[STUDY GUIDE] • HIGH-YIELD PRACTICE & REVIEW EDITION
AHIP Final Exam 2026/2027 Updated
Exam Questions and Verified
Answers
Comprehensive Examination Question Bank • Concept Mapping
TOTAL QUESTIONS EXAM TOPICS ANSWERS
105 Questions 11 Modules 100% Verified
DOCUMENT OVERVIEW
This document contains 105 verified questions with correct answers focusing on Medicare Advantage,
prescription drug coverage, and enrollment periods. Each question is designed to facilitate understanding of
Medicare regulations and options, making it suitable for exam preparation, review, and certification in health
insurance practices.
EXAM BLUEPRINT & TOPIC DISTRIBUTION
Systematic breakdown of subject domains and exam coverage.
Topic Module Scope & Core Focus Questions Share (%)
Explores the eligibility, benefits, and enrollment processes
Medicare Advantage Plans related to Medicare Advantage plans. 9 Qs 8.6%
Covers the aspects of Medicare Part D and prescription drug
Prescription Drug Coverage plans, including eligibility and coverage details. 9 Qs 8.6%
Examines the annual election period, special election periods,
Enrollment Periods and other enrollment timelines for Medicare. 9 Qs 8.6%
Discusses the coverage provided under Original Medicare
Medicare Parts A and B Parts A and B, focusing on benefits and eligibility. 9 Qs 8.6%
Addresses the guidelines and compliance issues related to
Marketing and Compliance marketing Medicare products and services. 9 Qs 8.6%
Explores the features and eligibility criteria for Medicare
Medicare Savings Accounts Savings Account plans. 9 Qs 8.6%
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,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
Focuses on the requirements and benefits of special needs
Special Needs Plans plans available to certain Medicare beneficiaries. 9 Qs 8.6%
Covers the processes for appealing Medicare decisions and
Appeals and Grievances addressing grievances. 9 Qs 8.6%
Discusses the options and assistance available for
Low-Income Subsidies low-income Medicare beneficiaries. 8 Qs 7.6%
Encourages understanding of how to compare different
Comparative Analysis of Plans Medicare plans and benefits. 8 Qs 7.6%
Includes fundamental questions about Medicare and its
General Medicare Knowledge structure. 17 Qs 16.2%
Total Exam Coverage 11 Integrated Topic Modules 105 Qs 100.0%
TOPIC 1: MEDICARE ADVANTAGE PLANS
9 Questions • 8.6% of Exam • Explores the eligibility, benefits, and enrollment processes related to Medicare Advantage plans.
QUESTION 1
Mrs. Radford asks whether there are any special eligibility requirements for Medicare
Advantage. What should you tell her?
Answer: Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage.
QUESTION 2
Which of the following individuals has enrolled in a plan based on a fixed enrollment
period?
Answer: Ben enrolls in a Medicare Advantage plan during the Medicare Advantage Open Enrollment Period
(MA
OEP).
QUESTION 3
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and
wonders what her options are for continuing MA-PD coverage. What would you say to
her in regard to a special enrollment period (SEP)?
Answer: She is likely to qualify for a SEP. She can choose an effective date of up to three months after the
month in which the enrollment form is received by the new plan, but the effective date may not be earlier than
the date of her permanent move.
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,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
QUESTION 4
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B
because he has coverage through an employer plan. If he wants to enroll in a Medicare
Advantage plan, what will he have to do?
Answer: He will have to enroll in Part B.
QUESTION 5
Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't sufficiently cover
his prescription drug
needs. He is interested in changing plans during the upcoming MA Open Enrollment
Period. What are his options during the MA OEP?
Answer: He can switch to a MA-PD plan.
QUESTION 6
Mr. Wells is trying to understand the difference between Original Medicare and
Medicare Advantage. What would be the correct description?
Answer: Medicare Advantage is a way of covering all the Original Medicare benefits through private health
insurance companies.
