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Exam (elaborations)

2026 AHIP Certification Exam Actual Questions with Verified Answers and Rationales: Medicare Advantage, Part D, and Compliance Study Guide

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This document contains a comprehensive collection of actual AHIP 2026 Certification Exam questions with verified answers and detailed rationales, covering all exam sections aligned with the latest CMS and AHIP training modules. It addresses Medicare eligibility including age-based, disability-based, and ESRD-based enrollment, along with Part A, Part B, Part D, and Medigap coverage details with costs, deductibles, and coinsurance requirements. The document also covers Medicare Advantage plan types including HMOs, PPOs, PFFS, MSA, and SNPs with enrollment criteria and provider access rules, special enrollment periods including disaster-related and institutional discharge SEPs, and Part D prescription drug coverage including formularies, TrOOP, insulin cost caps, and vaccine coverage. Additional topics include marketing compliance rules, compensation and recoupment policies, educational versus marketing events, and prohibited marketing practices.

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September 20, 2026
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