AHIP 2026 FINAL EXAM
CERTIFICATION EXAM | LATEST
UPDATES, COSTS, MODULE CHANGES,
STUDY GUIDE, PRACTICE QUESTIONS,
SOLUTIONS, ANSWERS, COMPLIANCE
TIPS & HOW TO PASS FAST
1. Mr. Arias, a naturalized citizen, previously enrolled in Medicare Part B
but has recently stopped paying his Part B premium. Mr. Arias is still
covered by Part A. He would like to enroll in a Medicare Advantage (MA)
plan and is still covered by Part A. What should you tell him? - CORRECT
ANSWER : -He is not eligible to enroll in a Medicare Advantage plan until
he re-enrolls in Medicare Part B.
2. Mrs. Joy, age 65, is entitled to Part A but has not yet enrolled in Part B.
She is considering enrolling in a Medicare Advantage plan (Part C). What
should you advise her to do before she can enroll in a Medicare
Advantage plan? - CORRECT ANSWER : -To join a Medicare Advantage
plan, she also must enroll in Part B.
,3. Mr. Kumar is considering a Medicare Advantage HMO and has questions
about his ability to access providers. What should you tell him? -
CORRECT ANSWER : -In most Medicare Advantage HMOs, Mr. Kumar
must generally obtain his services only from providers within the plan's
network (except in an emergency or where care is unavailable within the
network).
4. Mrs. Robles is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should
you tell her? - CORRECT ANSWER : -Mrs. Robles can obtain care from any
provider who participates in Original Medicare, but generally will have a
higher cost-sharing amount if she sees a provider who/that is not a part
of the PPO network.
5. Mrs. Lester is age 75 and enjoys a comfortable but not extremely high-
income level. She wishes to enroll in an MA MSA plan that she heard
about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive
medications. Currently, she is enrolled in Original Medicare and a
, standalone Part D plan. How would you advise Mrs. Lester? - CORRECT
ANSWER : -Mrs. Lester may enroll in an MA MSA plan and remain in her
current standalone Part D prescription drug plan.
6. Mr. Dalton is in excellent health, lives in his own home, and has a
sizeable income from his investments. He has a friend enrolled in a
Medicare Advantage Special Needs Plan (SNP). His friend has mentioned
that the SNP charges very low cost-sharing amounts and Mr. Dalton
would like to join that plan. What should you tell him? - CORRECT
ANSWER : -SNPs limit enrollment to certain subpopulations of
beneficiaries. Given his current situation, he is unlikely to qualify and
would not be able to enroll in the SNP.
7. Mr. Anderson wants to know whether he is eligible to sign up for a
Private fee-for-service (PFFS) plan. What questions would you need to
ask to determine his eligibility? - CORRECT ANSWER : -You would need to
ask Mr. Anderson if he is entitled to Part A, enrolled in Part B, and if he
lives in the PFFS plan's service area.
CERTIFICATION EXAM | LATEST
UPDATES, COSTS, MODULE CHANGES,
STUDY GUIDE, PRACTICE QUESTIONS,
SOLUTIONS, ANSWERS, COMPLIANCE
TIPS & HOW TO PASS FAST
1. Mr. Arias, a naturalized citizen, previously enrolled in Medicare Part B
but has recently stopped paying his Part B premium. Mr. Arias is still
covered by Part A. He would like to enroll in a Medicare Advantage (MA)
plan and is still covered by Part A. What should you tell him? - CORRECT
ANSWER : -He is not eligible to enroll in a Medicare Advantage plan until
he re-enrolls in Medicare Part B.
2. Mrs. Joy, age 65, is entitled to Part A but has not yet enrolled in Part B.
She is considering enrolling in a Medicare Advantage plan (Part C). What
should you advise her to do before she can enroll in a Medicare
Advantage plan? - CORRECT ANSWER : -To join a Medicare Advantage
plan, she also must enroll in Part B.
,3. Mr. Kumar is considering a Medicare Advantage HMO and has questions
about his ability to access providers. What should you tell him? -
CORRECT ANSWER : -In most Medicare Advantage HMOs, Mr. Kumar
must generally obtain his services only from providers within the plan's
network (except in an emergency or where care is unavailable within the
network).
4. Mrs. Robles is considering a Medicare Advantage PPO and has questions
about which providers she can go to for her health care. What should
you tell her? - CORRECT ANSWER : -Mrs. Robles can obtain care from any
provider who participates in Original Medicare, but generally will have a
higher cost-sharing amount if she sees a provider who/that is not a part
of the PPO network.
5. Mrs. Lester is age 75 and enjoys a comfortable but not extremely high-
income level. She wishes to enroll in an MA MSA plan that she heard
about from her neighbor. She also wants to have prescription drug
coverage since her doctor recently prescribed several expensive
medications. Currently, she is enrolled in Original Medicare and a
, standalone Part D plan. How would you advise Mrs. Lester? - CORRECT
ANSWER : -Mrs. Lester may enroll in an MA MSA plan and remain in her
current standalone Part D prescription drug plan.
6. Mr. Dalton is in excellent health, lives in his own home, and has a
sizeable income from his investments. He has a friend enrolled in a
Medicare Advantage Special Needs Plan (SNP). His friend has mentioned
that the SNP charges very low cost-sharing amounts and Mr. Dalton
would like to join that plan. What should you tell him? - CORRECT
ANSWER : -SNPs limit enrollment to certain subpopulations of
beneficiaries. Given his current situation, he is unlikely to qualify and
would not be able to enroll in the SNP.
7. Mr. Anderson wants to know whether he is eligible to sign up for a
Private fee-for-service (PFFS) plan. What questions would you need to
ask to determine his eligibility? - CORRECT ANSWER : -You would need to
ask Mr. Anderson if he is entitled to Part A, enrolled in Part B, and if he
lives in the PFFS plan's service area.
