AHIP FINAL EXAM EVALUATION TEST QUESTIONS WITH
ANSWERS GRADED A+ 2025/2026
During a sales presentation in Ms. Sullivan's home, she tells you that she has heard
about a type of Medicare health plan known as Private Fee-for-Service (PFFS). She
wants to know if this would be available to her. What should you tell her about PFFS
plans? -
Choose one answer. -
- a. A PFFS plan is a type of Medicare Supplement plan and she may enroll in one if it
is available in her area.
- b. A PFFS plan is exactly the same as Original Medicare, only offered by a private
entity and she may enroll in one if it is available in her area.
- c. PFFS plans are designed to cover only prescription drugs and if that is the type of
coverage she wants, she may enroll in one if it is available in her area.
- d. A PFFS plan is one of the various types of Medicare Advantage plans offered by
private entities and she may enroll in one if it is available in her area.
Question8 -
Marks: 1 -
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug
plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone prescription drug
plan (Part D plan) that his neighbor told him about. What should his agent do? -
Choose one answer. -
- a. Since Mr. Peters requested a description of the Part D plan, his agent must leave
the Part D plan brochure, but not an enrollment form, and would have to schedule
another appointment after at least 48 hours have passed to discuss the Part D plan with
Mr. Peters.
- b. Since Mr. Peters requested a description of the Part D plan, his agent must have
Mr. Peters sign a new scope of appointment form that includes Part D, and then the
agent may discuss the Part D plan so Mr. Peters can compare plans and make an
informed enrollment choice during the appointment.
- c. Since Mr. Peters requested a description of the Part D plan, his agent must inform
Mr. Peters that he can only sign up for the MA-PD plan and cannot receive a brochure
or any other information about the Part D plan now because he did not agree in
advance to discuss that plan
, - d. Since Mr. Peters requested a description of the Part D plan, his agent must discuss
both the Part D and the MA-PD plans and return after at least 48 hours to complete the
Part D plan enrollment form with Mr. Peters.
Question9 -
Marks: 1 -
Mr. Torres has a small savings account. He would like to pay for his monthly Part D
premiums with an automatic monthly withdrawal from his savings account until it is
exhausted, and then have his premiums withheld from his Social Security check. What
should you tell him? -
Choose one answer. -
- a. In general, he must select a single Part D premium payment mechanism that will be
used throughout the year.
- b. As long as he fills out the paperwork to begin withholding from his Social Security
check at least 63 days before such withholding should begin, he can change his method
of Part D premium payment and withholding will begin the month after his savings
account is exhausted.
- c. During 2017, many people experienced significant problems with deductions from
their Social Security check for their Part D premium. As a result, this method of payment
is no longer an option for Part D premium payments
- d. In general, to pay his Part D premium, he only can have automatic withdrawals
made from a checking account, so he will need to transfer the funds prior to beginning
such withdrawals.
Question10 -
Marks: 1 -
Since 2004 Ms. Eisenberg has had a Medigap plan that provides some drug coverage.
She has recently received a letter from her Medigap carrier informing her that her drug
coverage is not "creditable." She wants to know what this means. What should you tell
her? -
Choose one answer. -
- a. The letter is to inform her that her Medigap drug coverage must be supplemented
by purchasing coverage under a Part D plan. If she does not do so within 63 days, she
will not be able to obtain Part D coverage at a later date.
, - b. The letter is to inform her that the drug coverage offered through her Medigap plan
does not offer drug coverage that is at least comparable to that provided under the
Medicare Part D prescription drug program. If she does not have such creditable
coverage during periods when she is first eligible for the Part D program, she will face a
premium penalty if she enrolls in a Part D plan at a later date.
- c. The letter is to inform her that her Medigap plan's coverage has been determined
by the Federal government to be inadequate and the plan must therefore discontinue
offering such coverage. Ms. Eisenberg will have to select a different Medigap plan if she
wants drug coverage.
- d. The letter is to inform her that Medicare Part D prescription drug coverage is
available, but there is no need for her to change her drug coverage since it is just as
good as Part D. She may keep her current coverage through the Medigap plan.
Question11 -
Marks: 1 -
Richard is a licensed agent who represents Spartan Health Plan and its Medicare
Advantage (MA) plans. Richard has several clients who have recently come to him for
help who are in their initial coverage election period (ICEP) and are interested in
enrolling in one of Spartan Health Plan's MA plans. Alice will soon turn 65 and retire.
Alice has coverage through Spartan Health Plan offered by her employer. Bob had
health coverage through Spartan but dropped the coverage when he retired early to
travel overseas. Bob, who has just turned age 65, is now back in the United States.
Charlotte, who will turn 65 next month, has coverage through Athena Health plan - a
company Richard also represents. Who qualifies for the opt-in simplified enrollment
mechanism? -
Choose one answer. -
- a. Alice because she will not have a break between her non-Medicare and Medicare
coverage through Spartan Health Plan.
- b. Alice and Charlotte because each of them currently have health coverage and is in
their initial coverage election period (ICEP).
- c. Alice and Bob because each of them has had coverage through Spartan Health
Plan.
- d. Alice, Bob, and Charlotte because electronic health record interoperability will allow
Richard to access any needed information for their applications.