QUESTION 7
Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She is
considering enrollment in a Medicare Advantage plan (Part C). What should you advise
her to do before she can enroll in a Medicare Advantage plan?
Answer: To join a Medicare Advantage plan, she also must enroll in Part B.
Confidential • Student Study Edition • Practice & Review Guide Page 3 of 32
, STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
QUESTION 8
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and
would like to know which of the following services Original Medicare will cover if the
appropriate criteria are met. What could you tell her?
Answer: Original Medicare covers ambulance services.
QUESTION 9
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent.
It is one of three plans operated by the same organization in Mr. Lombardi's area. The
MA PPO plan does not include drug coverage, but the other two plans do. Mr. Lombardi
likes the PPO plan that does not include drug coverage and intends to obtain his drug
coverage through a stand-alone Medicare prescription drug plan. What should you tell
him about this situation?
Answer: He could enroll either in one of the MA plans that include prescription drug coverage or Original
Medicare with a Medigap plan and standalone Part D prescription drug coverage, but he cannot enroll in the
MA-only PPO plan and a stand-alone prescription drug plan.
TOPIC 2: PRESCRIPTION DRUG COVERAGE
9 Questions • 8.6% of Exam • Covers the aspects of Medicare Part D and prescription drug plans, including eligibility and coverage
details.
QUESTION 10
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him?
Answer: Mr. Carlini can stay with Original Medicare and also enroll in a Medicare prescription drug plan
through a private company that has contracted with the government to provide only such drug coverage to
eligible Medicare beneficiaries.
Confidential • Student Study Edition • Practice & Review Guide Page 4 of 32
AHIP Final Exam 2026/2027 Updated
Exam Questions and Verified
Answers
Comprehensive Examination Question Bank • Concept Mapping
TOTAL QUESTIONS EXAM TOPICS ANSWERS
105 Questions 11 Modules 100% Verified
DOCUMENT OVERVIEW
This document contains 105 verified questions with correct answers focusing on Medicare Advantage,
prescription drug coverage, and enrollment periods. Each question is designed to facilitate understanding of
Medicare regulations and options, making it suitable for exam preparation, review, and certification in health
insurance practices.
EXAM BLUEPRINT & TOPIC DISTRIBUTION
Systematic breakdown of subject domains and exam coverage.
Topic Module Scope & Core Focus Questions Share (%)
Explores the eligibility, benefits, and enrollment processes
Medicare Advantage Plans related to Medicare Advantage plans. 9 Qs 8.6%
Covers the aspects of Medicare Part D and prescription drug
Prescription Drug Coverage plans, including eligibility and coverage details. 9 Qs 8.6%
Examines the annual election period, special election periods,
Enrollment Periods and other enrollment timelines for Medicare. 9 Qs 8.6%
Discusses the coverage provided under Original Medicare
Medicare Parts A and B Parts A and B, focusing on benefits and eligibility. 9 Qs 8.6%
Addresses the guidelines and compliance issues related to
Marketing and Compliance marketing Medicare products and services. 9 Qs 8.6%
Explores the features and eligibility criteria for Medicare
Medicare Savings Accounts Savings Account plans. 9 Qs 8.6%
Confidential • Student Study Edition • Practice & Review Guide Page 1 of 32
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
Focuses on the requirements and benefits of special needs
Special Needs Plans plans available to certain Medicare beneficiaries. 9 Qs 8.6%
Covers the processes for appealing Medicare decisions and
Appeals and Grievances addressing grievances. 9 Qs 8.6%
Discusses the options and assistance available for
Low-Income Subsidies low-income Medicare beneficiaries. 8 Qs 7.6%
Encourages understanding of how to compare different
Comparative Analysis of Plans Medicare plans and benefits. 8 Qs 7.6%
Includes fundamental questions about Medicare and its
General Medicare Knowledge structure. 17 Qs 16.2%
Total Exam Coverage 11 Integrated Topic Modules 105 Qs 100.0%
TOPIC 1: MEDICARE ADVANTAGE PLANS
9 Questions • 8.6% of Exam • Explores the eligibility, benefits, and enrollment processes related to Medicare Advantage plans.
