2025 AHIP FINAL EXAM QUESTIONS
AND ANSWERS WITH COMPLETE
SOLUTION GRADED A+ UPDATE
2026/ 2027
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug
coverage. He found a stand-alone Medicare prescription drug plan in his area that offers
better coverage than that available through his MA-PD plan and in addition, has a low
premium. It won't cost him much more and, because he has the means to do so, he
wishes to enroll in the stand-alone prescription drug plan in addition to his MA-PD plan.
What should you tell him? - CORRECT ANSWES -- If Mr. Block enrolls in the stand-
alone Medicare prescription drug plan, he will be disenrolled from the Medicare
Advantage plan.
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last
year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D
prescription drug plan and did not enroll in a Medicare Advantage (MA) plan during the
last annual open enrollment period (AEP) which has just closed. Mr. Wendt has heard
certain MA plans might provide him with more specialized coverage for his diabetes and
wants to know if he must wait until the next annual open enrollment period (AEP) before
enrolling in such a plan. What should you tell him? - CORRECT ANSWES -- If there is a
special needs plan (SNP) in Mr. Wendt's area that specializes in caring for individuals
with diabetes, he may enroll in the SNP at any time under a special election period
(SEP).
Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug
coverage that was offered to company retirees. The company told Mr. Yoo that,
because he was affected by this change, he would qualify for a special election period.
Mr. Yoo contacted you to find out more about what this means. What can you tell him? -
CORRECT ANSWES -- It means that he qualifies for a one-time opportunity to enroll in
an MA-PD or Part D prescription drug plan.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare
for the last six years due to her disability and has never been enrolled in a Medicare
Advantage or a Part D plan before. She wants to enroll in a Part D plan. She knows that
there is such a thing as the "Part D Initial Enrollment Period" (IEP) and has concluded
that, since she has never enrolled in such a plan before, she should be eligible to enroll
under this period. What should you tell her about how the Part D Initial Enrollment
Period applies to her situation? - CORRECT ANSWES -- Ms. Claggett has had two
, IEPs and missed them both. The first occurred three months before and three months
after the month when she was first entitled to Part A OR enrolled in Part B. Because she
was eligible for Medicare before age 65, Ms. Claggett had a second IEP based on
turning age 65, which has also expired.
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for
Medicare Part A and did not enroll for Part B when first eligible because she has
insurance through her employer - Coffee Brew, Inc. She also did not enroll in Part D
because she had creditable coverage. She would like to retire in June and enroll in a
Medicare Advantage plan. She has been informed that her group coverage will end on
her retirement effective date. How would you advise Ms. Thomas? - CORRECT
ANSWES -- Ms. Thomas can enroll in Part B without a late penalty at any time she is
still covered by her employer group and 8 months after her last month of employer
group coverage without a penalty. However, because she wants to enroll in a MA plan
after retirement, she should make sure her Part B coverage is effective in time to use
the Medicare Advantage/Part D special election period for individuals changing from
employer group coverage to enroll in a MA plan or MA-PD. The SEP begins while she
has employer group coverage and will last until 2 months after the month after the
month her employer coverage ends. If she wants Part D coverage she should enroll in
an MA-PD or a PDP (depending on how she decides to receive her Part A and B
benefits) during this time.
Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the
paper that explains what he could do during the SEP. What can you tell him? -
CORRECT ANSWES -- If the SEP is for MA coverage, he will generally have one
opportunity to change his MA coverage.
Mrs. Schmidt is moving and a friend told her she might qualify for a "special election
period" to enroll in a new Medicare Advantage plan. She contacted you to ask what a
special election period is. What could you tell her? - CORRECT ANSWES -- It is a
period, outside of the Annual Election Period, when a Medicare beneficiary can select a
new or different Medicare Advantage and/or Part D prescription drug plan. Typically, the
special election period is beneficiary specific and results from events, such as when the
beneficiary moves outside of the service area.
Mrs. Kendrick is in good health, has worked for many years, and is six months away
from turning 65. She wants to know what she will have to do to enroll in a Medicare
Advantage (MA) plan as soon as possible. What could you tell her? - CORRECT
ANSWES -- She may enroll in an MA plan beginning three months immediately before
her first entitlement to both Medicare Part A and Part B.
Which of the following individuals has enrolled in a plan based on a fixed enrollment
period? - CORRECT ANSWES -- Ben enrolls in a Medicare Advantage plan during the
Medicare Advantage Open Enrollment Period (MA OEP).
Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage following her
retirement several years ago. Four months ago, Mrs. Ridgeway dropped her Medigap
policy to enroll in a Medicare Advantage (MA) plan for the first time. Unfortunately, Mrs.
Ridgeway has found that many of her providers are not in the MA plan's network. She
has come to you for advice. What should you tell her? - CORRECT ANSWES -- She
qualifies for a special election period (SEP) that will allow her to make a one-time
AND ANSWERS WITH COMPLETE
SOLUTION GRADED A+ UPDATE
2026/ 2027
Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug
coverage. He found a stand-alone Medicare prescription drug plan in his area that offers
better coverage than that available through his MA-PD plan and in addition, has a low
premium. It won't cost him much more and, because he has the means to do so, he
wishes to enroll in the stand-alone prescription drug plan in addition to his MA-PD plan.
