AHIP FINAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (ALREADY
GRADED A+); LATEST EDITION 2026
A Medicare beneficiary has walked into your office and
requested that you sit down with her and discuss her
options under the Medicare Advantage program. Before
engaging in such a discussion, what should you do? -
correct answer- You must have her sign a scope
of appointment form, indicating which products she
wishes to discuss. You may then proceed with the
discussion.
Agent Harriet Walker has recently begun marketing
Medicare Advantage and related products aimed at
meeting the needs of senior citizens. Client Mildred Jones
has expressed interest in a Medicare Advantage plan. It is
now the beginning of September. If you were in Agent
Walker's position, what would you do? - correct
answer- Inquire whether the client qualifies for a
special enrollment period, and if not, solicit an enrollment
application once the annual open enrollment election
period begins on October 15th.
,Agent Jennings makes a presentation on Medicare
advertised as an educational event. Agent Jennings
distributes materials that are solely educational. However,
she gives a brief presentation that mentions plan-specific
premiums. Is this a prohibited activity at an event that has
been advertised as educational? - correct answer-
Yes. When an event has been advertised as "educational,"
discussing plan-specific premiums is impermissible.
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)? -
correct 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.
Anita Magri will turn age 65 in August 2023. Anita intends
to enroll in Original Medicare Part A and Part B. She
would also like to enroll in a Medicare Supplement
,(Medigap) plan. Anita's older neighbor Mel has told her
about the Medigap Plan F in which he is enrolled. It not
only provides foreign travel emergency benefits but also
covers his Medicare Part B deductible. Anita comes to you
for advice. What should you tell her? - correct
answer- You are sorry to disappoint Anita, but a
Medigap F plan is no longer available to those who turn
age 65 after January 1, 2020. Anita might instead consider
other Medigap plans that offer foreign travel benefits but
do not cover the Part B deductible.
By contacting plans available in your area, you have
learned that the plan you represent has a significantly
lower monthly premium than the others. Furthermore,
you see that the plan you represent has a unique benefits
package. What should you do to make sure your clients
know about these pieces of information? - correct
answer- You may make comparisons between plans
if you can support them with studies or statistical data
and such comparisons are factually based and referenced.
Dr. Elizabeth Brennan does not contract with the ABC
PFFS plan but accepts the plan's terms and conditions for
payment. Mary Rodgers sees Dr. Brennan for treatment.
, How much may Dr. Brennan charge? - correct
answer- Dr. Brennan can charge Mary Rogers no
more than the cost sharing specified in the PFFS plan's
terms and condition of payment which may include
balance billing up to 15%of the Medicare rate.
During a sales presentation to Ms. Daley for a Medicare
Advantage plan that has a 5-star rating in customer
service and care coordination, and received an overall
plan performance rating of a 4-star, which of the following
would be the best statement to say to her? - correct
answer- The Medicare Advantage plan received a 5-
star rating in customer service and care coordination with
an overall performance rating of 4 stars.
Hank's Fish Store, Inc. is a small company with just 15
employees located in Florida. Hank, the store owner, has
provided excellent health benefits to the store's
workforce. William, one of the store's long-time
employees, will soon be reaching age 65 and eligible for
Medicare. William is in good health. He intends to remain
an active full-time employee, working several years after
becoming eligible for Medicare. What type(s) of retiree
health benefit will Hank's Fish Store be able to offer
CORRECT DETAILED ANSWERS (ALREADY
GRADED A+); LATEST EDITION 2026
A Medicare beneficiary has walked into your office and
requested that you sit down with her and discuss her
options under the Medicare Advantage program. Before
engaging in such a discussion, what should you do? -
correct answer- You must have her sign a scope
of appointment form, indicating which products she
wishes to discuss. You may then proceed with the
discussion.
Agent Harriet Walker has recently begun marketing
Medicare Advantage and related products aimed at
meeting the needs of senior citizens. Client Mildred Jones
has expressed interest in a Medicare Advantage plan. It is
now the beginning of September. If you were in Agent
Walker's position, what would you do? - correct
answer- Inquire whether the client qualifies for a
special enrollment period, and if not, solicit an enrollment
application once the annual open enrollment election
period begins on October 15th.
,Agent Jennings makes a presentation on Medicare
advertised as an educational event. Agent Jennings
distributes materials that are solely educational. However,
she gives a brief presentation that mentions plan-specific
premiums. Is this a prohibited activity at an event that has
been advertised as educational? - correct answer-
Yes. When an event has been advertised as "educational,"
discussing plan-specific premiums is impermissible.
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)? -
correct 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.
Anita Magri will turn age 65 in August 2023. Anita intends
to enroll in Original Medicare Part A and Part B. She
would also like to enroll in a Medicare Supplement
,(Medigap) plan. Anita's older neighbor Mel has told her
about the Medigap Plan F in which he is enrolled. It not
only provides foreign travel emergency benefits but also
covers his Medicare Part B deductible. Anita comes to you
for advice. What should you tell her? - correct
answer- You are sorry to disappoint Anita, but a
Medigap F plan is no longer available to those who turn
age 65 after January 1, 2020. Anita might instead consider
other Medigap plans that offer foreign travel benefits but
do not cover the Part B deductible.
By contacting plans available in your area, you have
learned that the plan you represent has a significantly
lower monthly premium than the others. Furthermore,
you see that the plan you represent has a unique benefits
package. What should you do to make sure your clients
know about these pieces of information? - correct
answer- You may make comparisons between plans
if you can support them with studies or statistical data
and such comparisons are factually based and referenced.
Dr. Elizabeth Brennan does not contract with the ABC
PFFS plan but accepts the plan's terms and conditions for
payment. Mary Rodgers sees Dr. Brennan for treatment.
, How much may Dr. Brennan charge? - correct
answer- Dr. Brennan can charge Mary Rogers no
more than the cost sharing specified in the PFFS plan's
terms and condition of payment which may include
balance billing up to 15%of the Medicare rate.
During a sales presentation to Ms. Daley for a Medicare
Advantage plan that has a 5-star rating in customer
service and care coordination, and received an overall
plan performance rating of a 4-star, which of the following
would be the best statement to say to her? - correct
answer- The Medicare Advantage plan received a 5-
star rating in customer service and care coordination with
an overall performance rating of 4 stars.
Hank's Fish Store, Inc. is a small company with just 15
employees located in Florida. Hank, the store owner, has
provided excellent health benefits to the store's
workforce. William, one of the store's long-time
employees, will soon be reaching age 65 and eligible for
Medicare. William is in good health. He intends to remain
an active full-time employee, working several years after
becoming eligible for Medicare. What type(s) of retiree
health benefit will Hank's Fish Store be able to offer