QUESTION 1
Mrs. Radford asks whether there are any special eligibility requirements for Medicare
Advantage. What should you tell her?
Answer: Mrs. Radford must be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage.
QUESTION 2
Which of the following individuals has enrolled in a plan based on a fixed enrollment
period?
Answer: Ben enrolls in a Medicare Advantage plan during the Medicare Advantage Open Enrollment Period
(MA
OEP).
QUESTION 3
Alice is enrolled in a MA-PD plan. She makes a permanent move across the country and
wonders what her options are for continuing MA-PD coverage. What would you say to
her in regard to a special enrollment period (SEP)?
Answer: She is likely to qualify for a SEP. She can choose an effective date of up to three months after the
month in which the enrollment form is received by the new plan, but the effective date may not be earlier than
the date of her permanent move.
Confidential • Student Study Edition • Practice & Review Guide Page 2 of 32
,STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
QUESTION 4
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B
because he has coverage through an employer plan. If he wants to enroll in a Medicare
Advantage plan, what will he have to do?
Answer: He will have to enroll in Part B.
QUESTION 5
Mr. Rodriguez is currently enrolled in a MA plan, but his plan doesn't sufficiently cover
his prescription drug
needs. He is interested in changing plans during the upcoming MA Open Enrollment
Period. What are his options during the MA OEP?
Answer: He can switch to a MA-PD plan.
QUESTION 6
Mr. Wells is trying to understand the difference between Original Medicare and
Medicare Advantage. What would be the correct description?
Answer: Medicare Advantage is a way of covering all the Original Medicare benefits through private health
insurance companies.
QUESTION 7
Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B. She is
considering enrollment in a Medicare Advantage plan (Part C). What should you advise
her to do before she can enroll in a Medicare Advantage plan?
Answer: To join a Medicare Advantage plan, she also must enroll in Part B.
Confidential • Student Study Edition • Practice & Review Guide Page 3 of 32
, STUDENT STUDY & MASTERY EDITION PRACTICE & REVIEW GUIDE
QUESTION 8
Mrs. Turner is comparing her employer's retiree insurance to Original Medicare and
would like to know which of the following services Original Medicare will cover if the
appropriate criteria are met. What could you tell her?
Answer: Original Medicare covers ambulance services.
QUESTION 9
Mr. Lombardi is interested in a Medicare Advantage (MA) PPO plan that you represent.
It is one of three plans operated by the same organization in Mr. Lombardi's area. The
MA PPO plan does not include drug coverage, but the other two plans do. Mr. Lombardi
likes the PPO plan that does not include drug coverage and intends to obtain his drug
coverage through a stand-alone Medicare prescription drug plan. What should you tell
him about this situation?
Answer: He could enroll either in one of the MA plans that include prescription drug coverage or Original
Medicare with a Medigap plan and standalone Part D prescription drug coverage, but he cannot enroll in the
MA-only PPO plan and a stand-alone prescription drug plan.
TOPIC 2: PRESCRIPTION DRUG COVERAGE
9 Questions • 8.6% of Exam • Covers the aspects of Medicare Part D and prescription drug plans, including eligibility and coverage
details.
QUESTION 10
Mr. Carlini has heard that Medicare prescription drug plans are only offered through
private companies under a program known as Medicare Advantage (MA), not by the
government. He likes Original Medicare and does not want to sign up for an MA
product, but he also wants prescription drug coverage. What should you tell him?
Answer: Mr. Carlini can stay with Original Medicare and also enroll in a Medicare prescription drug plan
through a private company that has contracted with the government to provide only such drug coverage to
eligible Medicare beneficiaries.
Confidential • Student Study Edition • Practice & Review Guide Page 4 of 32
