AHIP 2025 Final Exam Answer Key for 2025/2026 Certification Period
Contents
AHIP 2025 Final Exam Answer Key 1
1
, AHIP 2025 Final Exam Answer Key
1. Which of the following is a requirement for Medicare Advantage (MA) plans under
CMS guidelines?
A. MA plans must cover only Part A services.
B. MA plans must provide at least the same level of coverage as Original Medicare.
C. MA plans are not required to cover Part B services.
D. MA plans can exclude emergency care coverage.
Answer: B
Explanation: CMS requires MA plans to cover all Part A and Part B services pro-
vided by Original Medicare, often with additional benefits.
2. What is the annual deductible requirement for Part D plans in 2025 under the Inflation
Reduction Act (IRA)?
A. $545
B. $0 for all covered drugs
C. $35 for insulin products only
D. $250
Answer: B
Explanation: The IRA eliminates the Part D deductible for all covered drugs starting
in 2025, reducing out-of-pocket costs.
3. During which period can a beneficiary enroll in a Medicare Advantage plan if they
missed their Initial Enrollment Period (IEP)?
A. Annual Enrollment Period (AEP), October 15 to December 7
B. General Enrollment Period (GEP), January 1 to March 31
C. Special Enrollment Period (SEP), if they qualify
D. Both A and C
Answer: D
Explanation: Beneficiaries can enroll during AEP or an SEP if they qualify due to
specific circumstances (e.g., moving or losing coverage).
4. What is a key CMS marketing guideline for agents selling Medicare plans?
A. Agents can call beneficiaries without prior consent.
B. Agents must obtain a Scope of Appointment (SOA) before discussing plan options.
C. Agents can discuss non-Medicare products during an MA appointment.
D. Agents are not required to disclose their compensation.
Answer: B
Explanation: CMS requires an SOA to ensure beneficiaries consent to discuss specific
products, protecting against unsolicited marketing.
5. Which of the following is an example of fraud, waste, and abuse (FWA) in Medicare?
A. A provider billing for services not rendered
B. A beneficiary paying a copay for a covered service
C. An agent explaining plan benefits accurately
D. A plan offering a wellness program
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Contents
AHIP 2025 Final Exam Answer Key 1
1
, AHIP 2025 Final Exam Answer Key
1. Which of the following is a requirement for Medicare Advantage (MA) plans under
CMS guidelines?
A. MA plans must cover only Part A services.
B. MA plans must provide at least the same level of coverage as Original Medicare.
C. MA plans are not required to cover Part B services.
D. MA plans can exclude emergency care coverage.
Answer: B
Explanation: CMS requires MA plans to cover all Part A and Part B services pro-
vided by Original Medicare, often with additional benefits.
2. What is the annual deductible requirement for Part D plans in 2025 under the Inflation
Reduction Act (IRA)?
A. $545
B. $0 for all covered drugs
C. $35 for insulin products only
D. $250
Answer: B
Explanation: The IRA eliminates the Part D deductible for all covered drugs starting
in 2025, reducing out-of-pocket costs.
3. During which period can a beneficiary enroll in a Medicare Advantage plan if they
missed their Initial Enrollment Period (IEP)?
A. Annual Enrollment Period (AEP), October 15 to December 7
B. General Enrollment Period (GEP), January 1 to March 31
C. Special Enrollment Period (SEP), if they qualify
D. Both A and C
Answer: D
Explanation: Beneficiaries can enroll during AEP or an SEP if they qualify due to
specific circumstances (e.g., moving or losing coverage).
4. What is a key CMS marketing guideline for agents selling Medicare plans?
A. Agents can call beneficiaries without prior consent.
B. Agents must obtain a Scope of Appointment (SOA) before discussing plan options.
C. Agents can discuss non-Medicare products during an MA appointment.
D. Agents are not required to disclose their compensation.
Answer: B
Explanation: CMS requires an SOA to ensure beneficiaries consent to discuss specific
products, protecting against unsolicited marketing.
5. Which of the following is an example of fraud, waste, and abuse (FWA) in Medicare?
A. A provider billing for services not rendered
B. A beneficiary paying a copay for a covered service
C. An agent explaining plan benefits accurately
D. A plan offering a wellness program
2
