AHIP Final Review Module 2 (2026–2027) | Questions &
Verified Answers | Medicare Certification Exam Prep
1. Describe how Medicare Savings Account (MSA) Plans differ from
traditional Medicare in terms of coverage benefits.
MSA Plans combine a high-deductible health plan with a
savings account for medical expenses, offering more flexibility
in spending.
MSA Plans only cover hospital services and not outpatient care.
MSA Plans require members to use a specific network of
providers for all services.
MSA Plans provide comprehensive coverage without any
deductibles.
2. What type of Medicare plan is designed to provide additional services
that may help individuals remain in the community?
Private Fee-for-Service (PFFS)
Original Medicare
Medicare Savings Accounts (MSA)
Medicare Advantage (MA)
3. Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage
following her retirements 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?
She qualifies for a special enrollment period (SEP) that will
allow her to make a one-time election to return to Original
Medicare and she also has a guaranteed eligibility period to
, rejoin her Medigap plan.
She must wait until the next MA Open Enrollment Period (OEP)
during which she can elect to return to Original Medicare.
She must wait until the next Annual Election Period (AEP) during
which she may select another MA plan.
She qualifies for a special enrollment period (SEP) that will allow
her to make a one-time election to return to Original Medicare,
but she may or may not qualify to rejoin her Medigap plan based
on medical underwriting.
4. Mrs. Goodman enrolled in an MA-PD plan during the Annual Election
Period. In mid-January of the following year, she wants to switch back to
Original Medicare and enroll in a stand-alone prescription drug plan.
What should you tell her?
During the MA Open Enrollment Period, from January 1 - March
31, she may drop a MA or MA-PD plan and go back to Original
Medicare, but she may only enroll in a stand-alone prescription
drug plan if she also purchases a Medigap policy.
During the MA Open Enrollment Period, from January 1 - March
31, she may disenroll from the MA-PD plan into Original
Medicare and also may add a stand-alone prescription drug
plan.
During the MA Open Enrollment Period, from January 1 - March
31, she may only disenroll from a MA or MA-PD plan but cannot
enroll in a stand-alone Part D plan.
During the MA Open Enrollment Period, from January 1 - March
31, she may only add or drop Part D coverage, so she cannot
switch back to Original Medicare.
, 5. If Mary Rodgers is considering switching from Original Medicare to the
ABC PFFS plan, what factors should she evaluate regarding her
potential costs?
She should compare the PFFS plan to her previous plan without
considering her current health needs.
She should focus solely on the prescription drug coverage
offered by the PFFS plan.
She should evaluate the treatment costs, provider acceptance,
and any additional services covered by the PFFS plan.
She should only consider the monthly premium of the PFFS plan.
6. Ms. Lee is enrolled in an MA-PD plan but will be moving out of the
plan's service area next month. She is worried that she will not be able
to enroll in another plan available in her new residence until the Annual
Election Period. What should you tell her?
She will be able to enroll in a new plan because she qualifies for
a Special Enrollment Period that begins 30 days after a plan's
written communications are returned by the United States Postal
Service with a notification that the resident has moved. So, she
should be sure to notify the Postal Service immediately.
She may continue to keep her existing plan, because all
Medicare health plans are required to provide coverage to
anyone, no matter where they live.
She will have to wait until the next Annual Election Period to be
able to enroll in a plan available in her new location.
She is eligible for a Special Election Period that begins either
the month before her permanent move, if the plan is notified in
advance, or the month she provides notice of the move, and
this period typically lasts an additional two months.
7. Describe the relationship between Medicare Part B enrollment and
Verified Answers | Medicare Certification Exam Prep
1. Describe how Medicare Savings Account (MSA) Plans differ from
traditional Medicare in terms of coverage benefits.
MSA Plans combine a high-deductible health plan with a
savings account for medical expenses, offering more flexibility
in spending.
MSA Plans only cover hospital services and not outpatient care.
MSA Plans require members to use a specific network of
providers for all services.
MSA Plans provide comprehensive coverage without any
deductibles.
2. What type of Medicare plan is designed to provide additional services
that may help individuals remain in the community?
Private Fee-for-Service (PFFS)
Original Medicare
Medicare Savings Accounts (MSA)
Medicare Advantage (MA)
3. Mrs. Ridgeway enrolled in Original Medicare and Medigap coverage
following her retirements 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?
She qualifies for a special enrollment period (SEP) that will
allow her to make a one-time election to return to Original
Medicare and she also has a guaranteed eligibility period to
, rejoin her Medigap plan.
She must wait until the next MA Open Enrollment Period (OEP)
during which she can elect to return to Original Medicare.
She must wait until the next Annual Election Period (AEP) during
which she may select another MA plan.
She qualifies for a special enrollment period (SEP) that will allow
her to make a one-time election to return to Original Medicare,
but she may or may not qualify to rejoin her Medigap plan based
on medical underwriting.
4. Mrs. Goodman enrolled in an MA-PD plan during the Annual Election
Period. In mid-January of the following year, she wants to switch back to
Original Medicare and enroll in a stand-alone prescription drug plan.
What should you tell her?
During the MA Open Enrollment Period, from January 1 - March
31, she may drop a MA or MA-PD plan and go back to Original
Medicare, but she may only enroll in a stand-alone prescription
drug plan if she also purchases a Medigap policy.
During the MA Open Enrollment Period, from January 1 - March
31, she may disenroll from the MA-PD plan into Original
Medicare and also may add a stand-alone prescription drug
plan.
During the MA Open Enrollment Period, from January 1 - March
31, she may only disenroll from a MA or MA-PD plan but cannot
enroll in a stand-alone Part D plan.
During the MA Open Enrollment Period, from January 1 - March
31, she may only add or drop Part D coverage, so she cannot
switch back to Original Medicare.
, 5. If Mary Rodgers is considering switching from Original Medicare to the
ABC PFFS plan, what factors should she evaluate regarding her
potential costs?
She should compare the PFFS plan to her previous plan without
considering her current health needs.
She should focus solely on the prescription drug coverage
offered by the PFFS plan.
She should evaluate the treatment costs, provider acceptance,
and any additional services covered by the PFFS plan.
She should only consider the monthly premium of the PFFS plan.
6. Ms. Lee is enrolled in an MA-PD plan but will be moving out of the
plan's service area next month. She is worried that she will not be able
to enroll in another plan available in her new residence until the Annual
Election Period. What should you tell her?
She will be able to enroll in a new plan because she qualifies for
a Special Enrollment Period that begins 30 days after a plan's
written communications are returned by the United States Postal
Service with a notification that the resident has moved. So, she
should be sure to notify the Postal Service immediately.
She may continue to keep her existing plan, because all
Medicare health plans are required to provide coverage to
anyone, no matter where they live.
She will have to wait until the next Annual Election Period to be
able to enroll in a plan available in her new location.
She is eligible for a Special Election Period that begins either
the month before her permanent move, if the plan is notified in
advance, or the month she provides notice of the move, and
this period typically lasts an additional two months.
7. Describe the relationship between Medicare Part B enrollment and
