AHIP FINAL EXAM WITH 130+ ACTUAL EXAM
QUESTIONS AND CORRECT ANSWERS (EXPERT
VERIFIED SOLUTIONS) AHIP FINAL EXAM /2025
(NEW!!) MOST RECENT TESTED QUESTIONS
COVERED
THE AHIP FINAL EXAM 2025 STUDY GUIDE INCLUDES THE MOST COMMONLY
TESTED QUESTIONS ON MEDICARE REGULATIONS, ENROLLMENT ELIGIBILITY,
AND ETHICAL SALES PRACTICES. BUILT TO ALIGN WITH CURRENT CMS AND
AHIP TRAINING STANDARDS, THIS RESOURCE GUARANTEES A PASS BY
DELIVERING TARGETED, SCENARIO-BASED PRACTICE AND ACCURATE ANSWER
KEYS—IDEAL FOR INSURANCE PROFESSIONALS SEEKING CERTIFICATION
RENEWAL OR INITIAL LICENSURE.
Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare
coverage due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward
successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his
Medicare coverage will continue, what should you say? - CORRECT ANSWER-Individuals eligible
for Medicare based on ESRD generally lose eligibility 36 months after the month in which the
individual receives a kidney transplant unless they are eligible for Medicare on another basis such as
age or disability. Edward may, however, remain enrolled in Part B but solely for coverage of
immunosuppressive drugs if he has no other health care coverage that would cover the drugs.
Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. Mildred recently
learned that she is suffering from inoperable cancer and has just a few months to live. She would like
to spend these final months in hospice care. Mildred's family asks you whether hospice benefits will
be paid for under the Allcare Medicare Advantage plan. What should you say? - CORRECT
ANSWER-Mildred may remain enrolled in Allcare and make a hospice election. Hospice benefits
will be paid for by Original Medicare under Part A and Allcare will continue to pay for any non-
hospice services.
Mr. Diaz continued working with his company and was insured under his employer's group plan until
he reached age 68. He has heard that there is a premium penalty for those who did not sign up for
Part B when first eligible and wants to know how much he will have to pay. What should you tell
him? - CORRECT ANSWER-Mr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
,You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in
your state. You have completed the required training for each plan, but you did not achieve a
passing score on the tests that came after the training. What can you do in this situation? -
CORRECT ANSWER-You will not be able to represent any Medicare Advantage or Part D plan
until you complete the training and achieve an adequate score. However, you will not have to take a
test if you exclusively market employer/union group plans and the companies do not require testing.
Another agent you know has engaged in misconduct that has been verified by the plan she
represented. What sort of penalty might the plan impose on this individual? - CORRECT
ANSWER-The plan may withhold commission, require retraining, report the misconduct to a state
department of insurance or terminate the contract.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees' information to
market non-health related products such as life insurance and annuities. Which statement best
describes ABC's obligation to its enrollees regarding marketing such products? - CORRECT
ANSWER-It must obtain a HIPAA compliant authorization from an enrollee that indicates the plan
or plan sponsor may use their information for marketing purposes.
You have been providing a pre-Thanksgiving meal during sales presentations in November for many
years and your clients look forward to attending this annual event. When marketing Medicare
Advantage and Part D plans, what are you permitted to do with respect to meals? - CORRECT
ANSWER-You may provide light snacks, but a Thanksgiving style meal would be prohibited,
regardless of who provides or pays for the meal.
You have sought permission from a hospital to place brochures for your product in their gift shop
and cafeteria. The hospital administration expresses some hesitation about allowing marketing in a
health care facility. What should you tell them? - CORRECT ANSWER-Marketing in health care
facilities is an acceptable practice, as long as it takes place in common areas where patients are not
receiving health care services.
Another agent working for your agency claims that because you are not employed by the Medicare
Advantage plans that you represent, you are not subject to the same marketing requirements as the
plans themselves. How should you respond to such a statement? - CORRECT ANSWER-Your
coworker is not correct. Marketing on behalf of a plan is considered marketing by the plan and
requires that all contracted and employed agents comply with all Medicare marketing rules.
, Evan Marsh is a newly appointed agent. Evan intends to conduct an educational session on Medicare
at a senior citizens center near his home. He has advertised the session as an educational event.