Question12 -
ANSWERS GRADED A+ 2025/2026
During a sales presentation in Ms. Sullivan's home, she tells you that she has heard
about a type of Medicare health plan known as Private Fee-for-Service (PFFS). She
wants to know if this would be available to her. What should you tell her about PFFS
plans? -
Choose one answer. -
- a. A PFFS plan is a type of Medicare Supplement plan and she may enroll in one if it
is available in her area.
- b. A PFFS plan is exactly the same as Original Medicare, only offered by a private
entity and she may enroll in one if it is available in her area.
- c. PFFS plans are designed to cover only prescription drugs and if that is the type of
coverage she wants, she may enroll in one if it is available in her area.
- d. A PFFS plan is one of the various types of Medicare Advantage plans offered by
private entities and she may enroll in one if it is available in her area.
Question8 -
Marks: 1 -
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug
plan (MA-PD), Mr. Peters asked his agent to describe a stand-alone prescription drug
plan (Part D plan) that his neighbor told him about. What should his agent do? -
Choose one answer. -
- a. Since Mr. Peters requested a description of the Part D plan, his agent must leave
the Part D plan brochure, but not an enrollment form, and would have to schedule
another appointment after at least 48 hours have passed to discuss the Part D plan with
Mr. Peters.
- b. Since Mr. Peters requested a description of the Part D plan, his agent must have
Mr. Peters sign a new scope of appointment form that includes Part D, and then the
agent may discuss the Part D plan so Mr. Peters can compare plans and make an
informed enrollment choice during the appointment.
- c. Since Mr. Peters requested a description of the Part D plan, his agent must inform
Mr. Peters that he can only sign up for the MA-PD plan and cannot receive a brochure
or any other information about the Part D plan now because he did not agree in
advance to discuss that plan
, - d. Since Mr. Peters requested a description of the Part D plan, his agent must discuss
both the Part D and the MA-PD plans and return after at least 48 hours to complete the
Part D plan enrollment form with Mr. Peters.
Question9 -
Marks: 1 -
Mr. Torres has a small savings account. He would like to pay for his monthly Part D
premiums with an automatic monthly withdrawal from his savings account until it is
exhausted, and then have his premiums withheld from his Social Security check. What
should you tell him? -
Choose one answer. -
- a. In general, he must select a single Part D premium payment mechanism that will be
used throughout the year.
- b. As long as he fills out the paperwork to begin withholding from his Social Security
check at least 63 days before such withholding should begin, he can change his method
of Part D premium payment and withholding will begin the month after his savings
account is exhausted.
- c. During 2017, many people experienced significant problems with deductions from
their Social Security check for their Part D premium. As a result, this method of payment
is no longer an option for Part D premium payments
- d. In general, to pay his Part D premium, he only can have automatic withdrawals
made from a checking account, so he will need to transfer the funds prior to beginning
such withdrawals.
Question10 -
Marks: 1 -
Since 2004 Ms. Eisenberg has had a Medigap plan that provides some drug coverage.
She has recently received a letter from her Medigap carrier informing her that her drug
coverage is not "creditable." She wants to know what this means. What should you tell
her? -
Choose one answer. -
- a. The letter is to inform her that her Medigap drug coverage must be supplemented
by purchasing coverage under a Part D plan. If she does not do so within 63 days, she
will not be able to obtain Part D coverage at a later date.
, - b. The letter is to inform her that the drug coverage offered through her Medigap plan
does not offer drug coverage that is at least comparable to that provided under the
Medicare Part D prescription drug program. If she does not have such creditable
coverage during periods when she is first eligible for the Part D program, she will face a
premium penalty if she enrolls in a Part D plan at a later date.
- c. The letter is to inform her that her Medigap plan's coverage has been determined
by the Federal government to be inadequate and the plan must therefore discontinue
offering such coverage. Ms. Eisenberg will have to select a different Medigap plan if she
wants drug coverage.
- d. The letter is to inform her that Medicare Part D prescription drug coverage is
available, but there is no need for her to change her drug coverage since it is just as
good as Part D. She may keep her current coverage through the Medigap plan.
Question11 -
Marks: 1 -
Richard is a licensed agent who represents Spartan Health Plan and its Medicare
Advantage (MA) plans. Richard has several clients who have recently come to him for
help who are in their initial coverage election period (ICEP) and are interested in
enrolling in one of Spartan Health Plan's MA plans. Alice will soon turn 65 and retire.
Alice has coverage through Spartan Health Plan offered by her employer. Bob had
health coverage through Spartan but dropped the coverage when he retired early to
travel overseas. Bob, who has just turned age 65, is now back in the United States.
Charlotte, who will turn 65 next month, has coverage through Athena Health plan - a
company Richard also represents. Who qualifies for the opt-in simplified enrollment
mechanism? -
Choose one answer. -
- a. Alice because she will not have a break between her non-Medicare and Medicare
coverage through Spartan Health Plan.
- b. Alice and Charlotte because each of them currently have health coverage and is in
their initial coverage election period (ICEP).
- c. Alice and Bob because each of them has had coverage through Spartan Health
Plan.
- d. Alice, Bob, and Charlotte because electronic health record interoperability will allow
Richard to access any needed information for their applications.
Question12 -
