2027 AHIP Final Exam Practice Guide | Complete
Actual Exam Questions with Verified Correct
Answers and Detailed Rationales (100% Correct
Solutions) | Latest Updated Edition -226/2027 –
Already Graded A+
Question 1
You are meeting with Mrs. Hahn in her home. On her scope of appointment form,
she asked to discuss Medicare Advantage plans. During the meeting, she asked to
discuss a stand-alone prescription drug plan. What must happen before that
additional discussion can take place?
A. Since Mrs. Hahn specifically asked that you discuss the stand-alone Part D plan,
you may do so immediately without any additional paperwork.
B. Since Mrs. Hahn specifically asked that you discuss the stand-alone Part D plan,
you may do so, as long as she signs a new scope of appointment form first,
indicating that she wants to discuss the Part D plan.
C. You must end the meeting and reschedule for another day.
D. You may only discuss the Part D plan if her physician approves.
Answer: B
Rationale: A new Scope of Appointment (SOA) is required before discussing a
product not listed on the original SOA.
Question 2
Mr. Jerome Summers participated in Original Medicare for several years before
electing to enroll in a Medicare Savings Account (MSA) Medicare Advantage Plan
for the first time on November 1 during the Annual Election Period. He regrets his
decision and wants to change back to Original Medicare. How would you advise
him?
A. Mr. Summers may revoke his election if he does it no later than December 15 of
the same year. He is allowed to do this because he has never elected an MA MSA
pg. 1
,plan.
B. Mr. Summers must wait until the next Annual Election Period to make any
changes.
C. Mr. Summers can never return to Original Medicare once enrolled in an MSA
plan.
D. Mr. Summers must contact Medicare directly to request a special exception.
Answer: A
Rationale: MSA plans have a trial period allowing disenrollment by December 15.
Question 3
Mr. Ellis continued working with his company and was insured under his
employer's group plan until he reached age 68 when he retired. Five months later
he enrolled in Part B. He has heard there is a premium penalty for those who did
not sign up for Part B when first eligible. What should you tell him?
A. Mr. Ellis will pay a 10% penalty for each year he delayed enrollment.
B. Mr. Ellis will not pay any penalty because he had continuous coverage under his
employer's plan and he enrolled in Part B within the 8-month period immediately
following the last month he had group coverage.
C. Mr. Ellis will pay a 5% penalty for the five months he delayed enrollment.
D. Mr. Ellis must pay the full premium penalty for life.
Answer: B
Rationale: The 8-month Special Enrollment Period after group coverage ends
protects against Part B late enrollment penalties.
Question 4
Lucas Fields, turning age 65 next month, intends to work several more years at
Smallcap, Incorporated. Smallcap has 15 employees and offers employer-
sponsored healthcare coverage. Lucas asks if he will be entitled to Medicare and
how it will impact his employer coverage. How would you respond?
A. Lucas is not eligible for Medicare until he stops working.
B. Lucas is likely eligible for Medicare once he turns 65 and if he enrolls,
Medicare would become the primary payor of his healthcare claims and Smallcap
does not have to continue to offer him coverage comparable to those under age 65
pg. 2
,under its employer-sponsored group health plan and would become a secondary
payor.
C. Lucas must decline Medicare coverage while still working.
D. Smallcap must continue to be the primary payor regardless of Medicare
enrollment.
Answer: B
Rationale: For employers with fewer than 20 employees, Medicare is the primary
payer.
Question 5
Ms. Sutton is enrolled in an MA-PD plan but will be moving out of the plan's
service area next month. She is worried she will not be able to enroll in another
plan until the Annual Election Period. What should you tell her?
A. She must wait until the Annual Election Period to enroll in a new plan.
B. She is eligible for a special election period (SEP) 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.
C. She can only enroll in a stand-alone Part D plan after moving.
D. She will lose all Medicare coverage until the next AEP.
Answer: B
Rationale: Moving outside a plan's service area triggers an SEP.
