AHIP Exam Latest (2025/2026) Questions And Correct
Answers (Verified Answers) Plus Rationales 2025 Q&A
| Instant Download
1. Which enrollment period allows individuals to change their Medicare
Advantage plan each year?
Annual Enrollment Period (AEP)
The AEP runs from October 15 to December 7 every year, during which
beneficiaries can switch, enroll, or drop Medicare Advantage or Part D
plans.
2. Which entity approves marketing materials for Medicare Advantage plans?
Centers for Medicare & Medicaid Services (CMS)
CMS must review and approve all MA marketing materials to ensure they
are compliant with federal guidelines.
3. Which statement is true regarding agents discussing plan options with
potential enrollees?
They must only discuss plans agreed upon in the Scope of Appointment.
A Scope of Appointment form limits what products the agent can discuss,
ensuring compliance and avoiding unsolicited marketing.
4. When does the Medicare Initial Enrollment Period (IEP) occur?
It is a 7-month period surrounding an individual’s 65th birthday.
IEP includes the 3 months before, the month of, and the 3 months after
the 65th birthday month.
,5. What is the primary purpose of the Medicare Summary Notice (MSN)?
To inform beneficiaries about claims that Medicare has processed.
The MSN is a statement that explains what was billed to Medicare, what
Medicare paid, and what the beneficiary may owe.
6. What must agents do when leaving plan information with a beneficiary?
Leave only CMS-approved materials.
Only CMS-approved materials can be left behind to ensure accurate,
compliant information.
7. Which of these individuals is eligible for Medicare?
A 65-year-old who worked 40 quarters and is a U.S. citizen.
Most people qualify at 65 if they or their spouse worked and paid
Medicare taxes for at least 40 quarters.
8. Which marketing practice is strictly prohibited?
Offering cash as an incentive for enrollment.
CMS prohibits cash or monetary rebates to entice enrollment, which could
be considered inducement.
9. When must the Scope of Appointment form be completed?
Prior to discussing plan details.
This ensures that the beneficiary understands and agrees to the topics to
be discussed.
10.What does Medicare Part B cover?
Medically necessary outpatient services and preventive care.
Part B covers physician visits, outpatient procedures, durable medical
equipment, and preventive services.
, 11.What happens if a beneficiary enrolls in a Medicare Advantage plan and
later wants to switch back to Original Medicare?
They can do so during the AEP or MA OEP.
Beneficiaries can drop MA plans and return to Original Medicare during
certain enrollment periods.
12.Which statement best describes a Medicare Special Enrollment Period
(SEP)?
It allows enrollment changes due to certain life events.
SEPs include situations like moving, losing other coverage, or qualifying
for Extra Help.
13.What is the penalty for failing to enroll in Medicare Part B when first
eligible without other creditable coverage?
A permanent increase in the Part B premium.
The late enrollment penalty is 10% for each 12-month period you could
have had Part B but didn’t.
14.What should an agent do if a client wants to discuss life insurance during a
Medicare appointment?
They must schedule a separate appointment and complete a new Scope
of Appointment.
Combining discussions of non-health related products violates CMS rules
unless prearranged and documented.
15.What is the maximum commission an agent may receive for a Medicare
Advantage sale?
It is determined by CMS each year.
Answers (Verified Answers) Plus Rationales 2025 Q&A
| Instant Download
1. Which enrollment period allows individuals to change their Medicare
Advantage plan each year?
Annual Enrollment Period (AEP)
The AEP runs from October 15 to December 7 every year, during which
beneficiaries can switch, enroll, or drop Medicare Advantage or Part D
plans.
2. Which entity approves marketing materials for Medicare Advantage plans?
Centers for Medicare & Medicaid Services (CMS)
CMS must review and approve all MA marketing materials to ensure they
are compliant with federal guidelines.
3. Which statement is true regarding agents discussing plan options with
potential enrollees?
They must only discuss plans agreed upon in the Scope of Appointment.
A Scope of Appointment form limits what products the agent can discuss,
ensuring compliance and avoiding unsolicited marketing.
4. When does the Medicare Initial Enrollment Period (IEP) occur?
It is a 7-month period surrounding an individual’s 65th birthday.
IEP includes the 3 months before, the month of, and the 3 months after
the 65th birthday month.
,5. What is the primary purpose of the Medicare Summary Notice (MSN)?
To inform beneficiaries about claims that Medicare has processed.
The MSN is a statement that explains what was billed to Medicare, what
Medicare paid, and what the beneficiary may owe.
6. What must agents do when leaving plan information with a beneficiary?
Leave only CMS-approved materials.
Only CMS-approved materials can be left behind to ensure accurate,
compliant information.
7. Which of these individuals is eligible for Medicare?
A 65-year-old who worked 40 quarters and is a U.S. citizen.
Most people qualify at 65 if they or their spouse worked and paid
Medicare taxes for at least 40 quarters.
8. Which marketing practice is strictly prohibited?
Offering cash as an incentive for enrollment.
CMS prohibits cash or monetary rebates to entice enrollment, which could
be considered inducement.
9. When must the Scope of Appointment form be completed?
Prior to discussing plan details.
This ensures that the beneficiary understands and agrees to the topics to
be discussed.
10.What does Medicare Part B cover?
Medically necessary outpatient services and preventive care.
Part B covers physician visits, outpatient procedures, durable medical
equipment, and preventive services.
, 11.What happens if a beneficiary enrolls in a Medicare Advantage plan and
later wants to switch back to Original Medicare?
They can do so during the AEP or MA OEP.
Beneficiaries can drop MA plans and return to Original Medicare during
certain enrollment periods.
12.Which statement best describes a Medicare Special Enrollment Period
(SEP)?
It allows enrollment changes due to certain life events.
SEPs include situations like moving, losing other coverage, or qualifying
for Extra Help.
13.What is the penalty for failing to enroll in Medicare Part B when first
eligible without other creditable coverage?
A permanent increase in the Part B premium.
The late enrollment penalty is 10% for each 12-month period you could
have had Part B but didn’t.
14.What should an agent do if a client wants to discuss life insurance during a
Medicare appointment?
They must schedule a separate appointment and complete a new Scope
of Appointment.
Combining discussions of non-health related products violates CMS rules
unless prearranged and documented.
15.What is the maximum commission an agent may receive for a Medicare
Advantage sale?
It is determined by CMS each year.
