AHIP Final Exam 2027: 171+ Real Exam
Questions & Answers with Detailed Rationales
(Latest Verified Version)
Question 1
Mr. Davis is enrolled in a Medicare Advantage (MA) plan. He wants to know if
he must continue paying his Medicare Part B premium after enrolling in the MA
plan. What should the agent tell him?
A) No, the Medicare Advantage plan completely replaces the need to pay the
Part B premium.
B) Yes, he must continue to pay his Part B premium to the federal government
to remain enrolled in the MA plan.
C) He only pays the Part B premium if his MA plan has a monthly premium
,greater than $0.
D) The Part B premium is waived if he has been enrolled in Medicare for more
than five years.
VERIFIED ANSWER: B
EXPLANATION: To be eligible to enroll in a Medicare Advantage (Part C)
plan, a beneficiary must be entitled to Medicare Part A and actively enrolled
in Medicare Part B. Enrolling in an MA plan does not eliminate the
requirement to pay the standard monthly Part B premium to the federal
government, unless that premium is paid on their behalf by Medicaid or
another third party.
Question 2
Mrs. Gonzalez qualifies for Medicare due to age. She has accumulated 38
quarters of coverage under Social Security through her employment history.
Which of the following is true regarding her Part A enrollment?
A) She is entitled to premium-free Part A because she has more than 30 quarters
of coverage.
B) She cannot enroll in Part A under any circumstances until she reaches 40
quarters.
C) She must pay a monthly premium for Part A, but it will be a reduced
premium compared to someone with fewer than 30 quarters.
D) She must wait an additional two years before she can enroll in Part A.
VERIFIED ANSWER: C
EXPLANATION: Individuals who do not qualify for premium-free Medicare
Part A (which requires 40 quarters of covered employment) can purchase it if
,they meet citizenship and residency requirements. For beneficiaries with 30 to
39 quarters of coverage, a reduced monthly premium applies. Those with
fewer than 30 quarters pay the full premium.
Question 3
An agent is conducting a sales presentation for a Medicare Advantage plan.
During the meeting, the consumer mentions they also have a stand-alone
prescription drug plan (PDP). What must the agent explain if the consumer
enrolls in a Medicare Advantage HMO plan that includes prescription drug
coverage (MAPD)?
A) The consumer can keep both plans and use whichever one offers a lower
copay at the pharmacy.
B) Enrolling in the MAPD plan will automatically disenroll them from their
current stand-alone PDP.
C) The stand-alone PDP will automatically become a secondary payer to the
MAPD plan.
D) The consumer must manually call their old PDP provider to cancel it within
48 hours.
VERIFIED ANSWER: B
EXPLANATION: A beneficiary cannot hold both a Medicare Advantage plan
with prescription drug coverage (MAPD) and a stand-alone Prescription
Drug Plan (PDP) at the same time. Enrolling in an MAPD plan automatically
disenrolls the individual from their existing stand-alone PDP.
, Question 4
Under standard CMS marketing regulations, which of the following activities is
an agent explicitly permitted to perform during an educational event?
A) Distribute plan-specific enrollment applications.
B) Distribute generic educational materials and business cards.
C) Collect completed Scope of Appointment (SOA) forms for future individual
sales appointments.
D) Compare specific plan premium rates and copay structures.
VERIFIED ANSWER: B
EXPLANATION: Educational events are designed to inform beneficiaries
about Medicare programs generic options. CMS strictly prohibits marketing
or sales activities at these events, including distributing plan applications or
collecting SOAs. Distributing generic educational items, flyers, and agent
contact information/business cards is permitted.
Question 5
During an individual sales appointment for a Medicare Advantage plan, the
consumer expresses interest in purchasing a dental insurance policy not
associated with the MA plan. Under Scope of Appointment (SOA) guidelines,
what must the agent do?
A) The agent can immediately present the standalone dental plan without any
documentation.
B) The agent must document a new Scope of Appointment for the non-health
product, but does not need to wait 48 hours.
