION 1
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent.
It is one of three plans operated by the same organization in Mr. Lombardi's area. The
MA PPO plan does not include drug coverage, but the other two plans do. Mr.
Lombardi likes the PPO plan that does not include drug coverage and intends to obtain
his drug coverage through a stand-alone Medicare prescription drug plan. What should
you tell him about this situation?
Answer: He could enroll in one of the MA plans that include prescription drug coverage or a Medigap plan
and a stand-alone prescription drug plan, but he cannot enroll in the MA-only PPO plan and a stand-alone
prescription drug plan.
QUESTION 2
Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health
Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency
maintains a website marketing the MA plans with which it has contracts. Agent
Armstrong follows up with individuals who request more information about ABC MA
plans via the website and tries to persuade them to enroll in ABC plans. What statement
best describes the marketing and compliance rules that apply to Agent Armstrong?
Answer: Agent Armstrong needs to be licensed and appointed in every state in which beneficiaries to whom
he markets ABC MA plans are located.
Confidential • Student Study Edition • Practice & Review Guide Page 2 of 17
, STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
QUESTION 3
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial
Coverage Election Period (ICEP) has just
begun. Which of the following can she not do during the ICEP?
Answer: She can enroll in a Medigap plan to supplement the benefits of the MA plan that she's also enrolling
in.
QUESTION 4
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and
wonders what her options are for continuing MA-PD coverage. What would you say to
her in regard to a special enrollment period (SEP)?
Answer: She is likely to qualify for a SEP. She can choose an effective date of up to three months after the
month in which the enrollment form is received by the new plan, but the effective date may not be earlier than
the date of her permanent move.
QUESTION 5
Mrs. Ramos is considering a Medicare Advantage PPO and has questions about which
providers she can go to for her health care.
What should you tell her?
Answer: Mrs. Ramos can obtain care from any provider who participates in Original Medicare, but generally
will have a higher costsharing amount if she sees a provider who/that is not part of the PPO network.
TOPIC 2: MEDICARE PART D PRESCRIPTION DRUG COVERAGE
5 Questions • 10.0% of Exam • Covers the details of Medicare Part D, including eligibility and enrollment processes.
Confidential • Student Study Edition • Practice & Review Guide Page 3 of 17