Evan asks you what is permissible at such an event. What should you say? - CORRECT ANSWER-
Evan may provide a meal as long as its value is $15 or less per attendee and he may make available
business reply cards (BRCs).
Hector Hernandez is an independent agent. Hector sells plans on behalf of three Medicare
Advantage organizations that offer a total of 10 plans but does not represent all Medicare
Advantage organizations offering plans that are available in his area. Which of the following
statements best describes any steps Hector is required to take? - CORRECT ANSWER-During the
first minute of a sales call, Hector must use a disclaimer that says "I do not represent every plan
available in your area. I represent 3 organizations that offer 10 plans in your area. Please contact
Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on
all your options."
Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and asks you for
advice as to whether this is possible. What should you tell her? - CORRECT ANSWER-Marketing
representatives may initiate electronic contact through e-mail but an opt-out process must be
provided.
Sal D'Angelo is new to the Medicare marketplace having previously been focused on life insurance
and disability income protection products. He intends to conduct an educational seminar during the
AEP at a local hotel and then invite those who attend to a subsequent marketing meeting to discuss
the benefits of next year's plans. How would you advise Sal? - CORRECT ANSWER-Sal should
conduct the education seminar as an early morning meeting and the marketing meeting on the
following day in the late afternoon so that there are at least 12 hours between the two meetings.
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial Coverage
Election Period (ICEP) has just begun. Which of the following can she not do during the ICEP? -
CORRECT ANSWER-She can enroll in a Medigap plan to supplement the benefits of the MA plan
that she's also enrolling in.
You are visiting with Mr. Tully and his daughter at her request. He has advanced Alzheimer's and is
incapable of understanding the implications of choosing a Medicare Advantage or prescription drug
plan. Can his daughter fill out the enrollment form and sign it for him? - CORRECT ANSWER-Mr.
Tully's daughter can do so only, if she is authorized under state law as a court-appointed legal
guardian, has a durable power of attorney for health care decisions, or is authorized under state
surrogate consent laws to make health decisions.
QUESTIONS AND CORRECT ANSWERS (EXPERT
VERIFIED SOLUTIONS) AHIP FINAL EXAM /2025
(NEW!!) MOST RECENT TESTED QUESTIONS
COVERED
THE AHIP FINAL EXAM 2025 STUDY GUIDE INCLUDES THE MOST COMMONLY
TESTED QUESTIONS ON MEDICARE REGULATIONS, ENROLLMENT ELIGIBILITY,
AND ETHICAL SALES PRACTICES. BUILT TO ALIGN WITH CURRENT CMS AND
AHIP TRAINING STANDARDS, THIS RESOURCE GUARANTEES A PASS BY
DELIVERING TARGETED, SCENARIO-BASED PRACTICE AND ACCURATE ANSWER
KEYS—IDEAL FOR INSURANCE PROFESSIONALS SEEKING CERTIFICATION
RENEWAL OR INITIAL LICENSURE.
Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare
coverage due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward
successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his
Medicare coverage will continue, what should you say? - CORRECT ANSWER-Individuals eligible
for Medicare based on ESRD generally lose eligibility 36 months after the month in which the
individual receives a kidney transplant unless they are eligible for Medicare on another basis such as
age or disability. Edward may, however, remain enrolled in Part B but solely for coverage of
immunosuppressive drugs if he has no other health care coverage that would cover the drugs.
Mildred Savage enrolled in Allcare Medicare Advantage plan several years ago. Mildred recently
learned that she is suffering from inoperable cancer and has just a few months to live. She would like
to spend these final months in hospice care. Mildred's family asks you whether hospice benefits will
be paid for under the Allcare Medicare Advantage plan. What should you say? - CORRECT
ANSWER-Mildred may remain enrolled in Allcare and make a hospice election. Hospice benefits
will be paid for by Original Medicare under Part A and Allcare will continue to pay for any non-
hospice services.
Mr. Diaz continued working with his company and was insured under his employer's group plan until
he reached age 68. He has heard that there is a premium penalty for those who did not sign up for
Part B when first eligible and wants to know how much he will have to pay. What should you tell
him? - CORRECT ANSWER-Mr. Diaz will not pay any penalty because he had continuous
coverage under his employer's plan.