Question 6
Agent Ethan Murphy has properly set up a sales appointment to meet with client
John Cook at Agent Murphy's office. At the agreed time, Mr. Cook arrives with his
elderly neighbor Clara Burton, who wants to learn about her Medicare Advantage
options. What should Agent Ethan Murphy do?
A. Ask Clara to leave immediately since she was not on the original appointment.
B. Discuss both John's and Clara's options without any additional paperwork.
C. After executing a scope of appointment (SOA) with Clara Burton, meet with
John Cook and Clara Burton to discuss their Medicare Advantage options.
D. Only discuss John's options and ignore Clara completely.
pg. 3
, Answer: C
Rationale: A separate SOA is required for Clara before discussing MA options.
Question 7
Which of the following individuals has enrolled in a plan based on a fixed
enrollment period?
A. Tran enrolls in a Medicare Advantage plan during the Special Enrollment Period
because he moved.
B. Tran enrolls in a Medicare Advantage plan during the Medicare Advantage
Open Enrollment Period (MA OEP).
C. Tran enrolls in a Medicare Advantage plan during the Initial Enrollment Period
for his 65th birthday.
D. Tran enrolls in a Medicare Advantage plan during the Annual Election Period.
Answer: C
Rationale: The IEP is a fixed enrollment period based on age 65.
Question 8
Mr. Washington is turning 65 next month and has asked what he can do, and when
he must do it, with respect to enrolling in Part D. What could you tell him?
A. He must wait until the Annual Election Period to enroll in Part D.
B. He is currently in the Part D Initial Enrollment Period (IEP), and during this
time, he may make one Part D enrollment choice, including enrollment in a stand-
alone Part D plan or an MA-PD plan.
C. He can only enroll in Part D if he first enrolls in a Medicare Advantage plan.
D. He has no deadline for enrolling in Part D.
Answer: B
Rationale: The Part D IEP allows one enrollment choice.
Question 9
Mrs. Dunn would like her daughter, who lives in another state, to meet with you
during the Annual Election Period to help her complete her enrollment in a Part D
plan. When should her daughter plan to visit?
pg. 4
Actual Exam Questions with Verified Correct
Answers and Detailed Rationales (100% Correct
Solutions) | Latest Updated Edition -226/2027 –
Already Graded A+
Question 1
You are meeting with Mrs. Hahn in her home. On her scope of appointment form,
she asked to discuss Medicare Advantage plans. During the meeting, she asked to
discuss a stand-alone prescription drug plan. What must happen before that
additional discussion can take place?
A. Since Mrs. Hahn specifically asked that you discuss the stand-alone Part D plan,
you may do so immediately without any additional paperwork.
B. Since Mrs. Hahn specifically asked that you discuss the stand-alone Part D plan,
you may do so, as long as she signs a new scope of appointment form first,
indicating that she wants to discuss the Part D plan.
C. You must end the meeting and reschedule for another day.
D. You may only discuss the Part D plan if her physician approves.
Answer: B
Rationale: A new Scope of Appointment (SOA) is required before discussing a
product not listed on the original SOA.
Question 2
Mr. Jerome Summers participated in Original Medicare for several years before
electing to enroll in a Medicare Savings Account (MSA) Medicare Advantage Plan
for the first time on November 1 during the Annual Election Period. He regrets his
decision and wants to change back to Original Medicare. How would you advise
him?
A. Mr. Summers may revoke his election if he does it no later than December 15 of
the same year. He is allowed to do this because he has never elected an MA MSA
pg. 1
,plan.
B. Mr. Summers must wait until the next Annual Election Period to make any
changes.
C. Mr. Summers can never return to Original Medicare once enrolled in an MSA
plan.
D. Mr. Summers must contact Medicare directly to request a special exception.
Answer: A
Rationale: MSA plans have a trial period allowing disenrollment by December 15.
Question 3
Mr. Ellis continued working with his company and was insured under his
employer's group plan until he reached age 68 when he retired. Five months later
he enrolled in Part B. He has heard there is a premium penalty for those who did
not sign up for Part B when first eligible. What should you tell him?
