\
2026 AHIP
FINAL EXAM
Actual Questions and Answers
What’s Inside?
Actual AHIP 2026 Final Exam
questions with verified and explained
answers
Fully aligned with the latest CMS &
AHIP training modules
Detailed coverage of all exam sections,
Each question includes rationales and key references to
reinforce understanding
Content designed to mirror the official AHIP testing
environment
,**1.\Mr.\Capadona\would\like\to\purchase\a\Medicare\Advantage\(MA)\pla
n\and\a\Medigap\plan\to\pick\up\costs\not\covered\by\that\plan.\What\sho
uld\you\tell\him?**
A)\You\can\sell\him\a\Medigap\plan\to\help\with\costs\not\covered\under\Medic
are\Advantage.\\
B)\It\is\illegal\for\you\to\sell\Mr.\Capadona\a\Medigap\plan\if\he\is\enrolled\in\an\
MA\plan,\and\besides,\Medigap\only\works\with\Original\Medicare.\\
C)\Medigap\plans\are\designed\to\work\alongside\Medicare\Advantage\plans.\
\
D)\He\must\disenroll\from\his\MA\plan\before\buying\a\Medigap\plan.
**Correct\Answer:**\\
B)\It\is\illegal\for\you\to\sell\Mr.\Capadona\a\Medigap\plan\if\he\is\enrolled\in\an\
MA\plan,\and\besides,\Medigap\only\works\with\Original\Medicare.
**Expert\Rationale:**\\
Medigap\plans\are\supplemental\policies\that\fill\gaps\in\Original\Medicare\(Pa
rts\A\and\B)\coverage.\Federal\law\prohibits\issuance\of\a\Medigap\policy\to\an
yone\currently\enrolled\in\a\Medicare\Advantage\plan;\Medigap\cannot\pay\co
sts\associated\with\MA.\This\ensures\coordination\of\benefits\and\prevents\du
plicate\coverage.
---
**2.\Agent\John\Miller\is\meeting\with\Jerry\Smith,\a\new\prospect.\Jerry\i
s\currently\enrolled\in\Medicare\Parts\A\and\B.\Jerry\has\also\purchased\
,a\Medicare\Supplement\(Medigap)\plan\which\he\has\had\for\several\yea
rs.\However,\the\plan\does\not\provide\drug\benefits.\How\would\you\adv
ise\Agent\John\Miller\to\proceed?**
A)\Advise\Jerry\to\switch\to\a\Medicare\Advantage\plan\for\drug\coverage.\\
B)\Tell\prospect\Jerry\Smith\that\he\should\consider\adding\a\standalone\Part\
D\prescription\drug\coverage\policy\to\his\present\coverage.\\
C)\Inform\Jerry\that\Medigap\automatically\covers\prescription\drugs.\\
D)\Recommend\canceling\the\Medigap\plan.
**Correct\Answer:**\\
B)\Tell\prospect\Jerry\Smith\that\he\should\consider\adding\a\standalone\Part\
D\prescription\drug\coverage\policy\to\his\present\coverage.
**Expert\Rationale:**\\
Medigap\plans\sold\after\2006\do\not\include\prescription\drug\coverage.\Ben
eficiaries\needing\drug\coverage\must\enroll\in\a\standalone\Medicare\Part\D\
plan.\This\allows\individuals\to\retain\their\Medigap\coverage\while\accessing\
necessary\medications\through\an\appropriate\channel.
---
**3.\Mr.\Wu\is\eligible\for\Medicare.\He\has\limited\financial\resources\but
\failed\to\qualify\for\the\Part\D\low-
income\subsidy.\Where\might\he\turn\for\help\with\his\prescription\drug\
costs?**
, A)\Apply\for\Medicaid\to\cover\prescription\costs.\\
B)\Seek\assistance\from\pharmaceutical\company\discount\programs.\\
C)\Mr.\Wu\may\still\qualify\for\help\in\paying\Part\D\costs\through\his\State\Pha
rmaceutical\Assistance\Program\(SPAP).\\
D)\Try\to\enroll\in\a\Medigap\plan\with\drug\coverage.
**Correct\Answer:**\\
C)\Mr.\Wu\may\still\qualify\for\help\in\paying\Part\D\costs\through\his\State\Pha
rmaceutical\Assistance\Program\(SPAP).
**Expert\Rationale:**\\
States\may\offer\SPAPs\to\assist\residents\who\do\not\qualify\for\the\federal\Lo
w\Income\Subsidy\but\still\need\help\with\Part\D\drug\costs.\Eligibility\and\ben
efits\vary\by\state,\but\these\programs\can\provide\meaningful\financial\suppo
rt\when\other\federal\options\aren’t\available.
---
**4.\Mr.\Vasquez\is\in\good\health\and\wants\to\understand\the\health\car
e\costs\for\inpatient\hospital\services\under\Original\Medicare.\What\co
uld\you\tell\him?**
A)\He\pays\no\deductible\if\admitted\to\a\hospital.\\
B)\He\is\responsible\for\a\copayment\every\day\in\the\hospital.\\
C)\Under\Original\Medicare,\there\is\a\single\deductible\amount\due\for\the\firs
t\60\days\of\any\inpatient\hospital\stay,\after\which\it\converts\into\a\per-
day\coinsurance\amount\through\day\90.\After\day\90,\he\would\pay\a\daily\am
2026 AHIP
FINAL EXAM
Actual Questions and Answers
What’s Inside?