,You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in
your state. You have completed the required training for each plan, but you did not achieve a
passing score on the tests that came after the training. What can you do in this situation? -
CORRECT ANSWER-You will not be able to represent any Medicare Advantage or Part D plan
until you complete the training and achieve an adequate score. However, you will not have to take a
test if you exclusively market employer/union group plans and the companies do not require testing.
Another agent you know has engaged in misconduct that has been verified by the plan she
represented. What sort of penalty might the plan impose on this individual? - CORRECT
ANSWER-The plan may withhold commission, require retraining, report the misconduct to a state
department of insurance or terminate the contract.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its enrollees' information to
market non-health related products such as life insurance and annuities. Which statement best
describes ABC's obligation to its enrollees regarding marketing such products? - CORRECT
ANSWER-It must obtain a HIPAA compliant authorization from an enrollee that indicates the plan
or plan sponsor may use their information for marketing purposes.
You have been providing a pre-Thanksgiving meal during sales presentations in November for many
years and your clients look forward to attending this annual event. When marketing Medicare
Advantage and Part D plans, what are you permitted to do with respect to meals? - CORRECT
ANSWER-You may provide light snacks, but a Thanksgiving style meal would be prohibited,
regardless of who provides or pays for the meal.
You have sought permission from a hospital to place brochures for your product in their gift shop
and cafeteria. The hospital administration expresses some hesitation about allowing marketing in a
health care facility. What should you tell them? - CORRECT ANSWER-Marketing in health care
facilities is an acceptable practice, as long as it takes place in common areas where patients are not
receiving health care services.
Another agent working for your agency claims that because you are not employed by the Medicare
Advantage plans that you represent, you are not subject to the same marketing requirements as the
plans themselves. How should you respond to such a statement? - CORRECT ANSWER-Your
coworker is not correct. Marketing on behalf of a plan is considered marketing by the plan and
requires that all contracted and employed agents comply with all Medicare marketing rules.
, Evan Marsh is a newly appointed agent. Evan intends to conduct an educational session on Medicare
at a senior citizens center near his home. He has advertised the session as an educational event.
Evan asks you what is permissible at such an event. What should you say? - CORRECT ANSWER-
Evan may provide a meal as long as its value is $15 or less per attendee and he may make available
business reply cards (BRCs).
Hector Hernandez is an independent agent. Hector sells plans on behalf of three Medicare
Advantage organizations that offer a total of 10 plans but does not represent all Medicare
Advantage organizations offering plans that are available in his area. Which of the following
statements best describes any steps Hector is required to take? - CORRECT ANSWER-During the
first minute of a sales call, Hector must use a disclaimer that says "I do not represent every plan
available in your area. I represent 3 organizations that offer 10 plans in your area. Please contact
Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on
all your options."
Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and asks you for
advice as to whether this is possible. What should you tell her? - CORRECT ANSWER-Marketing
representatives may initiate electronic contact through e-mail but an opt-out process must be
provided.
Sal D'Angelo is new to the Medicare marketplace having previously been focused on life insurance
and disability income protection products. He intends to conduct an educational seminar during the
AEP at a local hotel and then invite those who attend to a subsequent marketing meeting to discuss
the benefits of next year's plans. How would you advise Sal? - CORRECT ANSWER-Sal should
conduct the education seminar as an early morning meeting and the marketing meeting on the
following day in the late afternoon so that there are at least 12 hours between the two meetings.
Mrs. Reeves is newly eligible to enroll in a Medicare Advantage plan and her MA Initial Coverage
Election Period (ICEP) has just begun. Which of the following can she not do during the ICEP? -
CORRECT ANSWER-She can enroll in a Medigap plan to supplement the benefits of the MA plan
that she's also enrolling in.
You are visiting with Mr. Tully and his daughter at her request. He has advanced Alzheimer's and is
incapable of understanding the implications of choosing a Medicare Advantage or prescription drug
plan. Can his daughter fill out the enrollment form and sign it for him? - CORRECT ANSWER-Mr.
Tully's daughter can do so only, if she is authorized under state law as a court-appointed legal
guardian, has a durable power of attorney for health care decisions, or is authorized under state
surrogate consent laws to make health decisions.