A. Mr. Ellis will pay a 10% penalty for each year he delayed enrollment.
B. Mr. Ellis will not pay any penalty because he had continuous coverage under his
employer's plan and he enrolled in Part B within the 8-month period immediately
following the last month he had group coverage.
C. Mr. Ellis will pay a 5% penalty for the five months he delayed enrollment.
D. Mr. Ellis must pay the full premium penalty for life.
Answer: B
Rationale: The 8-month Special Enrollment Period after group coverage ends
protects against Part B late enrollment penalties.
Question 4
Lucas Fields, turning age 65 next month, intends to work several more years at
Smallcap, Incorporated. Smallcap has 15 employees and offers employer-
sponsored healthcare coverage. Lucas asks if he will be entitled to Medicare and
how it will impact his employer coverage. How would you respond?
A. Lucas is not eligible for Medicare until he stops working.
B. Lucas is likely eligible for Medicare once he turns 65 and if he enrolls,
Medicare would become the primary payor of his healthcare claims and Smallcap
does not have to continue to offer him coverage comparable to those under age 65
pg. 2
,under its employer-sponsored group health plan and would become a secondary
payor.
C. Lucas must decline Medicare coverage while still working.
D. Smallcap must continue to be the primary payor regardless of Medicare
enrollment.
Answer: B
Rationale: For employers with fewer than 20 employees, Medicare is the primary
payer.
Question 5
Ms. Sutton is enrolled in an MA-PD plan but will be moving out of the plan's
service area next month. She is worried she will not be able to enroll in another
plan until the Annual Election Period. What should you tell her?
A. She must wait until the Annual Election Period to enroll in a new plan.
B. She is eligible for a special election period (SEP) 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.
C. She can only enroll in a stand-alone Part D plan after moving.
D. She will lose all Medicare coverage until the next AEP.
Answer: B
Rationale: Moving outside a plan's service area triggers an SEP.
Question 6
Agent Ethan Murphy has properly set up a sales appointment to meet with client
John Cook at Agent Murphy's office. At the agreed time, Mr. Cook arrives with his
elderly neighbor Clara Burton, who wants to learn about her Medicare Advantage
options. What should Agent Ethan Murphy do?
A. Ask Clara to leave immediately since she was not on the original appointment.
B. Discuss both John's and Clara's options without any additional paperwork.
C. After executing a scope of appointment (SOA) with Clara Burton, meet with
John Cook and Clara Burton to discuss their Medicare Advantage options.
D. Only discuss John's options and ignore Clara completely.
pg. 3
, Answer: C
Rationale: A separate SOA is required for Clara before discussing MA options.
Question 7
Which of the following individuals has enrolled in a plan based on a fixed
enrollment period?
A. Tran enrolls in a Medicare Advantage plan during the Special Enrollment Period
because he moved.
B. Tran enrolls in a Medicare Advantage plan during the Medicare Advantage
Open Enrollment Period (MA OEP).
C. Tran enrolls in a Medicare Advantage plan during the Initial Enrollment Period
for his 65th birthday.
D. Tran enrolls in a Medicare Advantage plan during the Annual Election Period.
Answer: C
Rationale: The IEP is a fixed enrollment period based on age 65.
Question 8
Mr. Washington is turning 65 next month and has asked what he can do, and when
he must do it, with respect to enrolling in Part D. What could you tell him?
A. He must wait until the Annual Election Period to enroll in Part D.
B. He is currently in the Part D Initial Enrollment Period (IEP), and during this
time, he may make one Part D enrollment choice, including enrollment in a stand-
alone Part D plan or an MA-PD plan.
C. He can only enroll in Part D if he first enrolls in a Medicare Advantage plan.
D. He has no deadline for enrolling in Part D.
Answer: B
Rationale: The Part D IEP allows one enrollment choice.
Question 9
Mrs. Dunn would like her daughter, who lives in another state, to meet with you
during the Annual Election Period to help her complete her enrollment in a Part D
plan. When should her daughter plan to visit?
pg. 4