Actual AHIP 2026 Final Exam
questions with verified and explained
answers
Fully aligned with the latest CMS &
AHIP training modules
Detailed coverage of all exam sections,
Each question includes rationales and key references to
reinforce understanding
Content designed to mirror the official AHIP testing
environment
,**1.\Mr.\Capadona\would\like\to\purchase\a\Medicare\Advantage\(MA)\pla
n\and\a\Medigap\plan\to\pick\up\costs\not\covered\by\that\plan.\What\sho
uld\you\tell\him?**
A)\You\can\sell\him\a\Medigap\plan\to\help\with\costs\not\covered\under\Medic
are\Advantage.\\
B)\It\is\illegal\for\you\to\sell\Mr.\Capadona\a\Medigap\plan\if\he\is\enrolled\in\an\
MA\plan,\and\besides,\Medigap\only\works\with\Original\Medicare.\\
C)\Medigap\plans\are\designed\to\work\alongside\Medicare\Advantage\plans.\
\
D)\He\must\disenroll\from\his\MA\plan\before\buying\a\Medigap\plan.
**Correct\Answer:**\\
B)\It\is\illegal\for\you\to\sell\Mr.\Capadona\a\Medigap\plan\if\he\is\enrolled\in\an\
MA\plan,\and\besides,\Medigap\only\works\with\Original\Medicare.
**Expert\Rationale:**\\
Medigap\plans\are\supplemental\policies\that\fill\gaps\in\Original\Medicare\(Pa
rts\A\and\B)\coverage.\Federal\law\prohibits\issuance\of\a\Medigap\policy\to\an
yone\currently\enrolled\in\a\Medicare\Advantage\plan;\Medigap\cannot\pay\co
sts\associated\with\MA.\This\ensures\coordination\of\benefits\and\prevents\du
plicate\coverage.
---
**2.\Agent\John\Miller\is\meeting\with\Jerry\Smith,\a\new\prospect.\Jerry\i
s\currently\enrolled\in\Medicare\Parts\A\and\B.\Jerry\has\also\purchased\
,a\Medicare\Supplement\(Medigap)\plan\which\he\has\had\for\several\yea
rs.\However,\the\plan\does\not\provide\drug\benefits.\How\would\you\adv
ise\Agent\John\Miller\to\proceed?**
A)\Advise\Jerry\to\switch\to\a\Medicare\Advantage\plan\for\drug\coverage.\\
B)\Tell\prospect\Jerry\Smith\that\he\should\consider\adding\a\standalone\Part\
D\prescription\drug\coverage\policy\to\his\present\coverage.\\
C)\Inform\Jerry\that\Medigap\automatically\covers\prescription\drugs.\\
D)\Recommend\canceling\the\Medigap\plan.
**Correct\Answer:**\\
B)\Tell\prospect\Jerry\Smith\that\he\should\consider\adding\a\standalone\Part\
D\prescription\drug\coverage\policy\to\his\present\coverage.
**Expert\Rationale:**\\
Medigap\plans\sold\after\2006\do\not\include\prescription\drug\coverage.\Ben
eficiaries\needing\drug\coverage\must\enroll\in\a\standalone\Medicare\Part\D\
plan.\This\allows\individuals\to\retain\their\Medigap\coverage\while\accessing\
necessary\medications\through\an\appropriate\channel.
---
**3.\Mr.\Wu\is\eligible\for\Medicare.\He\has\limited\financial\resources\but
\failed\to\qualify\for\the\Part\D\low-
income\subsidy.\Where\might\he\turn\for\help\with\his\prescription\drug\
costs?**
, A)\Apply\for\Medicaid\to\cover\prescription\costs.\\
B)\Seek\assistance\from\pharmaceutical\company\discount\programs.\\
C)\Mr.\Wu\may\still\qualify\for\help\in\paying\Part\D\costs\through\his\State\Pha
rmaceutical\Assistance\Program\(SPAP).\\
D)\Try\to\enroll\in\a\Medigap\plan\with\drug\coverage.
**Correct\Answer:**\\
C)\Mr.\Wu\may\still\qualify\for\help\in\paying\Part\D\costs\through\his\State\Pha
rmaceutical\Assistance\Program\(SPAP).
**Expert\Rationale:**\\
States\may\offer\SPAPs\to\assist\residents\who\do\not\qualify\for\the\federal\Lo
w\Income\Subsidy\but\still\need\help\with\Part\D\drug\costs.\Eligibility\and\ben
efits\vary\by\state,\but\these\programs\can\provide\meaningful\financial\suppo
rt\when\other\federal\options\aren’t\available.
---
**4.\Mr.\Vasquez\is\in\good\health\and\wants\to\understand\the\health\car
e\costs\for\inpatient\hospital\services\under\Original\Medicare.\What\co
uld\you\tell\him?**
A)\He\pays\no\deductible\if\admitted\to\a\hospital.\\
B)\He\is\responsible\for\a\copayment\every\day\in\the\hospital.\\
C)\Under\Original\Medicare,\there\is\a\single\deductible\amount\due\for\the\firs
t\60\days\of\any\inpatient\hospital\stay,\after\which\it\converts\into\a\per-
day\coinsurance\amount\through\day\90.\After\day\90,\he\would\pay\a\daily\am
