AHIP 2027 Medicare Certification Exam
Practice Actual Questions & Answers (AHIP)
Guarantee Pass
1. When does the Medicare Annual Election Period (AEP) occur each year?
A. January 1 – March 31
B. October 15 – December 7
C. April 1 – June 30
D. November 1 – January 15
Answer: B
Conceptual Explanation: The Annual Election Period (AEP) is the timeframe from October
15 through December 7 when Medicare beneficiaries can make changes to their coverage.
2. Which part of Medicare is primarily responsible for covering inpatient hospital stays and
skilled nursing facility care?
A. Part C
B. Part B
C. Part A
D. Part D
,Answer: C
Conceptual Explanation: Medicare Part A is Hospital Insurance, covering inpatient
hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
3. Under the Inflation Reduction Act, what is the maximum annual out-of-pocket limit for
Part D prescription drugs starting in 2025 and continuing into 2027?
A. $5,000
B. $2,000
C. $3,300
D. $7,550
Answer: B
Conceptual Explanation: Beginning in 2025, the out-of-pocket costs for Part D drugs are
capped at $2,000 per year for all beneficiaries.
4. An agent is meeting with a consumer to discuss Medicare Advantage. When must the
Scope of Appointment (SOA) form ideally be signed?
A. At the very end of the presentation
B. Within 24 hours after the appointment ends
C. Only if the consumer decides to enroll
D. At least 48 hours prior to the personal marketing appointment
Answer: D
, Conceptual Explanation: CMS rules generally require that a Scope of Appointment be
documented at least 48 hours before the marketing appointment, with limited exceptions
for walk-ins or the end of a formal enrollment period.
5. Which of the following is a prohibited marketing practice for Medicare Advantage plans?
A. Conducting an educational event at a public library
B. Conducting unsolicited door-to-door solicitation
C. Providing a business card to a consumer at an event
D. Calling a current client to discuss plan changes
Answer: B
Conceptual Explanation: Unsolicited door-to-door solicitation is strictly prohibited by
CMS marketing guidelines.
6. Medicare Part B covers which of the following services?
A. Inpatient surgery
B. Physician services and outpatient care
C. Long-term custodial care
D. Prescription drugs through a retail pharmacy
Answer: B
Conceptual Explanation: Part B covers medically necessary services like doctors’ services,
outpatient care, and durable medical equipment.
Practice Actual Questions & Answers (AHIP)
Guarantee Pass
1. When does the Medicare Annual Election Period (AEP) occur each year?
A. January 1 – March 31
B. October 15 – December 7
C. April 1 – June 30
D. November 1 – January 15
Answer: B
Conceptual Explanation: The Annual Election Period (AEP) is the timeframe from October
15 through December 7 when Medicare beneficiaries can make changes to their coverage.
2. Which part of Medicare is primarily responsible for covering inpatient hospital stays and
skilled nursing facility care?
A. Part C
B. Part B
C. Part A
D. Part D
,Answer: C
Conceptual Explanation: Medicare Part A is Hospital Insurance, covering inpatient
hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
3. Under the Inflation Reduction Act, what is the maximum annual out-of-pocket limit for
Part D prescription drugs starting in 2025 and continuing into 2027?
A. $5,000
B. $2,000
C. $3,300
D. $7,550
Answer: B
Conceptual Explanation: Beginning in 2025, the out-of-pocket costs for Part D drugs are
capped at $2,000 per year for all beneficiaries.
4. An agent is meeting with a consumer to discuss Medicare Advantage. When must the
Scope of Appointment (SOA) form ideally be signed?
A. At the very end of the presentation
B. Within 24 hours after the appointment ends
C. Only if the consumer decides to enroll
D. At least 48 hours prior to the personal marketing appointment
Answer: D
, Conceptual Explanation: CMS rules generally require that a Scope of Appointment be
documented at least 48 hours before the marketing appointment, with limited exceptions
for walk-ins or the end of a formal enrollment period.
5. Which of the following is a prohibited marketing practice for Medicare Advantage plans?
A. Conducting an educational event at a public library
B. Conducting unsolicited door-to-door solicitation
C. Providing a business card to a consumer at an event
D. Calling a current client to discuss plan changes
Answer: B
Conceptual Explanation: Unsolicited door-to-door solicitation is strictly prohibited by
CMS marketing guidelines.
6. Medicare Part B covers which of the following services?
A. Inpatient surgery
B. Physician services and outpatient care
C. Long-term custodial care
D. Prescription drugs through a retail pharmacy
Answer: B
Conceptual Explanation: Part B covers medically necessary services like doctors’ services,
outpatient care, and durable medical equipment.