Questions & Answers with Detailed Rationales
(Latest Verified Version)
Question 1
Mr. Davis is enrolled in a Medicare Advantage (MA) plan. He wants to know if
he must continue paying his Medicare Part B premium after enrolling in the MA
plan. What should the agent tell him?
A) No, the Medicare Advantage plan completely replaces the need to pay the
Part B premium.
B) Yes, he must continue to pay his Part B premium to the federal government
to remain enrolled in the MA plan.
C) He only pays the Part B premium if his MA plan has a monthly premium
,greater than $0.
D) The Part B premium is waived if he has been enrolled in Medicare for more
than five years.
VERIFIED ANSWER: B
EXPLANATION: To be eligible to enroll in a Medicare Advantage (Part C)
plan, a beneficiary must be entitled to Medicare Part A and actively enrolled
in Medicare Part B. Enrolling in an MA plan does not eliminate the
requirement to pay the standard monthly Part B premium to the federal
government, unless that premium is paid on their behalf by Medicaid or
another third party.
Question 2
Mrs. Gonzalez qualifies for Medicare due to age. She has accumulated 38
quarters of coverage under Social Security through her employment history.
Which of the following is true regarding her Part A enrollment?
A) She is entitled to premium-free Part A because she has more than 30 quarters
of coverage.
B) She cannot enroll in Part A under any circumstances until she reaches 40
quarters.
C) She must pay a monthly premium for Part A, but it will be a reduced
premium compared to someone with fewer than 30 quarters.
D) She must wait an additional two years before she can enroll in Part A.
VERIFIED ANSWER: C
EXPLANATION: Individuals who do not qualify for premium-free Medicare
Part A (which requires 40 quarters of covered employment) can purchase it if
,they meet citizenship and residency requirements. For beneficiaries with 30 to
39 quarters of coverage, a reduced monthly premium applies. Those with
fewer than 30 quarters pay the full premium.
Question 3
An agent is conducting a sales presentation for a Medicare Advantage plan.
During the meeting, the consumer mentions they also have a stand-alone
prescription drug plan (PDP). What must the agent explain if the consumer
enrolls in a Medicare Advantage HMO plan that includes prescription drug
coverage (MAPD)?
A) The consumer can keep both plans and use whichever one offers a lower
copay at the pharmacy.
B) Enrolling in the MAPD plan will automatically disenroll them from their
current stand-alone PDP.
C) The stand-alone PDP will automatically become a secondary payer to the
MAPD plan.
D) The consumer must manually call their old PDP provider to cancel it within
48 hours.
VERIFIED ANSWER: B
EXPLANATION: A beneficiary cannot hold both a Medicare Advantage plan
with prescription drug coverage (MAPD) and a stand-alone Prescription
Drug Plan (PDP) at the same time. Enrolling in an MAPD plan automatically
disenrolls the individual from their existing stand-alone PDP.
, Question 4
Under standard CMS marketing regulations, which of the following activities is
an agent explicitly permitted to perform during an educational event?
A) Distribute plan-specific enrollment applications.
B) Distribute generic educational materials and business cards.
C) Collect completed Scope of Appointment (SOA) forms for future individual
sales appointments.
D) Compare specific plan premium rates and copay structures.
VERIFIED ANSWER: B
EXPLANATION: Educational events are designed to inform beneficiaries
about Medicare programs generic options. CMS strictly prohibits marketing
or sales activities at these events, including distributing plan applications or
collecting SOAs. Distributing generic educational items, flyers, and agent
contact information/business cards is permitted.
Question 5
During an individual sales appointment for a Medicare Advantage plan, the
consumer expresses interest in purchasing a dental insurance policy not
associated with the MA plan. Under Scope of Appointment (SOA) guidelines,
what must the agent do?
A) The agent can immediately present the standalone dental plan without any
documentation.
B) The agent must document a new Scope of Appointment for the non-health
product, but does not need to wait 48 hours.
