AHIP 2027 FINAL PRACTICE EXAM
QUESTIONS AND ANSWERS
1. Which of the following describes the Medicare Advantage Open Enrollment Period (MA
OEP)?
A. It runs from October 15 to December 7 each year.
B. It is the period when an individual first becomes eligible for Medicare Part A and B.
C. It allows individuals enrolled in an MA plan to switch to another MA plan or return to
Original Medicare from January 1 to March 31.
D. It is only available for individuals who have a Special Needs Plan (SNP).
Answer: C
Conceptual Explanation: The MA OEP runs from January 1 through March 31, allowing
MA-enrolled individuals to make a one-time change to another MA plan or return to
Original Medicare.
2. An agent is hosting a formal sales event. Which of the following is a prohibited activity?
A. Providing light snacks and refreshments.
B. Distributing plan brochures and enrollment kits.
C. Collecting Scope of Appointment forms for future meetings.
,D. Requiring attendees to sign an attendance sheet before entering.
Answer: D
Conceptual Explanation: CMS guidelines prohibit agents from requiring attendees to
provide contact information or sign in as a prerequisite for attending a marketing or sales
event.
3. What is the nominal value limit for items provided to beneficiaries for marketing purposes
as of the 2027 guidelines?
A. $50 per item, regardless of frequency.
B. $25 per item, with no annual limit.
C. $10 per item, with an aggregate of $50 per person per year.
D. $15 per item, with an aggregate of $75 per person per year.
Answer: D
Conceptual Explanation: The nominal value remains at $15 per item, with an aggregate of
$75 per person per year, to ensure gifts do not influence the beneficiary’s decision.
4. Which Part D coverage phase is characterized by the beneficiary paying a percentage of the
cost until they reach the out-of-pocket threshold?
A. Deductible Phase
B. Initial Coverage Phase
C. Coverage Gap (Donut Hole)
, D. Catastrophic Coverage Phase
Answer: B
Conceptual Explanation: In the Initial Coverage Phase, beneficiaries pay their plan’s cost-
sharing (copays/coinsurance) until the total drug cost reaches a specific limit.
5. A beneficiary who is ‘dual eligible’ is entitled to benefits from which two programs?
A. Medicare and Social Security
B. Medicare Part A and Part B only
C. Medicare and Medicaid
D. Medicare and Private Employer Insurance
Answer: C
Conceptual Explanation: Dual eligible refers to individuals who qualify for both Medicare
and some form of assistance from their state’s Medicaid program.
6. Which of the following is a requirement for a beneficiary to enroll in a Medicare Advantage
plan?
A. They must live in the plan’s service area.
B. They must have End-Stage Renal Disease (ESRD) only.
C. They must be at least 70 years old.
D. They must not have any other health insurance.
QUESTIONS AND ANSWERS
1. Which of the following describes the Medicare Advantage Open Enrollment Period (MA
OEP)?
A. It runs from October 15 to December 7 each year.
B. It is the period when an individual first becomes eligible for Medicare Part A and B.
C. It allows individuals enrolled in an MA plan to switch to another MA plan or return to
Original Medicare from January 1 to March 31.
D. It is only available for individuals who have a Special Needs Plan (SNP).
Answer: C
Conceptual Explanation: The MA OEP runs from January 1 through March 31, allowing
MA-enrolled individuals to make a one-time change to another MA plan or return to
Original Medicare.
2. An agent is hosting a formal sales event. Which of the following is a prohibited activity?
A. Providing light snacks and refreshments.
B. Distributing plan brochures and enrollment kits.
C. Collecting Scope of Appointment forms for future meetings.
,D. Requiring attendees to sign an attendance sheet before entering.
Answer: D
Conceptual Explanation: CMS guidelines prohibit agents from requiring attendees to
provide contact information or sign in as a prerequisite for attending a marketing or sales
event.
3. What is the nominal value limit for items provided to beneficiaries for marketing purposes
as of the 2027 guidelines?
A. $50 per item, regardless of frequency.
B. $25 per item, with no annual limit.
C. $10 per item, with an aggregate of $50 per person per year.
D. $15 per item, with an aggregate of $75 per person per year.
Answer: D
Conceptual Explanation: The nominal value remains at $15 per item, with an aggregate of
$75 per person per year, to ensure gifts do not influence the beneficiary’s decision.
4. Which Part D coverage phase is characterized by the beneficiary paying a percentage of the
cost until they reach the out-of-pocket threshold?
A. Deductible Phase
B. Initial Coverage Phase
C. Coverage Gap (Donut Hole)
, D. Catastrophic Coverage Phase
Answer: B
Conceptual Explanation: In the Initial Coverage Phase, beneficiaries pay their plan’s cost-
sharing (copays/coinsurance) until the total drug cost reaches a specific limit.
5. A beneficiary who is ‘dual eligible’ is entitled to benefits from which two programs?
A. Medicare and Social Security
B. Medicare Part A and Part B only
C. Medicare and Medicaid
D. Medicare and Private Employer Insurance
Answer: C
Conceptual Explanation: Dual eligible refers to individuals who qualify for both Medicare
and some form of assistance from their state’s Medicaid program.
6. Which of the following is a requirement for a beneficiary to enroll in a Medicare Advantage
plan?
A. They must live in the plan’s service area.
B. They must have End-Stage Renal Disease (ESRD) only.
C. They must be at least 70 years old.
D. They must not have any other health insurance.