What should you tell him? - CORRECT ANSWES -- If Mr. Block enrolls in the stand-
alone Medicare prescription drug plan, he will be disenrolled from the Medicare
Advantage plan.
Mr. Wendt suffers from diabetes which has gotten progressively worse during the last
year. He is currently enrolled in Original Medicare (Parts A and B) and a Part D
prescription drug plan and did not enroll in a Medicare Advantage (MA) plan during the
last annual open enrollment period (AEP) which has just closed. Mr. Wendt has heard
certain MA plans might provide him with more specialized coverage for his diabetes and
wants to know if he must wait until the next annual open enrollment period (AEP) before
enrolling in such a plan. What should you tell him? - CORRECT ANSWES -- If there is a
special needs plan (SNP) in Mr. Wendt's area that specializes in caring for individuals
with diabetes, he may enroll in the SNP at any time under a special election period
(SEP).
Mr. Yoo's employer has recently dropped comprehensive creditable prescription drug
coverage that was offered to company retirees. The company told Mr. Yoo that,
because he was affected by this change, he would qualify for a special election period.
Mr. Yoo contacted you to find out more about what this means. What can you tell him? -
CORRECT ANSWES -- It means that he qualifies for a one-time opportunity to enroll in
an MA-PD or Part D prescription drug plan.
Ms. Claggett is sixty-six (66) years old. She has been covered under Original Medicare
for the last six years due to her disability and has never been enrolled in a Medicare
Advantage or a Part D plan before. She wants to enroll in a Part D plan. She knows that
there is such a thing as the "Part D Initial Enrollment Period" (IEP) and has concluded
that, since she has never enrolled in such a plan before, she should be eligible to enroll
under this period. What should you tell her about how the Part D Initial Enrollment
Period applies to her situation? - CORRECT ANSWES -- Ms. Claggett has had two
, IEPs and missed them both. The first occurred three months before and three months
after the month when she was first entitled to Part A OR enrolled in Part B. Because she
was eligible for Medicare before age 65, Ms. Claggett had a second IEP based on
turning age 65, which has also expired.
Ms. Thomas has worked for many years and is turning 68 in June. She is eligible for
Medicare Part A and did not enroll for Part B when first eligible because she has
insurance through her employer - Coffee Brew, Inc. She also did not enroll in Part D
because she had creditable coverage. She would like to retire in June and enroll in a
Medicare Advantage plan. She has been informed that her group coverage will end on
her retirement effective date. How would you advise Ms. Thomas? - CORRECT
ANSWES -- Ms. Thomas can enroll in Part B without a late penalty at any time she is
still covered by her employer group and 8 months after her last month of employer
group coverage without a penalty. However, because she wants to enroll in a MA plan
after retirement, she should make sure her Part B coverage is effective in time to use
the Medicare Advantage/Part D special election period for individuals changing from
employer group coverage to enroll in a MA plan or MA-PD. The SEP begins while she
has employer group coverage and will last until 2 months after the month after the
month her employer coverage ends. If she wants Part D coverage she should enroll in
an MA-PD or a PDP (depending on how she decides to receive her Part A and B
benefits) during this time.
Mr. Garcia was told he qualifies for a special election period (SEP), but he lost the
paper that explains what he could do during the SEP. What can you tell him? -
CORRECT ANSWES -- If the SEP is for MA coverage, he will generally have one
opportunity to change his MA coverage.
Mrs. Schmidt is moving and a friend told her she might qualify for a "special election
period" to enroll in a new Medicare Advantage plan. She contacted you to ask what a
special election period is. What could you tell her? - CORRECT ANSWES -- It is a
period, outside of the Annual Election Period, when a Medicare beneficiary can select a
new or different Medicare Advantage and/or Part D prescription drug plan. Typically, the
special election period is beneficiary specific and results from events, such as when the
beneficiary moves outside of the service area.
Mrs. Kendrick is in good health, has worked for many years, and is six months away
from turning 65. She wants to know what she will have to do to enroll in a Medicare
Advantage (MA) plan as soon as possible. What could you tell her? - CORRECT
ANSWES -- She may enroll in an MA plan beginning three months immediately before
her first entitlement to both Medicare Part A and Part B.
Which of the following individuals has enrolled in a plan based on a fixed enrollment
period? - CORRECT ANSWES -- Ben enrolls in a Medicare Advantage plan during the
Medicare Advantage Open Enrollment Period (MA OEP).
Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage following her
retirement several years ago. Four months ago, Mrs. Ridgeway dropped her Medigap
policy to enroll in a Medicare Advantage (MA) plan for the first time. Unfortunately, Mrs.
Ridgeway has found that many of her providers are not in the MA plan's network. She
has come to you for advice. What should you tell her? - CORRECT ANSWES -- She
qualifies for a special election period (SEP) that will allow her to make a one-time
